"没有消息是好消息"是足够的吗? 一项探讨儿科住院计划中临床推理评估的主题分析
James Bowen1, Matthew Kelleher2, Benjamin Kinnear2
1Division of Pediatric Hospital Medicine (J Bowen and LE Herrmann), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Academic pediatrics
|November 7, 2024
概括
在儿科住院中评估临床推理 (CR) 是一个挑战,因为缺乏共享的理解. 改进CR评估需要安全的环境和纵向观察,以早期发现学员的缺陷.
科学领域:
- 医学教育 医学教育
- 儿科住院培训培训 儿科住院培训
- 临床推理评估评估
背景情况:
- 临床推理 (CR) 对临床医生至关重要.
- 在儿科住院中对CR的评估方法尚未明确定义.
- 了解项目领导者的观点是改善CR评估的关键.
研究的目的:
- 探索儿科住院计划领导者对CR评估的观点.
- 确定如何在实习生中识别CR缺陷.
- 在儿科住院内发现CR评估中的障碍和促进者.
主要方法:
- 对20个半结构面试的专题分析与儿科住院计划的领导者.
- 社会建设主义的世界观被采纳用于分析.
- 代招聘和分析,直到主题充分性,与成员检查可信度.
主要成果:
- 领导者和监督者之间对于CR评估缺乏共享的心理模型.
- 出现了四个主题:监督员报告行为,而不是诊断;CR评估需要自主决策显示器,安全的调查环境和纵向观察.
- 障碍包括以家庭为中心的轮次和以团队为基础的护理,阻碍CR评估.
结论:
- 确定了有效CR评估的关键组件.
- 突出了导致错过缺陷识别的障碍.
- 通过特定元素,可以提高早期识别CR缺陷的评估机会.
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