文章基本信息

标题：“The 2-Dimensional Approach”: a novel tool to help learners organize their knowledge and improve their clinical reasoning skills.
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作者：Hisashi Shimozono ; Makoto Takahashi ; Makoto Tomita 等
期刊名称：MedEdPublish
电子版ISSN：2312-7996
出版年度：2019
卷号：8
期号：2
页码：1-16
DOI：10.15694/mep.2019.000134.1
出版社：Association for Medical Education in Europe (AMEE)
摘要：Background: Clinical reasoning is an essential competence of a physician. Particularly, pathophysiological understanding is the key for novices to organize their knowledge and improve clinical reasoning. To this end, we propose a “2-Dimensional (2D) Approach” that visualizes pathophysiology by using a matrix of organs and systems.Methods: This study was a prospective observational study of 100 residents (PGY-1), who attended a lecture on the 2D Approach. They underwent a pre- and post-test that assessed their ability to list differentials for various symptoms and to choose the most likely diagnosis for a case vignette. We stratified the participants according to their baseline knowledge level on the pretest into 2 groups (high-knowledge and low-knowledge). In each of the 2 groups, we compared the change in the pre- and post-test scores between participants who used the 2D Approach during the posttest and those who did not. Results: In the high-knowledge group (n=59), the change in the pre- and post-test scores was significantly larger in the 2D Approach users than non-users (p=0.046), while in the low-knowledge group (n=41), there was no significant difference in the change of the scores between the 2D Approach users and non-users. Conclusions: On condition that residents have sufficient knowledge, the 2D Approach helps them organize their knowledge and improve their clinical reasoning skills, through visualization of pathophysiology on a matrix of organs and systems.
关键词：the 2D Approach; novel tool; visualization of pathophysiology; knowledge organization; clinical reasoning; diagnosis.