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The Use of Clinical Reasoning Skills in the Setting of Uncertainty: A Case of Trial Femoral Head Migration.
Anatomical Sciences Education ( IF 5.2 ) Pub Date : 2019-03-04 , DOI: 10.1002/ase.1869
Alejandro Quiroga-Garza 1 , Rodrigo Teran-Garza 1 , Rodrigo Enrique Elizondo-Omaña 1 , Santos Guzmán-López 1
Affiliation  

Clinical skills and medical knowledge enable physicians to overcome the uncertainty of emergent and rare clinical scenarios. Recently, a growing emphasis on evidence‐based medicine (EBM) has flooded medical curricula of universities across the globe with guideline‐based material, and while it has given teachers and students new tools to improve medical education, clinical reasoning must be reaffirmed in its capacity to provide physicians with the ability to solve unexpected clinical scenarios. Anatomical education in medical school should have two main objectives: to acquire anatomical knowledge and to develop the skill of applying that knowledge in clinical scenarios. The authors present a clinical scenario in which an unexpected and rare complication occurred during a routine elective hip replacement surgery. The general surgeon presiding over the case, also an anatomy professor, solved the problem using clinical reasoning and anatomical knowledge. It was a clear example of how clinical reasoning is key in approaching unprecedented, rare, or unknown complications. The intention of this scenario is to remind colleagues and medical schools that, although EBM is the standard, educators must uphold sound clinical reasoning to best prepare health care providers for their careers.

中文翻译:

临床推理技巧在不确定性环境中的应用:一例股骨头迁移试验。

临床技能和医学知识使医生能够克服新兴和罕见临床情况的不确定性。最近,对循证医学(EBM)的日益重视已使全球大学的医学课程充斥着基于指南的材料,尽管它为教师和学生提供了改善医学教育的新工具,但必须在其临床实践中重申临床推理。为医生提供解决意外临床情况的能力。医学院的解剖学教育应有两个主要目标:获得解剖学知识,并发展将其应用于临床的技能。作者介绍了一种临床情况,其中在常规的选择性髋关节置换手术中发生了意料不到的罕见并发症。主持该病例的普通外科医师,也是一名解剖学教授,使用临床推理和解剖学知识解决了这个问题。这是一个清晰的例子,说明了临床推理如何成为解决前所未有,罕见或未知并发症的关键。这种情况的目的是提醒同事和医学院,尽管以循证医学为标准,但教育工作者必须坚持合理的临床推理方法,以便为医疗服务提供者为自己的职业做好最充分的准备。
更新日期:2019-03-04
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