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技术可以增强,但不能替代患者护理所需的关键人类技能。

Technology Can Augment, but Not Replace, Critical Human Skills Needed for Patient Care.

机构信息

J. Alrassi is resident physician, Department of Otolaryngology-Head and Neck Surgery, State University of New York Downstate Health Sciences University, Brooklyn, New York; ORCID: https://orcid.org/0000-0003-4851-1697 .

P.J. Katsufrakis is president and chief executive officer, National Board of Medical Examiners, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0001-9077-9190 .

出版信息

Acad Med. 2021 Jan 1;96(1):37-43. doi: 10.1097/ACM.0000000000003733.


DOI:10.1097/ACM.0000000000003733
PMID:32910005
Abstract

The practice of medicine is changing rapidly as a consequence of electronic health record adoption, new technologies for patient care, disruptive innovations that breakdown professional hierarchies, and evolving societal norms. Collectively, these have resulted in the modification of the physician's role as the gatekeeper for health care, increased shift-based care, and amplified interprofessional team-based care. Technological innovations present opportunities as well as challenges. Artificial intelligence, which has great potential, has already transformed some tasks, particularly those involving image interpretation. Ubiquitous access to information via the Internet by physicians and patients alike presents benefits as well as drawbacks: patients and providers have ready access to virtually all of human knowledge, but some websites are contaminated with misinformation and many people have difficulty differentiating between solid, evidence-based data and untruths. The role of the future physician will shift as complexity in health care increases and as artificial intelligence and other technologies advance. These technological advances demand new skills of physicians; memory and knowledge accumulation will diminish in importance while information management skills will become more important. In parallel, medical educators must enhance their teaching and assessment of critical human skills (e.g., clear communication, empathy) in the delivery of patient care. The authors emphasize the enduring role of critical human skills in safe and effective patient care even as medical practice is increasingly guided by artificial intelligence and related technology, and they suggest new and longitudinal ways of assessing essential noncognitive skills to meet the demands of the future. The authors envision practical and achievable benefits accruing to patients and providers if practitioners leverage technological advancements to facilitate the development of their critical human skills.

摘要

随着电子健康记录的采用、患者护理新技术、打破专业等级制度的颠覆性创新以及不断发展的社会规范的出现,医学实践正在迅速发生变化。这些变化共同导致了医生作为医疗保健守门人的角色发生改变,基于班次的护理增加,以及以跨专业团队为基础的护理增强。技术创新带来了机遇和挑战。人工智能具有巨大的潜力,已经改变了一些任务,特别是那些涉及图像解释的任务。医生和患者都可以通过互联网随时随地获取信息,这既带来了好处,也带来了弊端:患者和提供者可以几乎获得所有人类知识,但有些网站充斥着错误信息,而且许多人难以区分可靠的、基于证据的数据和虚假信息。随着医疗保健复杂性的增加以及人工智能和其他技术的进步,未来医生的角色将发生转变。这些技术进步要求医生具备新的技能;记忆和知识积累的重要性将降低,而信息管理技能将变得更加重要。与此同时,医学教育者必须加强在提供患者护理方面的批判性人类技能(例如,清晰的沟通、同理心)的教学和评估。作者强调,即使医学实践越来越受到人工智能和相关技术的指导,批判性人类技能在安全有效的患者护理中仍具有持久作用,并提出了新的和纵向的方法来评估基本的非认知技能,以满足未来的需求。如果从业者利用技术进步来促进他们的批判性人类技能的发展,那么作者设想患者和提供者将获得实际可行的益处。

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