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However, as both retrieving an old problem state from declarative memory and updating the problem state takes time, using multiple problem states causes considerable interference.
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But since folks are slow to update, the problem persists.
Some clinicians reported an implicit or explicit expectation that they updated the problem list, but none had received specific guidance or training on effective problem list utilization, and several reported uncertainty about ownership of and responsibility for the problem list.
However, half of the providers (51%) believed the problem list was unreliable and inaccurate and a majority erroneously believed that adding an encounter diagnosis automatically updates the problem list (60%).
For many providers, the lack of reliability meant that they would still review (and possibly update) the problem list, but that they will augment the problem list with other sources of information such as medications, notes, recent hospital discharge summaries or interviewing the patient (see the Alternatives theme).
During their interview with the patient, they would work through the problem list, asking questions and updating the record problem by problem, and adding problems in real time as new concerns were identified.
To automatically generate multiple-answer problems in EAR, teachers update the problem-solving knowledge through a dialogue with the system regarding the knowledge, while also confirming the generated problems (see Fig. 6) (Ogawa, et al., 2011).
This kind of Bayesian updating makes the problem of drawing inferences about one's neighbors rather complex and quickly becomes intractable even in simple networks.
"Everyone always points to the racial stuff as the problem with updating the book," Mr. Hess said last week.
The Landmark approach [ 2, 3] resolves the problem by updating the population of interest.
For some odd reason we're having lots of problems updating the site this week.
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