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[Learning concepts of diagnosis in family medicine: the "mark robinson sign" - the traces that should not be there].[学习家庭医学中的诊断概念：“马克·罗宾逊征”——不应出现的痕迹]
Aten Primaria. 2015 Nov;47(9):596-602. doi: 10.1016/j.aprim.2015.02.008. Epub 2015 May 8.
2
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'Thinking on my feet': an improvisation course to enhance students' confidence and responsiveness in the medical interview.“随机应变”：一门提升学生在医学面试中自信心与反应能力的即兴课程。
Educ Prim Care. 2013 Feb;24(2):119-24. doi: 10.1080/14739879.2013.11493466.
4
[The professional profile of the family physician. The Working Group of the Sociedad Española de Medicina Familiar y Comunitaria].[家庭医生的专业概况。西班牙家庭与社区医学协会工作组]
Aten Primaria. 1999 Mar 15;23(4):236-40, 242-6, 248.
5
[On bioethics and family medicine (I). The Working Group of the semFYC (Sociedad Española de Medicina Familiar y Comunitaria)].
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Rev Med Chil. 2008 Feb;136(2):186-92. Epub 2008 May 7.
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本文引用的文献

1
Deciding about fast and slow decisions.关于快速决策和慢速决策的抉择。
Acad Med. 2014 Feb;89(2):197-200. doi: 10.1097/ACM.0000000000000121.
2
A method for inferring medical diagnoses from patient similarities.从患者相似度推断医疗诊断的方法。
BMC Med. 2013 Sep 2;11:194. doi: 10.1186/1741-7015-11-194.
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From mindless to mindful practice--cognitive bias and clinical decision making.从无意识实践到有意识实践——认知偏差与临床决策
N Engl J Med. 2013 Jun 27;368(26):2445-8. doi: 10.1056/NEJMp1303712.
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Clarifying assumptions to enhance our understanding and assessment of clinical reasoning.阐明假设以增强我们对临床推理的理解和评估。
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Clinical intuition in family medicine: more than first impressions.家庭医学中的临床直觉：不仅仅是第一印象。
Ann Fam Med. 2013 Jan-Feb;11(1):60-6. doi: 10.1370/afm.1433.
6
[Clinical pathways in the presentation of symptoms, considered as a plastic work of art in Family Medicine].[症状呈现中的临床路径，被视为家庭医学中的一件可塑性艺术作品]
Aten Primaria. 2012 Sep;44(9):511-3. doi: 10.1016/j.aprim.2012.05.005. Epub 2012 Jul 10.
7
GPs' decision-making--perceiving the patient as a person or a disease.全科医生的决策——将患者视为个体还是疾病。
BMC Fam Pract. 2012 May 16;13:38. doi: 10.1186/1471-2296-13-38.
8
Exploring deliberate practice in medicine: how do physicians learn in the workplace?探索医学中的刻意练习：医生如何在工作场所中学习？
Adv Health Sci Educ Theory Pract. 2011 Mar;16(1):81-95. doi: 10.1007/s10459-010-9246-3. Epub 2010 Sep 18.
9
To think is good: querying an initial hypothesis reduces diagnostic error in medical students.思考是有益的：质疑初始假设可减少医学生的诊断错误。
Acad Med. 2010 Jul;85(7):1125-9. doi: 10.1097/ACM.0b013e3181e1b229.
10
Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice.非临床因素对临床决策的影响：对循证实践的重大挑战。
J R Soc Med. 2010 May;103(5):178-87. doi: 10.1258/jrsm.2010.100104.

[学习家庭医学中的诊断概念：“马克·罗宾逊征”——不应出现的痕迹]

[Learning concepts of diagnosis in family medicine: the "mark robinson sign" - the traces that should not be there].

作者信息

Turabián José Luis, Samarín-Ocampos Elena, Minier Luis, Pérez-Franco Benjamín

机构信息

Medicina de Familia y Comunitaria, Centro de Salud Polígono Industrial, Toledo, España.

Medicina de Familia y Comunitaria, Unidad Docente de Toledo, Toledo, España.

出版信息

Aten Primaria. 2015 Nov;47(9):596-602. doi: 10.1016/j.aprim.2015.02.008. Epub 2015 May 8.

DOI:10.1016/j.aprim.2015.02.008
PMID:25959290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6983828/
Abstract

We review the mechanisms of the mental operation to identify the disease in family medicine, using five cases where the diagnosis process began in "the trace that should not be there" or "Robinson sign" as happened to Robinson Crusoe when he saw a human footprint on the beach of the "desert island". How could it be there?; It was a mystery, and based on metaphors, we framed the mechanism of "the trace that should not be there" mainly in the first phase of clinical or intuitive reasoning, but this intuition of the doctor should be accompanied by the diagnostic process, like the "basso continuo" of Baroque music, allowing improvisation and personal style, and in this way, eventually observing the footprint "that should not have been there" that may arise in the analytical, as well as in the verification phase of the assumptions made.

摘要

我们回顾了家庭医学中识别疾病的思维操作机制，采用了五个病例，其中诊断过程始于“不该出现的痕迹”或“鲁滨逊征”，就像鲁滨逊·克鲁索在“荒岛”海滩上看到人类脚印时那样。它怎么会在那里呢？这是个谜，基于隐喻，我们将“不该出现的痕迹”机制主要构建于临床或直观推理的第一阶段，但医生的这种直觉应伴随着诊断过程，就像巴洛克音乐的“通奏低音”，允许即兴创作和个人风格，如此一来，最终便能观察到可能出现在分析阶段以及对所做假设进行验证阶段的“本不该出现的脚印”。