如何团队临床推理发生在病房巡回:对学习的影响
Justin J Choi1, Jigar H Contractor1, Vimla L Patel2
1Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA.
The clinical teacher
|June 29, 2023
概括
在病房巡回期间,团队临床推理优先考虑信息共享,而不是差异诊断讨论. 初级医疗学员的参与较少,这表明需要制定策略来加强他们对临床推理的参与.
科学领域:
- 医学教育 医学教育
- 临床推理 临床推理
- 基于团队的团队学习
背景情况:
- 病房巡回对医学教育和团队临床推理至关重要.
- 了解团队临床推理过程是提高教学方法的关键.
研究的目的:
- 评估团队在病房巡回期间如何进行临床推理.
- 为提高在临床环境中的临床推理教学的策略提供信息.
主要方法:
- 专注的民族学被用来观察五个不同的医院病房团队超过六周.
- 通过内容分析,分析了41个新患者陈述的现场笔记.
主要成果:
- 病房巡回会花费了更多的时间来分享信息,而不是讨论差异诊断 (46%的病例缺乏差异诊断).
- 层次结构影响了参与,初级学习者 (医学学生,实习生) 较少参与临床推理讨论.
结论:
- 当前的病房环绕实践可能会限制初级学习者参与临床推理.
- 需要策略来积极地让医学学生和实习生参与以团队为基础的临床推理,以优化学习.
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