Chai Jason, Evans Lloyd, Hughes Tom
Cardiff University, Cardiff, UK.
Department of Neurology, University Hospital of Wales, Cardiff, UK.
Clin Teach. 2017 Aug;14(4):263-267. doi: 10.1111/tct.12546. Epub 2016 Jun 30.
Diagnostic errors are well documented in the literature and emphasise the need to teach diagnostic skills at an early stage in medical school to create effective and safe clinicians. Hence, there may be a place for diagnostic aids (such as the Surgical Sieve) that provide a framework for generating ideas about diagnoses. With repeated use of the Surgical Sieve in teaching sessions with students, and prompted by the traditional handheld wheels used in antenatal clinics, we developed the Compass Medicine, a handheld diagnostic wheel comprising three concentric discs attached at the centre. We report a preliminary study comparing the Surgical Sieve and the Compass Medicine in generating differential diagnoses.
A total of 48 third-year medical students from Cardiff University participated in a study aimed at measuring the efficacy of diagnostic aids (Surgical Sieve and Compass Medicine) in generating diagnoses. We quantified the effect each aid had on the number of diagnoses generated, and compared the size of the effect between the two diagnostic aids. There may be a place for diagnostic aids that provide a framework for generating ideas about diagnoses RESULTS: The study suggests that both diagnostic aids prompted users to generate a greater number of diagnoses, but there was no significant difference in the size of effect between the two diagnostic aids.
We hope that our study with diagnostic aids will encourage the use of robust tools to teach medical students an easily visualised framework for diagnostic thinking.
文献中对诊断错误有充分记载，这强调了在医学院早期阶段教授诊断技能以培养高效且安全的临床医生的必要性。因此，可能需要诊断辅助工具（如外科筛检法）来为生成诊断思路提供一个框架。在与学生的教学课程中多次使用外科筛检法，并受产前诊所使用的传统手持转盘的启发，我们开发了指南针医学，这是一种手持诊断转盘，由三个在中心相连的同心圆盘组成。我们报告一项比较外科筛检法和指南针医学在生成鉴别诊断方面的初步研究。
来自卡迪夫大学的48名三年级医学生参与了一项旨在测量诊断辅助工具（外科筛检法和指南针医学）在生成诊断方面功效的研究。我们量化了每种辅助工具对生成诊断数量的影响，并比较了两种诊断辅助工具之间影响大小。可能需要为生成诊断思路提供框架的诊断辅助工具 结果：研究表明，两种诊断辅助工具都促使使用者生成了更多诊断，但两种诊断辅助工具在影响大小上没有显著差异。
我们希望我们对诊断辅助工具的研究将鼓励使用可靠的工具来教授医学生一个易于可视化的诊断思维框架。
