Welch Paul, Plummer David, Young Louise, Quirk Frances, Larkins Sarah, Evans Rebecca, Sen Gupta Tarun
James Cook University.
Griffiths University.
MedEdPublish (2016). 2017 Jan 5;6:2. doi: 10.15694/mep.2017.000002. eCollection 2017.
This article was migrated. The article was marked as recommended. Clinical reasoning is fundamental to medical education and clinical practice ( Schmidt & Mamede, 2015). Despite its centrality, clinical reasoning is often regarded as difficult to conceptualise and teach ( Charlin, 2012; Pinnock & Welch, 2014). The pivotal role of clinical reasoning constitutes a compelling case for better understanding, more efficient teaching and practice that is more systematic and evidence-based. Clinical reasoning has been regarded as an art rather than a science ( Braude, 2012) and has attracted less research effort than befits its important function. The authors examined the suitability of grounded theory methodology to provide a more complete understanding of the clinical reasoning process. Grounded theory and clinical reasoning are processes which both qualitatively evaluate and analyse information from an interview subject as well as additional sources and arrive at a robust, defensible theory to explain their findings. Grounded theory offers considerable utility for (i) understanding and modelling clinical reasoning, (ii) researching clinical reasoning and (iii) as a heuristic for teaching clinical reasoning skills. This paper explores the parallels between grounded theory methodology and clinical reasoning, as well as the suitability of grounded theory as a framework for informing and transforming our understanding of clinical reasoning.
本文已迁移。该文章被标记为推荐文章。临床推理是医学教育和临床实践的基础(施密特和马梅德,2015年)。尽管其核心地位重要,但临床推理通常被认为难以概念化和教授(沙兰,2012年;平诺克和韦尔奇,2014年)。临床推理的关键作用构成了一个令人信服的理由,促使我们更好地理解它,进行更有效的教学,并开展更系统、基于证据的实践。临床推理一直被视为一门艺术而非科学(布劳德,2012年),且相较于其重要功能,所吸引的研究精力较少。作者们研究了扎根理论方法对于更全面理解临床推理过程的适用性。扎根理论和临床推理都是对来自访谈对象以及其他来源的信息进行定性评估和分析的过程,并得出一个可靠、站得住脚的理论来解释他们的发现。扎根理论在以下方面具有相当大的效用:(i)理解和构建临床推理模型;(ii)研究临床推理;(iii)作为教授临床推理技能的一种启发式方法。本文探讨了扎根理论方法与临床推理之间的相似之处,以及扎根理论作为一个框架用于增进和转变我们对临床推理理解的适用性。