临床推理中的变革性学习:在本科初级医疗保健医学教育中的元合成
Nur Faraheen Abdul Rahman1,2, Nathan Davies1, Julia Suhaimi3
1Research Department of Primary Care and Population Health, University College London Institute of Epidemiology and Population Health, London, UK.
概括
本系统性审查探讨了初级保健中的临床推理教育,发现变革性学习理论可以阐明学生的发展. 有效的教学包括指导学生通过复杂的案例来建立能力和信心.
科学领域:
- 医学教育 医学教育
- 主要护理是指初级护理.
- 临床推理 临床推理
背景情况:
- 临床推理是一个关键的医疗技能,在本科初级保健中讨论了教学细微差别.
- 现有的文献缺乏关于在这些环境中如何教授和学习临床推理的全面理解.
研究的目的:
- 系统地审查和综合现有关于在本科初级保健机构中教授和学习临床推理的研究.
- 应用变革性学习理论来理解医学学生临床推理技能的演变.
主要方法:
- 针对29项具有不同设计的精选研究进行了专注的元合成.
- 变革性学习理论被用作分析数据的框架.
- 研究分析了教学方法,学习维度和患者参与的作用.
主要成果:
- 初级保健实习使用各种方法 (床边教学,咨询,模拟) 来促进临床推理.
- 变革性学习理论确定了学生临床推理发展的不同阶段:启动,坚持,时间/空间和能力/信心.
- 临床教师充当指导者 (强化者,鉴赏者,调解者,监测者),患者参与对于共同构建推理至关重要.
结论:
- 理论基础在很大程度上塑造了临床推理教学,需要更广泛的方法多样性.
- 在初级保健的复杂性内,有意向的学生指导对于有效的临床推理发展至关重要.
- 通过变革性学习进行的干预可以通过跨越认知界限来增强有意义的临床推理学习体验.
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