医学决策认知过程中的快慢思考

Jorge Luis Díaz-Alday, Caridad Guadalupe Villegas-Delgado, Carlos Héctor Delgado-Villegas
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引用次数: 0

摘要

作为一名医生,无论是诊断还是治疗,都需要快速准确地做出决定,这对患者的安全也有影响。人们提出了一些理论来解释临床医生如何进行推理,并指出了熟练和缺乏经验的临床医生之间的差异。我们的大脑有两个思维系统:快和慢。快速与直觉和自动决策有关,只需很少的精力或注意力,只需很少的信息就能做出决策。慢速认知处理涉及更深层次、更具分析性的认知处理,需要付出努力,而且可能很费力。最新研究表明,大多数医疗决策都采用快速思维。这种形式的直觉思维是过程的一部分,非常有效,但也容易出现认知错误。推理的二元理论反映了直觉在大多数决策中的重要性,让我们能够更好地理解我们医生在日常工作中是如何思考的。医学院校应利用新的教学空间,在综合讲习班、医疗实践或综合课程等科目中,采用类似的方法,极大地促进基于问题的学习,为我们的学生提供获得知识和批判性思维能力的机会,以便在任何情况下,用两种思维系统全面地解决医疗问题。更多年的课堂教学、继续医学教育、建议认证并不能解决问题,有些人认为要消除医疗实践中的认知错误,就必须重新设计和创新。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Think fast and slow in the cognitive process for decision making in medicine
Being a doctor requires making quick and accurate decisions, whether it is diagnosis or therapy, and has implications for patient safety. Several theories have been proposed to explain how clinicians make their reasoning, pointing out differences between skilled and inexperienced clinicians. Our brain has two systems of thought: fast and slow. Fast is associated with intuitive and automatic decisions, requires little energy or attention, allows decisions to be made with little information. Slow cognitive processing involves deeper, more analytical cognitive processing, requires effort, and can be strenuous. Recent research indicates that quick thinking is used in most medical decisions. This form of intuitive thinking is part of the process is very effective, but it is also vulnerable to cognitive errors. The dual theory of reasoning, reflecting the great importance of intuition in most decisions, allows us to better understand how we doctors think in our daily practice. Medical schools should use new didactic spaces in which problem-based learning is greatly facilitated, in subjects such as integrated workshops, medical practice, or integrative sessions, with similar methodology, that provide our students with opportunities to obtain knowledge and critical thinking skills to solve medical problems in a holistic way, in any context, with both systems of thought. More years in the classroom, continuing medical education, certification by advice do not solve the problem, there are those who invoke to eliminate cognitive errors in medical practice, that it must be redesigned and reinvented.
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