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避免“会诊中断”——一种全科实习医生日常监督与教学模式

Avoiding 'consultation interruptus' - a model for the daily supervision and teaching of general practice registrars.

作者信息

Ingham Gerard

机构信息

Daylesford, Victoria and Medical Educator, Beyond Medical Education, Bendigo, Victoria, Australia.

出版信息

Aust Fam Physician. 2012 Aug;41(8):627-9.

Abstract

BACKGROUND

In general practice placements, much of the teaching occurs when the supervisor is called into the consulting room by the registrar while the patient is still present. How should this unique learning environment affect on teaching strategies?

OBJECTIVE

This article analyses the nature of general practice teaching and proposes a different model of teaching in a 'patient-present' environment.

DISCUSSION

General practice registrars are advanced learners who benefit from exploration of clinical reasoning in patient encounters. However, teaching interactions that undermine the patient-registrar relationship will affect the registrar's exposure to continuity of care. In this article, a model for the supervisor to follow when entering the registrar's consulting room while the patient is still present is described. This model emphasises leaving the registrar in control of the consultation and the use of 'thinking aloud' to explore clinical reasoning while at the same time preserving the relationship between registrar and patient.

摘要

背景

在全科实习中,很多教学活动是在患者仍在场时,住院医生把带教老师叫进诊室的情况下进行的。这种独特的学习环境应如何影响教学策略?

目的

本文分析了全科教学的本质,并提出了在“患者在场”环境下的一种不同教学模式。

讨论

全科住院医生是进阶学习者,他们能从患者诊疗过程中的临床推理探索中受益。然而,破坏患者与住院医生关系的教学互动会影响住院医生对连续性医疗服务的接触。本文描述了一种带教老师在患者仍在场时进入住院医生诊室应遵循的模式。该模式强调让住院医生掌控诊疗过程,并通过“大声思考”来探索临床推理,同时维护住院医生与患者之间的关系。

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