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运用理论来阐释资深临床医生如何界定、学习和传授临床推理。

Using theory to interpret how senior clinicians define, learn, and teach clinical reasoning.

作者信息

Gee Waverley, Anakin Megan, Pinnock Ralph

机构信息

University of Otago.

出版信息

MedEdPublish (2016). 2017 Oct 12;6:182. doi: 10.15694/mep.2017.000182. eCollection 2017.

Abstract

This article was migrated. The article was marked as recommended. : Dual process theory and script theory have been used to understand and explain how students learn clinical reasoning. This study used these tools to interpret how experienced teachers described their definitions of clinical reasoning, their own history learning about clinical reasoning, and their methods of teaching clinical reasoning. : Interview data from 14 senior clinicians were investigated thematically using a general inductive approach then interpreted using principles and concepts associated with dual process theory and script theory, including the concept of deliberate practice and script consciousness. : Senior clinicians' definitions of clinical reasoning were consistent with the literature. Few of them recalled being explicitly taught clinical reasoning. They identified teaching as a way to further develop their own clinical reasoning. They taught it opportunistically using an apprenticeship and role-modelling approach in clinical contexts. Their teaching techniques included supervised practice, reflection, think aloud, focused data collection guided by the clinical presentation, and iterative reasoning. : Dual process theory, script theory, and the concepts of mindful practice and deliberate practice were found to be useful tools to understand how senior clinicians taught and learned clinical reasoning. These findings are guiding our clinical reasoning curriculum and faculty development programme.

摘要

本文已迁移。该文章被标记为推荐文章:双重加工理论和脚本理论已被用于理解和解释学生如何学习临床推理。本研究使用这些工具来解读经验丰富的教师如何描述他们对临床推理的定义、他们自己学习临床推理的经历以及他们教授临床推理的方法。:采用一般归纳法对14位资深临床医生的访谈数据进行了主题研究,然后运用与双重加工理论和脚本理论相关的原则和概念进行解读,包括刻意练习和脚本意识的概念。:资深临床医生对临床推理的定义与文献一致。他们中很少有人记得曾接受过临床推理的明确教学。他们将教学视为进一步发展自己临床推理能力的一种方式。他们在临床环境中通过学徒制和榜样示范的方式机会性地进行教学。他们的教学技巧包括监督实践、反思、大声思考、根据临床表现进行有针对性的数据收集以及迭代推理。:双重加工理论、脚本理论以及正念练习和刻意练习的概念被发现是理解资深临床医生如何教授和学习临床推理的有用工具。这些发现正在指导我们的临床推理课程和教师发展计划。

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