PDF(Pubmed)
Abstract：
This article was migrated. The article was marked as recommended. Background: Final year medical students at the University Duisburg-Essen, Germany, are unsatisfied with their clinical judgement skills in common elective and emergency clinical situations. A competency based medical curriculum determines that clinical judgement is an essential tool in effective patient care, patient safety and limiting clinical error. Approaches to clinical judgement include either analytical, intuitive or a combination of both approaches. Novices show specific factors, which are typical in inexperienced clinicians. Simulation provides opportunities in a competency-based medical education curriculum. There is limited evidence showing that simulation can provide an effective environment for teaching and learning clinical decision-making skills. This project explores how final year medical students at the University of Duisburg-Essen approach the clinical decision-making process as well as how simulation influences this process. Methods: Ethics approval was obtained from the local ethics committee. After completing a 10-week simulation course,thirty-five students completed a clinical decision-making instrument to categorise their clinical decision-making approaches. The Novice Decision Making Model and the Cognitive Continuum Model were combined with learning theories in Simulation (Social Cognitive Theory) and used to explore and interpret data collected through questionnaires, interviews and observation. Results: The majority (60%) of students employed a predominantly analytic approach, some students showed intuitive tendencies in clinical situations. During interviews students displayed typical novice approaches to decision-making and expressed positive comments relating to simulation. Conclusions: Simulation presents an opportunity for teaching and learning clinical decision-making. Results show the need for further inquiry into learning clinical decision-making through simulation. This research provides initial evidence that simulation can be incorporated into curricular teaching of clinical decision-making.
摘要：
本文已迁移。这篇文章被标记为推荐。背景：杜伊斯堡-埃森大学的最后一年医学生，德国,在常见的选择性和紧急临床情况下，对他们的临床判断能力不满意。基于能力的医学课程决定了临床判断是有效患者护理的重要工具，患者安全和限制临床错误。临床判断的方法包括分析，直觉或两种方法的组合。新手表现出特定的因素，这在没有经验的临床医生中是典型的。模拟为基于能力的医学教育课程提供了机会。有限的证据表明，模拟可以为教学和学习临床决策技能提供有效的环境。该项目探讨了杜伊斯堡-埃森大学的最后一年医学生如何处理临床决策过程以及模拟如何影响这一过程。方法：从当地伦理委员会获得伦理批准。完成为期10周的模拟课程后，35名学生完成了临床决策工具，以对其临床决策方法进行分类。将新手决策模型和认知连续模型与模拟学习理论（社会认知理论）相结合，并用于探索和解释通过问卷调查收集的数据，采访和观察。结果：大多数（60％）的学生采用了主要的分析方法，一些学生在临床情况下表现出直觉倾向。在访谈中，学生展示了典型的新手决策方法，并表达了与模拟有关的积极评论。结论：模拟为教学和学习临床决策提供了机会。结果表明，需要进一步探究通过模拟学习临床决策。这项研究提供了初步证据，证明模拟可以纳入临床决策的课程教学中。
