探索医学学生和专家临床医生的临床决策差异
Marcos Rojas1, Argenta Price2, Candice Jeehae Kim1,3
1Graduate School of Education, Stanford University, Stanford, California, USA.
Advances in medical education and practice
|December 30, 2024
概括
专家临床医生和医学学生在临床推理实践和决策方面有所不同. 识别这些差异可以改善医学教育和评估工具,以改善学生的临床推理发展.
科学领域:
- 医学教育 医学教育
- 认知科学 认知科学
- 学习科学 学习科学
背景情况:
- 在医疗教育中整合临床推理理论和实践仍然存在挑战.
- 现有的临床推理理论模型往往在教学和评估中缺乏实际应用.
- 这项研究通过比较学生和专家使用解决问题的框架进行临床推理来弥补这一差距.
研究的目的:
- 为了比较医学学生和专家临床医生之间的临床推理实践和决策.
- 为了确定这些群体之间的诊断过程中的特定差异.
- 为改善临床推理指导提供一个框架.
主要方法:
- 一个基于学习科学问题解决框架的问卷是为一个儿科传染病病例开发的.
- 从10名专家临床医生和斯坦福大学74名医学学生 (2019-2023) 收集了数据.
- 演性内容分析用于编码响应,并识别临床推理实践和决策中的模式.
主要成果:
- 经验地开发了一个详细的临床推理框架,包括九种实践和二十九种决定.
- 在四个实践中的十个关键决策中,观察到专家和学生之间的显著差异.
- 这些实践包括差异诊断的制定,诊断计划的执行,数据的重新评估和解决方案的审查.
结论:
- 在统一的问题解决框架内,医学学生和专家医生之间临床推理的细微差异被确定.
- 了解这些差异可以为开发有针对性的教学材料和评估工具提供信息.
- 这项研究有助于教育工作者培养医疗学员基本的临床推理技能.
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