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本文引用的文献

1
Physiologic measurements of cognitive load in clinical reasoning.临床推理中认知负荷的生理测量。
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2
Empathy in patient care: from 'Clinical Empathy' to 'Empathic Concern'.患者关怀中的同理心:从“临床同理心”到“共情关怀”。
Med Health Care Philos. 2021 Dec;24(4):573-585. doi: 10.1007/s11019-021-10033-4. Epub 2021 Jul 1.
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Catching a Liar Through Facial Expression of Fear.通过恐惧的面部表情识破说谎者。
Front Psychol. 2021 Jun 8;12:675097. doi: 10.3389/fpsyg.2021.675097. eCollection 2021.
4
What is clinical empathy? Perspectives of community members, university students, cancer patients, and physicians.临床同理心是什么?社区成员、大学生、癌症患者和医生的观点。
Patient Educ Couns. 2021 May;104(5):1237-1245. doi: 10.1016/j.pec.2020.11.001. Epub 2020 Nov 9.
5
Situativity: a family of social cognitive theories for understanding clinical reasoning and diagnostic error.情境性:用于理解临床推理和诊断错误的一系列社会认知理论。
Diagnosis (Berl). 2020 Aug 27;7(3):169-176. doi: 10.1515/dx-2019-0100.
6
Effects of live and video simulation on clinical reasoning performance and reflection.现场模拟和视频模拟对临床推理表现及反思的影响。
Adv Simul (Lond). 2020 Jul 31;5:17. doi: 10.1186/s41077-020-00133-1. eCollection 2020.
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Understanding context specificity: the effect of contextual factors on clinical reasoning.理解语境特异性:语境因素对临床推理的影响。
Diagnosis (Berl). 2020 Aug 27;7(3):257-264. doi: 10.1515/dx-2020-0016.
8
Sequence matters: patterns in task-based clinical reasoning.序列很重要:基于任务的临床推理模式。
Diagnosis (Berl). 2020 Aug 27;7(3):281-289. doi: 10.1515/dx-2019-0095.
9
The Linguistic Effects of Context Specificity: Exploring Affect, Cognitive Processing, and Agency in Physicians' Think-Aloud Reflections.语境特异性的语言效应:探索医生出声思维反思中的情感、认知加工和主体能动性。
Diagnosis (Berl). 2020 Aug 27;7(3):273-280. doi: 10.1515/dx-2019-0103.
10
Contextual factors and clinical reasoning: differences in diagnostic and therapeutic reasoning in board certified versus resident physicians.情境因素与临床推理:获得委员会认证的医生与住院医师在诊断和治疗推理方面的差异。
BMC Med Educ. 2017 Nov 15;17(1):211. doi: 10.1186/s12909-017-1041-x.

专注的好奇心:复杂患者诊疗过程中临床推理的“热点”

Engaged curiosity: "Hot spots" for clinical reasoning in complex patient encounters.

作者信息

Soh Michael, Mullikin Dolores, Durning Steven J, Merkebu Jerusalem

机构信息

School of Graduate Studies, University of Maryland, Baltimore, USA.

Mary Bridge Children's Hospital, Tacoma, WA, USA.

出版信息

PEC Innov. 2025 Jun 6;7:100408. doi: 10.1016/j.pecinn.2025.100408. eCollection 2025 Dec.

DOI:10.1016/j.pecinn.2025.100408
PMID:40546327
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12182341/
Abstract

OBJECTIVE

This study explores how, if at all, engaged curiosity - a genuine, emotionally engaged interest in learning more about the complexity of another's particular emotional perspective - emerges in the clinical reasoning process and its relationship with contextual factors and clinical reasoning performance.

METHODS

Think-alouds transcripts from nineteen physicians in internal medicine from three military training facilities were thematically analyzed for instances of engaged curiosity and examined through the lens of contextual factors and clinical reasoning performance.

RESULTS

Our findings indicate that engaged curiosity can be likened to placeholders that physicians employ early on to "bookmark" sources of patient concern. These sources, or hot spots, deserve follow up, particularly when cognitive resources are unavailable to "attend" to a deeper understanding of the patient's experience.

CONCLUSION

Engaged curiosity provides a unique lens for better understanding the relationship between empathy and clinical reasoning and warrants further research on its impact on the patient and their care.

INNOVATION

Engaged curiosity could serve as a novel way to train physicians to think and engage more empathically with their patients.

摘要

目的

本研究探讨了在临床推理过程中,若存在的话,投入性好奇心——一种对更深入了解他人特定情感视角的复杂性的真实、情感投入的兴趣——是如何出现的,以及它与情境因素和临床推理表现的关系。

方法

对来自三个军事训练机构的19名内科医生的出声思维记录进行主题分析,以找出投入性好奇心的实例,并从情境因素和临床推理表现的角度进行考察。

结果

我们的研究结果表明,投入性好奇心可以比作医生早期用来“标记”患者关注点来源的占位符。这些来源或热点值得跟进,尤其是当认知资源无法用于“关注”对患者经历的更深入理解时。

结论

投入性好奇心为更好地理解同理心与临床推理之间的关系提供了一个独特的视角,值得进一步研究其对患者及其护理的影响。

创新点

投入性好奇心可以作为一种新颖的方式来培训医生,使其更具同理心去思考并与患者互动。