倾听学习者:一个有基础的理论方法临床推理补救在儿科住院治疗
James Bowen1, Johnathan Mollman2, Lisa E Herrmann1
1Division of Pediatric Hospital Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 3024, Cincinnati, OH 45229; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267.
儿科住院计划可以通过区分CR缺陷,定制干预措施和解决结构性障碍来改善临床推理 (CR) 支持. 这种以证据为基础的模型指导医疗补救,以改善医生培训.
科学领域:
- 医学教育 医学教育
- 医生培训 医生培训 医生培训
- 临床推理 临床推理
背景情况:
- 临床推理 (CR) 技能对医生至关重要,但对评估和支持具有挑战性.
- 儿科住院计划在解决CR赤字方面面临着独特的障碍.
- 现有的康复框架缺乏针对儿科培训的具体指导.
研究的目的:
- 开发一个以证据为基础的过程,以支持儿科住院的CR缺陷.
- 在儿科内确定CR整治的最佳实践和挑战.
主要方法:
- 基于理论的方法与二次分析的20次采访的儿科项目领导人.
- 与CR专家进行了8次额外的采访,以完善补救过程.
- 利用不断的比较来整合专家反,并确定最佳实践.
主要成果:
- 开发了CR支持的多步模式,包括将CR与其他能力区分开来,并评估了诸如倦怠等促成因素.
- 强调需要值得信赖的支持者和量身定制的补救方法.
- 确定了儿科的结构性障碍,例如以家庭为中心的轮次,这些障碍限制了CR实践机会.
结论:
- 该研究提供了一个务实的,基于证据的过程,用于儿童医疗住院的CR补救.
- 该模型为加强CR支持的计划提供了可操作的指导,即使资源有限.
- 解决了环境障碍和专家知识,以有效发展医生.
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