Schaye Verity, Janjigian Michael, Hauck Kevin, Shapiro Neil, Becker Daniel, Lusk Penelope, Hardowar Khemraj, Zabar Sondra, Dembitzer Anne
Department of Medicine, New York University School of Medicine, 462 1st Avenue, New York, NY 10016, USA.
NYC Health and Hospitals/Bellevue, New York, NY, USA.
Diagnosis (Berl). 2019 Jun 26;6(2):109-113. doi: 10.1515/dx-2018-0059.
Background Clinical reasoning (CR) is a core competency in medical education. Few studies have examined efforts to train faculty to teach CR and lead CR curricula in medical schools and residencies. In this report, we describe the development and preliminary evaluation of a faculty development workshop to teach CR grounded in CR theory. Methods Twenty-six medicine faculty (nine hospitalists and 17 subspecialists) participated in a workshop that introduced a framework to teach CR using an interactive, case-based didactic followed by role-play exercises. Faculty participated in pre- and post-Group Observed Structured Teaching Exercises (GOSTE), completed retrospective pre-post assessments (RPPs), and made commitment to change statements (CTCs). Results In the post-GOSTE, participants significantly improved in their use of problem representation and illness scripts to teach CR. RPPs revealed that faculty were more confident in their ability and more likely to teach CR using educational strategies grounded in CR educational theory. At 2-month follow-up, 81% of participants reported partially implementing these teaching techniques. Conclusions After participating in this 3-h workshop, faculty demonstrated increased ability to use these teaching techniques and expressed greater confidence and an increased likelihood to teach CR. The majority of faculty reported implementing these newly learned educational strategies into practice.
背景 临床推理（CR）是医学教育中的一项核心能力。很少有研究探讨在医学院校和住院医师培训中为培训教师教授临床推理及领导临床推理课程所做的努力。在本报告中，我们描述了一个基于临床推理理论的教师发展工作坊的开发及初步评估。方法 26名医学教师（9名住院医师和17名专科医师）参加了一个工作坊，该工作坊介绍了一个使用交互式、基于案例的教学法并随后进行角色扮演练习来教授临床推理的框架。教师们参加了小组观察结构化教学练习（GOSTE）的前后评估，完成了回顾性前后评估（RPP），并做出了改变承诺声明（CTC）。结果 在GOSTE后测中，参与者在使用问题表征和疾病脚本教授临床推理方面有显著提高。RPP显示，教师对自己的能力更有信心，并且更有可能使用基于临床推理教育理论的教育策略来教授临床推理。在2个月的随访中，81%的参与者报告部分实施了这些教学技巧。结论 参加这个3小时的工作坊后，教师们展示了使用这些教学技巧的能力有所提高，并表现出更大的信心以及教授临床推理的可能性增加。大多数教师报告将这些新学到的教育策略应用到了实践中。
