叙事分析,以追踪在住院期间临床推理的发展
Keshrie Naidoo1, Jane Baldwin1, Jessie Lesar1
1Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, USA.
Journal of clinical education in physical therapy
|December 17, 2025
概括
反思性叙事增强了居民的临床推理技能 (CRS). 在培训结束时,居民使用了更多的CRS类型,协作推理显示出显著的发展.
科学领域:
- 医学教育 医学教育
- 发展临床推理 发展临床推理
- 定性研究方法 定性研究方法
背景情况:
- 反思性叙述对于记录和改进医学培训中的临床推理至关重要.
- 了解临床推理策略在住院生中的发展对于有效的教学至关重要.
研究的目的:
- 为了研究临床推理策略的发展,在居民接触到一个特定的模型.
- 在12个月的培训期间,分析居民使用推理策略的专题变化.
主要方法:
- 五位整形外科住院医生的反射叙述的回顾性分析.
- 使用临床推理策略 (CRS) 模型进行主题分析,包括八种不同的推理类型.
- 为CRS类型编码居民叙述,并分析代码频率以跟踪发展.
主要成果:
- 在八个CRS策略中,有七个在居民叙述中被确定.
- 在培训一年中,每位居民平均使用CRS的比例从4.8增加到5.8.
- 诊断和干预程序推理是最常见的;协作推理显示出最多的增长 (在住院结束时100%的利用率).
结论:
- 反思性叙述是有效的教学工具,可以促进居民的反思和患者护理理解.
- 临床叙述的定性数据分析为临床推理技能的发展提供了宝贵的见解.
- 这项研究证明了叙事分析在评估在住院期间临床推理技能进展的有用性.
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