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刻意的临床惰性:运用元认知改善决策

Deliberate clinical inertia: Using meta-cognition to improve decision-making.

作者信息

Keijzers Gerben, Fatovich Daniel M, Egerton-Warburton Diana, Cullen Louise, Scott Ian A, Glasziou Paul, Croskerry Pat

机构信息

Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.

School of Medicine, Bond University, Gold Coast, Queensland, Australia.

出版信息

Emerg Med Australas. 2018 Aug;30(4):585-590. doi: 10.1111/1742-6723.13126. Epub 2018 Jul 2.

Abstract

Deliberate clinical inertia is the art of doing nothing as a positive response. To be able to apply this concept, individual clinicians need to specifically focus on their clinical decision-making. The skill of solving problems and making optimal clinical decisions requires more attention in medical training and should play a more prominent part of the medical curriculum. This paper provides suggestions on how this may be achieved. Strategies to mitigate common biases are outlined, with an emphasis on reversing a 'more is better' culture towards more temperate, critical thinking. To incorporate such an approach in medical curricula and in clinical practice, institutional endorsement and support is required.

摘要

蓄意的临床惰性是一种将不作为作为积极应对方式的策略。为了能够应用这一概念,个体临床医生需要特别关注自身的临床决策。解决问题和做出最佳临床决策的技能在医学培训中需要更多关注,并且应该在医学课程中占据更突出的地位。本文就如何实现这一点提供了建议。概述了减轻常见偏差的策略,重点是将“越多越好”的文化转变为更适度、批判性的思维。要将这种方法纳入医学课程和临床实践,需要机构的认可和支持。

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