Suppr超能文献

著名医生对专家诊断实践的看法。

Renowned physicians' perceptions of expert diagnostic practice.

机构信息

University of Toronto Faculty of Medicine, Learning Institute, Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

Acad Med. 2012 Oct;87(10):1413-7. doi: 10.1097/ACM.0b013e31826735fc.

Abstract

PURPOSE

To further the development of a substantive theory of expert diagnostic practice, the authors explored the ways in which exceptional physicians, nominated by their peers, conceptualized their own diagnostic expertise specifically and diagnostic excellence generally.

METHOD

In this grounded theory, interview-based study, physicians at six North American research sites were nominated by their peers as exceptional diagnosticians and exceptional professionals and invited to participate in the study. A saturation sample included 34 participants, 20 exceptional diagnosticians, and 14 exceptional professionals. Using a constant comparative approach, the authors conducted one-on-one interviews with participants, transcribed the audiotapes of those interviews, and analyzed them for emergent themes. They developed a stable thematic structure and applied it to the entire data set.

RESULTS

Four interconnected themes emerged that inform the community's understanding of how physicians conceptualize expert diagnostic practice: (1) possession of extensive knowledge built through purposeful, continuous engagement in clinical practice, (2) possession of the skills to effectively gather patient stories, (3) reflective integration of that knowledge and those patient stories during diagnosis, and (4) continuous learning through clinical practice.

CONCLUSIONS

Exploring these results within the context of current discourses in medical education brings to the forefront two key features of physicians' construction of diagnostic excellence: (1) the integrated nature of the medical competencies that underpin the diagnostic process and (2) the optimally adaptive nature of the diagnostic process. These findings can inform the development of practical and effective pedagogical strategies to guide trainees, clinicians, and medical educators who strive for excellence.

摘要

目的

为了进一步发展专家诊断实践的实质性理论,作者探讨了杰出医生(由同行提名)具体地将自己的诊断专长和一般的诊断卓越概念化的方式。

方法

在这项基于扎根理论的、基于访谈的研究中,来自北美六个研究地点的医生被同行提名为本领域的杰出诊断医生和杰出专业人士,并邀请他们参与研究。一个饱和样本包括 34 名参与者,其中 20 名是杰出诊断医生,14 名是杰出专业人士。作者采用恒比比较方法对参与者进行一对一访谈,转录访谈的录音,并对其进行分析以提取出主题。他们开发了一个稳定的主题结构,并将其应用于整个数据集。

结果

出现了四个相互关联的主题,这些主题使人们对医生如何概念化专家诊断实践有了更深入的了解:(1)通过有目的、持续参与临床实践而建立的广泛知识的拥有;(2)有效收集患者故事的技能;(3)在诊断过程中对该知识和患者故事的反思性整合;(4)通过临床实践进行持续学习。

结论

在医学教育领域当前的讨论背景下探索这些结果,突显了医生构建诊断卓越的两个关键特征:(1)支撑诊断过程的医学能力的综合性质;(2)诊断过程的最佳适应性性质。这些发现可以为指导追求卓越的学员、临床医生和医学教育工作者的实用有效的教学策略的制定提供信息。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验