Hays R B, Jolly B C, Caldon L J M, McCrorie P, McAvoy P A, McManus I C, Rethans J-J
School of Medicine, James Cook University, Townsville, Australia.
Med Educ. 2002 Oct;36(10):965-71. doi: 10.1046/j.1365-2923.2002.01317.x.
Some doctors who perform poorly appear not to be aware of how their performance compares with accepted practice. The way that professionals maintain their existing expertise and acquire new knowledge and skills - that is, maintain their 'currency' of practice - requires a capacity to change. This capacity to change probably requires the individual doctor to possess insight into his or her performance as well as motivation to change. There may be a range of levels of insight in different individuals. At some point this reaches a level which is inadequate for effective self-regulation. Insight and performance may be critically related and there are instances where increasing insight in the presence of decreasing performance can also cause difficulties.
This paper presents an exploration into the nature of insight, its relationship to professional performance and its measurement as part of performance, reflecting the combined experiences of a group of experienced education researchers and the results of literature searches on insight and performance.
There may be individuals in whom insight is so lacking that they are beyond remediation. If there is a dichotomy between adequate and inadequate levels of insight, testing this could be a cost-effective way of determining where efforts for remediation should be focussed.
一些表现不佳的医生似乎并未意识到自己的表现与公认的行医规范相比如何。专业人员维持现有专业知识并获取新知识和技能的方式——即保持其“行医时效性”——需要具备改变的能力。这种改变的能力可能要求个体医生能够洞察自己的表现并有改变的动力。不同个体的洞察水平可能存在差异。在某些情况下,这种洞察水平会低至不足以进行有效的自我调节。洞察与表现可能密切相关,而且在某些情况下,表现下降时洞察力增强也可能会引发问题。
本文探讨了洞察的本质、其与专业表现的关系以及作为表现一部分的测量方法,反映了一组经验丰富的教育研究人员的综合经验以及关于洞察与表现的文献检索结果。
可能存在一些极度缺乏洞察力以至于无法补救的个体。如果洞察水平存在足够与不足的二分法,对此进行测试可能是确定补救工作应聚焦何处的一种经济有效的方式。