使用诊断错误和不当行为索赔的临床病例:对GP临床推理教育中的焦虑和诊断绩效的影响
Charlotte van Sassen1,2, Silvia Mamede3,4, Jacky Hooftman3,5,6
1Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. c.vansassen@erasmusmc.nl.
Advances in health sciences education : theory and practice
|February 3, 2025
概括
将诊断错误和不当行为案例纳入临床推理教育 (CRE) 并不会增加学习者的焦虑或对诊断绩效产生负面影响. 这些案例可以安全地集成,以提高医疗培训的各种例子.
科学领域:
- 医学教育 医学教育
- 诊断推理 诊断推理
- 患者安全 患者安全
背景情况:
- 错误和错误的实践案例突出了医学中的知识差距和背景因素.
- 将这些病例纳入临床推理教育 (CRE) 可能会提高诊断技能,但也可能引起焦虑.
- 在CRE中,这种情况的最佳使用方式尚不清楚.
研究的目的:
- 调查错误和不当行为案例细节对CRE中的焦虑和诊断绩效的影响.
- 探索影响学习的因素,包括信心,满意度和回顾性影响.
- 确定这些病例是否可以安全地纳入医疗培训.
主要方法:
- 一个三阶段的实验,一般医生住院医生和监督随机分配到中立,错误或不当行为索赔条件.
- 在审查案例简报之前和之后测量的焦虑水平.
- 在解决中性临床病例后评估的诊断性能,信心,满意度和长期影响.
主要成果:
- 与中性病例相比,涉及诊断错误或不当行为索赔的案例细节并没有增加焦虑.
- 未来的诊断性能在所有实验条件中都是相似的.
- 自我报告的信心,学习者满意度和长期影响评分在各组之间没有显著差异.
结论:
- 诊断错误和不当行为案例小组可以安全地整合到临床推理教育中.
- 这些案例为扩大医学案例库提供了有价值,丰富的背景示例.
- 它们的使用似乎不会对诊断性能产生负面影响,也不会导致学习者过度焦虑.
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