Shapiro J, Talbot Y
Department of Family Medicine, University of California, Irvine, College of Medicine.
Fam Med. 1991 Aug;23(6):450-6.
This article contends that what makes family practice unique as a medical specialty is not so much its content (eg, continuity of care, broad range of patient population) as it is the process of clinical practice (ie, how the specialty is actually practiced in ongoing patient encounters). However, insufficient attention has been paid to critically analyzing and interpreting this process. We present a model derived from other "practice professions," such as architecture, known as reflection-in-action. This model is offered as a way of first apprehending and subsequently teaching the "professional artistry" which constitutes a critical component of family practice. Specific teaching approaches designed to enhance reflective medical practice are delineated.
本文认为,家庭医学作为一门医学专业的独特之处,与其说是其内容(如连续性医疗、广泛的患者群体),不如说是临床实践的过程(即该专业在持续的患者诊疗过程中实际是如何开展的)。然而,对这一过程进行批判性分析和解读的关注却不够充分。我们提出了一个源自其他“实践型专业”(如建筑学)的模型,即行动中的反思。提供这个模型是为了首先理解并随后传授构成家庭医学关键组成部分的“专业技艺”。文中还阐述了旨在加强反思性医疗实践的具体教学方法。