Gibson M, Kaaden J, Balla J I
Office of the Clinical Dean, Prince Henry's Hospital, Melbourne, Victoria.
Clin Exp Neurol. 1987;23:183-6.
The problem-solving strategies of fifth year medical students were studied using two simulated cases. One of these cases involved a neurological problem which was unfamiliar to the students. With the use of stimulated recall the study looked at the origin of the first hypothesis. The symptoms given by the patient did not trigger an appropriate hierarchy of questions and the students resorted to problem-solving techniques, such as drawing on commonsense. In some cases they matched symptoms against clinical cases they had seen previously. Recall from lectures was used occasionally. Instead of rational methods of hypothesis generation, they were most likely to be influenced by recent clinical exposures. Students having identical experiences may have had differing perceptions of these exposures. As a result, their early hypothesis formation showed marked individual variation. These findings need to be considered in the light of how students learn and the content of the teaching that is meaningful to them.
使用两个模拟病例研究了五年级医学生的问题解决策略。其中一个病例涉及学生不熟悉的神经问题。通过使用刺激回忆，该研究考察了第一个假设的起源。患者给出的症状没有引发适当的问题层次结构，学生们 resort to 问题解决技巧，比如依靠常识。在某些情况下，他们将症状与之前见过的临床病例进行匹配。偶尔会回忆讲座内容。他们不是采用合理的假设生成方法，而是最有可能受到近期临床接触的影响。有相同经历的学生对这些接触可能有不同的认知。因此，他们早期的假设形成表现出明显的个体差异。需要根据学生的学习方式以及对他们有意义的教学内容来考虑这些发现。 （注：“resort to”直译为“诉诸于”，这里意译为“采用”更合适些）
