Educational goals have generally shifted from knowing everything in a specific domain to knowing how to deal with complex problems. Reasoning and information- processing skills have become more important than the sheer amount of information memorized. In medical education, the same evolution has occurred. Diagnostic reasoning processes get more strongly emphasized. Whereas previously knowing all symptoms and diseases was stressed, reasoning skills have now become educationally more important. They must enable professionals to distinguish between differential diagnoses and to recognize patterns of illnesses (e.g., Myers & Dorsey, 1994).
Authentic or realistic tasks have been advocated to foster the acquisition of complex problem-solving processes (Jacobson & Spiro, 1995; Jonassen, 1997). In medical education, this has led to the use of expert systems. Such systems were initially developed to assist practitioners in their practice (NEOMYCIN, in Cormie, 1988; PATHMASTER in Frohlich, Miller & Morrow, 1990; LIED in Console, Molino, Ripa di Meana & Torasso, 1992) and simulate real situations. These systems were expected to provoke or develop students’ diagnostic reasoning processes. However, the implementation of such expert systems in regular educational settings has not been successful. Instead of developing reasoning processes, these systems assume them to be available. They focus on quickly getting to a solution rather than reflecting on possible alternatives. Consequently, it was concluded that students need more guidance in the development of diagnostic reasoning skills (Console et al., 1992, Cromie, 1988; Friedman, France & Drossman, 1991), and that instructional support was lacking.
KABISA is one of the computer programs purposely designed to help students in the development of their diagnostic reasoning skills (Van den Ende, Blot, Kesten, Van Gompel & Van den Enden, 1997). It is a dedicated computer-based training program for acquiring and optimizing diagnostic reasoning skills in tropical medicine.