Hunzeker Adam, Amin Rohul
Psychiatrist, Womack Army Medical Center.
Psychiatrist, Madigan Army Medical Center.
MedEdPORTAL. 2016 Sep 16;12:10451. doi: 10.15766/mep_2374-8265.10451.
Diagnostic ambiguity is commonplace in psychiatric practice. With limited etiological understanding behind the illnesses that we treat, it can be a daunting task to diagnostically approach a complex patient. To avoid diagnostic pitfalls, it is paramount to employ carefully constructed diagnostic cognitive processes. The aim of this resource is to decrease diagnostic thought errors through education via acquired knowledge and skills.
This workshop is intended as a primer for psychiatric medical students, interns, residents, and practicing psychiatrists who have not yet been exposed to this topic. The resource consists of a brief didactic session (knowledge portion of the topic) followed by small-group sessions (skills portion of the topic), led by discussion of clinical vignettes incorporating complex medical-psychiatric patients. The cases highlight the various cognitive biases and anchor points that can contribute to diagnostic error. In order to make it easier for educators to implement, the workshop can be delivered in a single 1-hour session. With the provided material, this educational session can be easily delivered by a single facilitator.
Formal and informal feedback from learners demonstrates that this resource is effective at teaching cognitive bias to learners.
While psychiatric learners are used to metacognitive approaches in clinical settings, they often lag behind other medical specialties in discussing these topics related to their own diagnostic reasoning and acumen. This is especially important in psychiatry given the evolving nature of our specialty.
诊断的模糊性在精神病学实践中很常见。由于我们所治疗疾病背后的病因学理解有限,对复杂患者进行诊断可能是一项艰巨的任务。为避免诊断陷阱,采用精心构建的诊断认知过程至关重要。本资源的目的是通过传授知识和技能进行教育,以减少诊断思维错误。
本次工作坊旨在作为尚未接触过该主题的精神科医学生、实习生、住院医师及执业精神科医生的入门课程。该资源包括一个简短的讲授环节(该主题的知识部分),随后是小组讨论环节(该主题的技能部分),通过对包含复杂医学 - 精神科患者的临床案例进行讨论来引导。这些案例突出了可能导致诊断错误的各种认知偏差和锚定因素。为便于教育工作者实施,该工作坊可在1小时的单次课程中进行。借助所提供的材料,一名主持人即可轻松开展此次教育课程。
学习者的正式和非正式反馈表明,该资源在向学习者传授认知偏差方面是有效的。
虽然精神科学习者在临床环境中习惯使用元认知方法,但在讨论与自身诊断推理和敏锐度相关的这些主题时,他们往往落后于其他医学专业。鉴于我们专业不断发展的性质,这在精神病学中尤为重要。