Center for Health Professions Education, Uniformed Services University of the Health Sciences, MD, USA.
Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
Korean J Med Educ. 2024 Jun;36(2):145-155. doi: 10.3946/kjme.2024.292. Epub 2024 May 30.
Clinical reasoning has been characterized as being an essential aspect of being a physician. Despite this, clinical reasoning has a variety of definitions and medical error, which is often attributed to clinical reasoning, has been reported to be a leading cause of death in the United States and abroad. Further, instructors struggle with teaching this essential ability which often does not play a significant role in the curriculum. In this article, we begin with defining clinical reasoning and then discuss four principles from the literature as well as a variety of techniques for teaching these principles to help ground an instructors' understanding in clinical reasoning. We also tackle contemporary challenges in teaching clinical reasoning such as the integration of artificial intelligence and strategies to help with transitions in instruction (e.g., from the classroom to the clinic or from medical school to residency/registrar training) and suggest next steps for research and innovation in clinical reasoning.
临床推理一直被认为是医生的一个重要方面。尽管如此,临床推理有多种定义,而医学错误通常归因于临床推理,据报道,它是美国和国外导致死亡的主要原因之一。此外,教师在教授这一基本能力方面存在困难,而这一能力通常在课程中没有起到重要作用。在本文中,我们首先定义临床推理,然后讨论文献中的四项原则以及各种教授这些原则的技术,以帮助教师理解临床推理。我们还探讨了临床推理教学中的当代挑战,如人工智能的整合以及帮助教学过渡的策略(例如,从课堂到临床,或从医学院到住院医师/研究员培训),并为临床推理的研究和创新提出了下一步的建议。