Department of Medicine (NEP), F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland 20814, USA.
Acad Med. 2010 May;85(5):894-901. doi: 10.1097/ACM.0b013e3181d7427c.
Physician training and practice occur in complex environments. These complex environments, or contexts, raise important challenges and opportunities for research and training in medical education. The authors explore how studies from fields outside medicine can assist medical educators with their approach to the notion of context in the clinical encounter. First, they discuss the use of the term context in the clinical encounter as it relates to medical education. They then detail the meaning and use of the term in diverse fields outside medicine, such as mathematics, physics, and psychology, all of which suggest a nonlinear approach to the notion of context. Next, the authors highlight two inclusive theories, situated cognition and ecological psychology, that propose factors that relate to context and that suggest some potential next steps for research and practice. By redefining context as it relates to the clinical encounter (by linking it to theory and research from several diverse fields), the authors hope to move the field forward by providing guidance for the theory, research, and practice of medical education.
医生的培训和实践是在复杂的环境中进行的。这些复杂的环境或背景给医学教育的研究和培训带来了重要的挑战和机遇。作者探讨了如何利用医学以外领域的研究来帮助医学教育者了解临床环境中语境的概念。首先,他们讨论了临床环境中语境这一术语在医学教育中的应用。然后,他们详细介绍了这一术语在医学以外的不同领域的含义和用法,如数学、物理学和心理学,这些领域都表明了对语境概念的非线性方法。接下来,作者强调了两种包容性理论,即情境认知和生态心理学,这些理论提出了与语境相关的因素,并为研究和实践提供了一些潜在的下一步建议。通过将语境与来自多个不同领域的理论和研究联系起来,作者希望重新定义与临床环境相关的语境(通过将其与几个不同领域的理论和研究联系起来),为医学教育的理论、研究和实践提供指导,从而推动这一领域的发展。