背景和临床推理的不可分割性
Andrew Olson1,2, Juliane E Kämmer3, Ahmed Taher4
1Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Journal of evaluation in clinical practice
|February 1, 2024
概括
临床推理,传统上被视为个人的认知过程,越来越多地被理解为一个动态系统. 本次审查强调医疗保健生态系统是临床推理和诊断的真正背景.
科学领域:
- 医学教育 医学教育
- 认知科学 认知科学
- 医疗保健系统 医疗保健系统
背景情况:
- 临床推理的早期模型专注于个体认知过程 (分析/非分析).
- 传统的患者安全,教学和评估方法强调个体临床医生.
- 现有的认知理论不充分支持临床推理作为个人和系统过程.
研究的目的:
- 在更广泛的背景下审查和加强对临床推理的理解.
- 突出医疗保健中以个人为中心的认知模型的局限性.
- 强调医疗保健生态系统在临床推理中的作用.
主要方法:
- 临床推理理论和证据的文献综述.
- 对临床推理的传统和当代观点的分析.
- 综合发现,以支持基于系统的观点.
主要成果:
- 临床推理是临床环境中个人之间发生的动态过程.
- 现代医疗保健生态系统 (人,过程,技术) 是临床接触和推理的重要背景.
- 目前的理论对于临床推理作为系统过程的现象学缺乏具体性.
结论:
- 临床推理必须被理解为医疗保健系统内的复杂相互作用.
- 未来的研究和实践应该将个人认知与系统动态相结合.
- 一个全面的理解需要承认多面的医疗保健环境.
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