Charlin B, Tardif J, Boshuizen H P
Faculty of Medicine, University of Montreal, Quebec, Canada.
Acad Med. 2000 Feb;75(2):182-90. doi: 10.1097/00001888-200002000-00020.
Medical diagnosis is a categorization task that allows physicians to make predictions about features of clinical situations and to determine appropriate course of action. The script concept, which first arose in cognitive psychology, provides a theoretical framework to explain how medical diagnostic knowledge can be structured for diagnostic problem solving. The main characteristics of the script concept are pre-stored knowledge, values acceptable or not acceptable for each illness attribute, and default values. Scripts are networks of knowledge adapted to goals of clinical tasks. The authors describe how scripts are used in diagnostic tasks, how the script concept fits within the clinical reasoning literature, how it contrasts with competing theories of clinical reasoning, how educators can help students build and refine scripts, and how scripts can be used to assess clinical competence.
医学诊断是一项分类任务，它使医生能够对临床情况的特征进行预测，并确定适当的行动方案。脚本概念最初出现在认知心理学中，它提供了一个理论框架，用以解释如何构建医学诊断知识以解决诊断问题。脚本概念的主要特征包括预先存储的知识、每种疾病属性可接受或不可接受的值以及默认值。脚本是适应临床任务目标的知识网络。作者描述了脚本在诊断任务中的使用方式、脚本概念如何融入临床推理文献、它与临床推理的竞争理论有何不同、教育工作者如何帮助学生构建和完善脚本，以及脚本如何用于评估临床能力。
