Patel V L, Arocha J F, Shortliffe E H
Cognitive Studies in Medicine, Center for Medical Education, McGill University, Montreal, Quebec, Canada.
Int J Med Inform. 2000 Nov;60(2):143-50. doi: 10.1016/s1386-5056(00)00114-3.
Recent advances in theories of learning and knowledge acquisition in culturally-situated environments have illuminated the role of cognition in changing behavior, and in turn on influencing performance for the long term. One such advance focuses on the relationship between explicit formal training and implicit knowledge acquired through daily interactive activities in schools and organizations. The former relates more to instruction regarding the policy issues whereas the latter is tied closely to cultural, moral and organizational values. In this paper, we draw on these theories of cognition and learning to show the shift in thinking that is needed regarding education of health professionals, including steps required to assure that the protection of confidential information becomes part of their routine practices. Illustrative examples are used to show the nature of conceptual change in the health professional's knowledge organization and reasoning strategies that is necessary for more sustained behavior change with regards to protecting data confidentiality and privacy of individual patients. This re-conceptualization is intended to be reflected at various levels of training and education for health professionals, including influences on personal and organizational practices as well as revisions in medical-school and graduate-medical curricula.
文化情境化环境中学习与知识获取理论的最新进展,阐明了认知在改变行为以及长期影响表现方面的作用。其中一项进展聚焦于显性的正规培训与通过学校和组织中的日常互动活动所获取的隐性知识之间的关系。前者更多地与政策问题的指导相关,而后者则与文化、道德和组织价值观紧密相连。在本文中,我们借鉴这些认知与学习理论,以展示在卫生专业人员教育方面所需的思维转变,包括确保保护机密信息成为其日常实践一部分所需的步骤。通过示例来说明卫生专业人员知识组织和推理策略中的概念转变的本质,这种转变对于在保护患者数据保密性和隐私方面实现更持久的行为改变是必要的。这种重新概念化旨在反映在卫生专业人员培训和教育的各个层面,包括对个人和组织实践的影响以及医学院校和毕业后医学课程的修订。