Montaldo L Gustavo, Herskovic L Pedro
Departamento de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile.
Departamento de Pediatría y Cirugía Infantil Oriente y Departamento de Educación en Ciencias de la Salud, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2013 Jul;141(7):823-30. doi: 10.4067/S0034-98872013000700001.
Clinical reasoning is the most important competente in the training process of a physician.
To develop a method for teaching clinical reasoning based on prototypes of clinical cases.
The study was conducted on sixty-four third year medical students. The study and control groups attended lectures and tutorial sessions with patients. The study group attended additionally discussion seminars of prototypical clinical cases. A clinical reasoning test was applied at the start and end of the learning period to both groups. At the end of the study, the opinions of students of the study group were collected in a focus group.
After the learning period, both groups significantly increased their clinical reasoning skills. However, the improvement in the study group was more than double than that of the control group. The absolute improvement in the study group was 30.9%. Students interviewed in the focus group were unanimous in expressing their satisfaction in each and every aspect discussed.
The teaching of clinical reasoning to third year medical students by means of pattern recognition in seminars with clinical cases improved significantly their skills.
临床推理是医生培训过程中最重要的能力。
开发一种基于临床病例原型的临床推理教学方法。
对64名三年级医学生进行了研究。研究组和对照组参加了有患者参与的讲座和辅导课程。研究组还参加了典型临床病例的讨论研讨会。在学习期开始和结束时对两组学生都进行了临床推理测试。在研究结束时，通过焦点小组收集了研究组学生的意见。
学习期结束后，两组学生的临床推理能力均显著提高。然而，研究组的提高幅度是对照组的两倍多。研究组的绝对提高率为30.9%。在焦点小组接受访谈的学生一致表示对所讨论的各个方面都很满意。
通过临床病例研讨会中的模式识别向三年级医学生教授临床推理，可显著提高他们的技能。
