Teaching clinical reasoning in emergency medicine requires educators to foster diagnostic accuracy and judicious decision-making amidst chaotic ambient factors including clinician fatigue, high cognitive load, and diverse patient expectations. The current study applies the early work of Jurgen Habermas and his knowledge-constitutive interests as a lens to explore an educational approach where physician-educators were asked to make their expert reasoning visible to emergency medicine trainees, to more deliberately make visible and accessible the context-specific thinking that emergency physicians routinely use. An action research methodology was used. The ‘making thinking visible’ teaching approach was introduced to five emergency medicine educators working in large public hospital emergency departments. Participants were asked to trial this teaching method and document its impact on student learning over two reporting cycles. Based on written reports of trialing the teaching approach, participants identified a need to change from: (1) introducing thinking structures to cultivating enquiry; and, (2) providing explanations based on cognitive thinking routines towards encouraging the learner to see the relevance of the clinical context. Educators described how they developed a more diagnostic and reflexive approach to learners, recognized the need to cultivate independent thinking, and valued the opportunity to reflect on their usual teaching. Teaching clinical reasoning using the ‘making thinking visible’ approach prompted educators to decrease the emphasis on providing technical information to assisting learners to understand the purposes and meanings behind clinical reasoning in emergency medicine. The knowledge-constitutive interests work of Jurgen Habermas was found to provide a robust framework supporting this emancipatory teaching approach.

中文翻译：

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“从更高的地方开始”：将哈贝马斯与急诊医学背景下的临床推理教学联系起来

在急诊医学中教授临床推理需要教育工作者在混乱的环境因素（包括临床医生疲劳、高认知负荷和多样化的患者期​​望）中培养诊断的准确性和明智的决策。当前的研究应用 Jurgen Habermas 的早期工作和他的知识构成兴趣作为一个镜头来探索一种教育方法，在这种方法中，医生教育者被要求向急诊医学受训者展示他们的专家推理，以便更有意地使上下文可见和可访问-急诊医生经常使用的特定思维。使用了行动研究方法。向在大型公立医院急诊科工作的五名急诊医学教育工作者介绍了“让思维可视化”的教学方法。参与者被要求试用这种教学方法，并记录其在两个报告周期内对学生学习的影响。根据尝试教学方法的书面报告，参与者认为需要从：（1）引入思维结构转变为培养探究性；(2) 提供基于认知思维例程的解释，以鼓励学习者看到临床背景的相关性。教育工作者描述了他们如何为学习者开发一种更具诊断性和反思性的方法，认识到培养独立思考的必要性，并重视反思他们平时教学的机会。使用“使思维可见”方法教授临床推理促使教育者减少对提供技术信息的重视，以帮助学习者理解急诊医学临床推理背后的目的和意义。Jurgen Habermas 的知识构成兴趣工作被发现为支持这种解放性教学方法提供了一个强大的框架。