Amey Lisa, Donald Kenneth J, Teodorczuk Andrew
Associate Academic Lead Years 3 and 4, School of Medicine, Gold Coast Campus, Griffith University, Queensland, Australia.
Assessment Lead, School of Medicine, Gold Coast Campus, Griffith University, Queensland, Australia.
Br J Hosp Med (Lond). 2017 Jul 2;78(7):399-401. doi: 10.12968/hmed.2017.78.7.399.
Clinical reasoning is often not explicitly addressed in the early medical school curriculum. As a result, students observe the process while on clinical placements with little or no understanding of the complex processes underlying it. Clinical reasoning has significant implications for patient safety. Medical errors as a consequence of faulty reasoning contribute to patient morbidity and mortality. Educating medical students at an early stage about the processes of clinical reasoning and strategies to avoid associated errors can have positive impacts upon patient safety. The authors propose that clinical reasoning should be taught as early as the first year of medical school, using frameworks, anatomical knowledge and mnemonics. Using this approach with simulated cases during the pre-clinical years, students will be equipped with an understanding of the clinical reasoning process as it unfolds before them while on clinical placements, enhancing their overall learning experience.
临床推理在医学院早期课程中往往未得到明确阐述。因此,学生在临床实习时观察这一过程,但对其背后的复杂过程了解甚少或一无所知。临床推理对患者安全具有重大影响。推理错误导致的医疗差错会增加患者的发病率和死亡率。在医学教育早期就向医学生传授临床推理过程及避免相关错误的策略,会对患者安全产生积极影响。作者建议,应在医学院校的第一年就开始教授临床推理,可采用框架、解剖学知识和记忆法。在临床前阶段将这种方法应用于模拟病例,学生在临床实习时就能理解临床推理过程是如何在他们面前展开的,从而提升他们的整体学习体验。