在日常工作中强化急诊医学临床决策方法训练初探  

Preliminary Study of Strength the Training in Clinical Decision-making Methods of Emergency Medicine during Daily Work

作　　者：李尚林[1] 张亚平[1] 邰韩珍 

机构地区：[1]北京丰台医院急诊科,北京100070

出　　处：《医学与哲学（B）》2011年第10期69-70,80,共3页Medicine & Philosophy(B)

摘　　要：急诊医学是临床决策应用最频繁的学科之一。为了提高我院急诊科医师的临床决策水平,全科医师在3人"研究小组"带领下,于2009年10月至2010年12月,通过研习有关文献掌握常用的临床决策方法;在分诊、接诊、抢救、晨会、主任查房、病例讨论会等日常工作环节,强化临床决策方法的训练和运用。比较4种主要决策方法在"训练前组"和"训练后组"抢救病例的应用比例,发现快捷的"模式识别法"和"运用规则法"的使用比例明显提高,严谨而费时的"假设-演绎法"的使用比例明显降低,"事件驱动法"和"失误率"无明显变化。提示:在日常工作中强化急诊医学临床决策方法的训练有助于提高急诊医师的临床决策水平。Emergency Medicine is one of the most frequent subjects using clinical decision--making. From Oct. 2009 to Dec. 2010, in order to improve emergency department physician ability in clinical decision--making, the emergency physicians in the three ＂study group＂ led, learning the common clinical decision--making methods through studying the literature, strength the training and practice of clinical decision--making by some daily work such as triage, admissions, emergency, morning meeting, director of rounds, case discussions. Comparing four main decision-- making methods in the ＂pre-- training group＂ and ＂post--training group＂ of application, it＇s found that the proportion of using fast Upattern recognition＂ and ＂rule--using algorithm＂ method increased significantly, In contrast, the proportion of using rigorous and time--consuming ＂hypothetico--deductive＂ method decreased much, and there is no obvious changes on the proportion of using ＂event driven＂ method and ＂error rate＂. Tip： In the daily work to strengthen the training of emergency medicine clinical decision --making method is feasible and benefits to improve emergency physicians ability on clinical decision--making.

关 键 词：急诊医学 临床决策 方法学 训练 

分 类 号：R-052[医药卫生]