"HARD"培训环境培养了独特的位置感:对"位置"和临床推理发展进行范围审查和概念框架
Sisira Dharmaratne1, Wasana Jayarathne2,3, Asela Olupeliyawa4
1Translational Health Research Institute, Western Sydney University, Sydney, Australia.
The Australian journal of rural health
|January 13, 2026
概括
现场医疗教育 (PBME) 培养学员的临床推理 (CR). 农村环境中的"HARD"框架 (实践参与,大量接触,责任,多样性) 增强了CR和医生身份.
科学领域:
- 医学教育研究 医学教育研究
- 医生培训 医生培训 医生培训
- 发展临床推理 发展临床推理
背景情况:
- 基于地点的医学教育 (PBME) 对于培养适合特定地点的医生至关重要.
- 临床推理 (CR) 是一个核心的,特定于环境的能力,对于有效的医疗实践至关重要.
研究的目的:
- 综合证据,说明"地点"如何影响医疗学员临床推理 (CR) 的发展.
- 在医疗教育中对CR的位置影响的概念化.
主要方法:
- 对同行评审文章 (1975-2024) 进行系统审查,遵循PRISMA ScR指南.
- 在Medline,CINAHL,Scopus和ERIC数据库中进行了搜索.
- 27项建设主义内容分析包括了定义地方和CR发展的研究.
主要成果:
- 主要来自农村,医疗服务不足地区的证据揭示了"HARD"框架:实践参与,大量患者接触,支持责任和临床实践中的多样性.
- 在大多数研究中,CR发展是间接发现,与特定的位置支付相关.
- "HARD"元素是通过纵向的综合实习,例行并行咨询,紧密团队和劳动力限制来实现的.
结论:
- "HARD"框架的特点是地方依赖和依恋,培养CR和专家临床医生身份.
- 这一框架强调了医疗教育中的位置的独特性.
- 应用"HARD"框架可以促进PBME奖学金,并为服务不足的地区准备医生.
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