紧急医学的诊断推理和认知错误:对教学和学习的影响
Thierry Pelaccia1,2, Jonathan Sherbino3,4, Peter Wyer5
1Prehospital Emergency Care Service (SAMU 67), Strasbourg University Hospital, Strasbourg, France.
概括
紧急医疗 (EM) 中的双过程理论解释了诊断推理. 研究表明,快速 (系统1) 和缓慢 (系统2) 思维之间存在和的关系,挑战了目前对EM居民的偏见纠正培训.
科学领域:
- 认知科学 认知科学
- 医学教育 医学教育
- 紧急医疗 紧急医疗
背景情况:
- 在紧急医疗 (EM) 中,准确的诊断是关键和复杂的.
- 双过程理论,区分快速 (系统1) 和缓慢 (系统2) 的思维,是EM中一个有效的模型.
- 系统1使用经验来快速假设;系统2使用分析来诊断.
研究的目的:
- 审查认知科学,医学教育和EM中的双过程理论的文献.
- 在诊断推理中分析系统1和系统2之间的关系的解释.
- 为EM居民的诊断推理提出改进的教育策略.
主要方法:
- 在认知科学,医学教育和紧急医疗领域进行文献综述.
- 在诊断推理中对双流程理论的突出解释的分析.
- 确定对临床学习者培训的影响.
主要成果:
- 有两种对系统1和系统2相互作用的解释.
- 在EM中常见的一种解释是,系统1的错误被视为偏差,被系统2纠正.
- 研究不支持这种"检查与平衡"模式;提出了一个替代的和模式.
结论:
- 目前的EM培训建议系统2纠正系统1偏差缺乏研究支持.
- 另一个解释是,系统1和系统2在知识的驱动下和地工作.
- 对于新兴市场居民来说,需要基于这种和模式的新教育策略.
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