Division of Hospital Medicine, VA Portland Healthcare System, Portland, OR, USA.
Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
Diagnosis (Berl). 2022 Dec 1;10(1):9-12. doi: 10.1515/dx-2022-0043. eCollection 2023 Feb 1.
Teaching clinical reasoning has long challenged educators because it requires familiarity with reasoning concepts, experience with describing thinking, and comfort with exposing uncertainty and error. We propose that teachers adopt the cognitive apprenticeship model and a method of disclosing uncertainty known as intellectual streaking. These approaches reflect a shift in the educator's mindset from transmitting medical knowledge to broadcasting cognition. We provide several examples to guide the adoption of these strategies and make recommendations for teachers and training programs to improve the teaching of clinical reasoning.
教授临床推理一直以来都令教育工作者感到困难,因为这需要他们熟悉推理概念、有描述思维过程的经验,并且能够坦然面对不确定性和错误。我们建议教师采用认知学徒制模型和一种名为“暴露不确定性”的方法,即“intellectual streaking”。这些方法反映了教育者思维模式的转变,即从传授医学知识转变为传播认知。我们提供了几个示例来指导这些策略的采用,并为教师和培训计划提出了改进临床推理教学的建议。