Harasym P, Baumber J, Bryant H, Fundytus D, Preshaw R, Watanabe M, Wyse G
Med Educ. 1980 Nov;14(6):381-6. doi: 10.1111/j.1365-2923.1980.tb02388.x.
Currently, research does not agree as to the extent to which medical content and problem-solving processes underlie clinical problem-solving. The results of research in this area fall into two categories: (1) clinical problem-solving is primarily dependent upon medical content specific within the case, and (2) clinical problem-solving is a skill, or series of skills, which can be applied to all clinical problems. In the study reported in this paper, seventy-one second-year medical students who had completed a 2-year, body-systems oriented curriculum were given an examination designed to measure clinical problem-solving. The results indicated that gathering data on patient history and hypotheses generation were specific skills common to clinical problem-solving, while hypotheses refinement, identification of relevant physical examinations, ordering laboratory investigations and making a diagnosis were case-related.
目前，对于医学内容和解决问题的过程在多大程度上构成临床问题解决的基础，研究尚无定论。该领域的研究结果分为两类：（1）临床问题解决主要依赖于病例中特定的医学内容；（2）临床问题解决是一种技能或一系列技能，可应用于所有临床问题。在本文所报告的研究中，71名已完成两年以身体系统为导向课程的二年级医学生接受了一项旨在测量临床问题解决能力的考试。结果表明，收集患者病史数据和生成假设是临床问题解决共有的特定技能，而假设细化、确定相关体格检查、安排实验室检查以及做出诊断则与病例相关。
