Wearne Susan
Flinders University Rural Clinical School, Australia.
Aust Fam Physician. 2011 Jan-Feb;40(1-2):63-7.
General practitioners need the skills to perform a core set of procedures. The increase in community based medical education gives GPs more opportunity and responsibility to facilitate medical students and junior doctors' acquisition of these core skills.
This article summarises how procedural skills are learned and describes a practical framework for constructing a supportive learning environment that is safe for patients and learners.
Procedural skills are learned in stages starting with a 'big picture' concept of the skill and its place in clinical care. Next the skill becomes fixed through deliberate practice with specific, constructive feedback based on observation. Autonomous practice is reached after further practice and exposure to increased complexity. General practitioners can facilitate skill development by using a staged learning cycle, building on their learner's prior knowledge and skill.
全科医生需要具备执行一系列核心操作的技能。基于社区的医学教育的增加，使全科医生有更多机会和责任来促进医学生和初级医生掌握这些核心技能。
本文总结了操作技能的学习方式，并描述了一个构建对患者和学习者安全的支持性学习环境的实用框架。
操作技能的学习分阶段进行，首先是对技能及其在临床护理中的位置有一个“总体概念”。接下来，通过基于观察的具体、建设性反馈进行刻意练习，使技能得以巩固。经过进一步练习并接触到更复杂的情况后，才能达到自主操作。全科医生可以通过利用分阶段的学习循环，基于学习者的先前知识和技能，来促进技能发展。
