专家医生的知识结构及诊断推理方式  

The Knowledge Structure and Diagnostic Reasoning of Medical Experts

作　　者：王雁[1] 姚梅林[1] 

机构地区：[1]北京师范大学心理学院,北京100875

出　　处：《心理科学进展》2009年第1期64-70,共7页Advances in Psychological Science

基　　金：北京市哲学社会科学"十一五"规划项目资助(批准号06AgJY028)

摘　　要：医学专长研究中"中间者效应"的发现,引发了研究者对专家医生知识结构的探讨。在"知识打包"的基础上,医生的临床知识以"疾病脚本"的方式组织起来。随着临床经验的增加,专家医生积累了丰富的疾病脚本。在临床诊断中,他们无需对病人所有的体征和症状进行仔细地和系统地分析,而是通过非分析性的推理方式——"模式识别"或"样例识别"便可自动激活与之匹配的疾病脚本,据此对病人做出迅速而准确的诊断。医学专长的本质就在于专家医生以"疾病脚本"的方式组织起来的知识结构。"适应性专长"代表了未来医学专长研究的新方向。The discovering of ‘intermediate effect＇ in medical expertise research inspires researchers to explore the knowledge structure of medical experts. On the basis of ‘knowledge encapsulation＇, medical experts‘knowledge is organized with ’illness script‘. With the accumulation of clinical experiences, medical experts acquire ample illness scripts＇. On diagnostic reasoning, they needn＇t carefully and systematically analyze all the signs and symptoms of the patient, but activate the matching ‘illness script＇ automatically and make a diagnosis. This activation, called non-analytic, is based on recognition of either an instance or a pattern. The nature of medical expertise lies in the knowledge organization of the medical expert. ‘Adaptive expertise＇ represents the future direction of expertise research.

关 键 词：医学专长 专家医生 知识结构 诊断推理方式 适应性专长 

分 类 号：B842.5[哲学宗教—基础心理学]