认知框架和时间压力作为临床推理的调节者:一个案例对照研究
Andrew J Monick1, Xiao Chi Zhang1
1Sidney Kimmel Medical College at Thomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania.
The western journal of emergency medicine
|August 12, 2025
概括
认知框架和时间压力显著影响紧急医生的诊断推理. 不同的信息呈现影响了考虑肺栓塞等特定诊断的可能性.
科学领域:
- 医学教育 医学教育
- 认知心理学 认知心理学
- 紧急医疗 紧急医疗
背景情况:
- 紧急医生 (EP) 面临时间限制和认知偏见.
- 信息陈述改变决策的框架效应是紧急医疗 (EM) 中的一个关键挑战.
- 了解信息框架如何影响临床决策对于EP来说至关重要.
研究的目的:
- 评估认知框架和时间压力是否影响紧急医生的差异诊断.
- 调查信息呈现对模拟EM病例诊断推理的影响.
主要方法:
- 出席的EP和EM住院医生审查了两个病例 (肺栓塞和间歇性肺部疾病).
- 维涅特呈现为有框架和无框架的版本,有或没有时间压力.
- 参与者提供了差异性诊断,主要结果是确定预期的诊断.
主要成果:
- 不同的认知框架显著影响了EPs将肺栓塞 (PE) 确定为感兴趣的诊断的可能性 (P = .01).
- 认知框架的影响扩展到PE导致差异诊断的可能性 (P = .01).
结论:
- 认知框架和时间压力可以独立地影响EP的诊断推理.
- 这些发现对紧急医学的医学教育有重大影响.
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