Yang Erin H, Rencic Joseph, Rezigh Alec B, Kulkarni Prathit A
Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
General Internal Medicine Section, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Diagnosis (Berl). 2025 May 29. doi: 10.1515/dx-2025-0005.
Illness scripts are mental networks of information about medical diseases and are used by clinicians to efficiently make diagnostic and treatment decisions. The traditional components of an illness script include the epidemiologic risk factors, pathophysiology, and clinical findings of a disease [Feltovich PJ, Barrows HS. Issues of generality in medical problem solving. In: Schmidt HG, De Volder ML, editors. Tutorials in problem-based learning. Assen/Maastricht: Van Gorcum; 1984:128-42 pp]. Here, we coin the term illness script builder templates (ISBTs), which are educational tools to help learners develop their illness scripts. While the actual concept of ISBTs is not new, we aim to explicitly distinguish these discrete learning tools from illness scripts themselves, which are mental frameworks. ISBTs have significant pedagogic value. They are being more widely adopted in clinical curricula in medical school, as they have been well-received by students and educationally effective. ISBTs allow the integration of new knowledge to be intuitive, as they take advantage of our predilection toward story-based learning. Limitations to ISBTs also exist, especially when considering their optimal length and structure as well as complexity for different levels of learners. We additionally explore the specific strengths and limitations of ISBTs and propose strategies to maximize their use in education and clinical practice.
疾病脚本是关于医学疾病的信息的心理网络，临床医生利用它来高效地做出诊断和治疗决策。疾病脚本的传统组成部分包括疾病的流行病学危险因素、病理生理学和临床发现[费尔托维奇PJ，巴罗斯HS。医学问题解决中的普遍性问题。见：施密特HG，德沃尔德ML，编辑。基于问题的学习教程。阿森/马斯特里赫特：范戈尔库姆；1984年：第128 - 142页]。在此，我们创造了“疾病脚本构建器模板”（ISBTs）这一术语，它是帮助学习者构建其疾病脚本的教育工具。虽然ISBTs的实际概念并不新颖，但我们旨在明确区分这些离散的学习工具与疾病脚本本身，疾病脚本本身是心理框架。ISBTs具有重要的教学价值。它们在医学院校的临床课程中得到更广泛的采用，因为它们受到了学生的欢迎且具有教育效果。ISBTs使新知识的整合变得直观，因为它们利用了我们对基于故事的学习的偏好。ISBTs也存在局限性，尤其是在考虑其最佳长度、结构以及针对不同水平学习者的复杂性时。我们还探讨了ISBTs的具体优势和局限性，并提出了在教育和临床实践中最大限度地利用它们的策略。
