Eastwood Jennifer L, Koppelman-White Elysa, Mi Misa, Wasserman Jason Adam, Krug Iii Ernest F, Joyce Barbara
Department of Anatomy and Cell Biology, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, USA.
Department of Philosophy, Oakland University, Rochester, Michigan, USA.
Int J Med Educ. 2017 Jan 7;8:1-12. doi: 10.5116/ijme.5849.bfce.
To review the research literature on epistemic cognition in medical education.
We conducted database searches using keywords related to epistemic cognition and medical education or practice. In duplicate, authors selected and reviewed empirical studies with a central focus on epistemic cognition and participant samples including medical students or physicians. Independent thematic analysis and consensus procedures were used to identify major findings about epistemic cognition and implications for research and medical education.
Twenty-seven articles were selected. Themes from the findings of selected studies included developmental frameworks of epistemic cognition revealing simple epistemological positions of medical learners, increasing epistemological sophistication with experience, relationships between epistemic cognition and context, patterns in epistemic orientations to clinical practice, and reactions to ambiguity and uncertainty. Many studies identified the need for new instruments and methodologies to study epistemic cognition in medical education settings and its relationship to clinical outcomes. Relationships between epistemological beliefs and humanistic patient care and influences of medical education practices were commonly cited implications for medical education.
Epistemic cognition is conceptualized and operationalized in a variety of ways in the medical research literature. Advancing theoretical frameworks and developing new methodological approaches to examine epistemic cognition are important areas for future research. Also, examination of the relationship between the contexts of medical learning and practice and epistemic cognition has potential for improving medical education. This work also establishes a need for further investigation into the implications of epistemic cognition for humanistic orientations and ultimately for patient care.
回顾医学教育中关于认知认知的研究文献。
我们使用与认知认知和医学教育或实践相关的关键词进行数据库搜索。作者重复筛选并回顾了以认知认知为核心焦点、参与者样本包括医学生或医生的实证研究。采用独立的主题分析和共识程序来确定关于认知认知的主要发现以及对研究和医学教育的启示。
共筛选出27篇文章。所选研究结果的主题包括认知认知的发展框架，揭示了医学学习者简单的认识论立场，随着经验增加认识论的复杂性，认知认知与情境的关系，临床实践认知取向的模式，以及对模糊性和不确定性的反应。许多研究指出需要新的工具和方法来研究医学教育环境中的认知认知及其与临床结果的关系。认识论信念与人文患者护理之间的关系以及医学教育实践的影响通常被认为是对医学教育的启示。
在医学研究文献中，认知认知以多种方式被概念化和操作化。推进理论框架和开发新的方法来检验认知认知是未来研究的重要领域。此外，研究医学学习和实践情境与认知认知之间的关系对于改善医学教育具有潜力。这项工作还表明需要进一步研究认知认知对人文取向以及最终对患者护理的影响。
