To do or not to do: Teaching the skill of deciding what to do in the face of uncertainty.

IF 1.6 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Australian Journal of General Practice Pub Date : 2024-12-01 DOI:10.31128/AJGP-08-23-6949
Gerard Ingham
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Abstract

Background: The management of uncertainty is a core general practice skill best learnt in clinical practice.

Objective: This article outlines strategies a general practice supervisor can implement to help registrars acquire the skills of managing and coping with uncertainty.

Discussion: The medical education literature recommends supervisors being explicit about the different paradigm operating in primary care and normalising the existence and tolerance of uncertainty. Fundamental consultation skills used in the management of uncertainty should be demonstrated. These include shared decision making, safety netting and arranging follow-up. During teaching sessions, problem cases can be explored using Murtagh's diagnostic model to develop clinical reasoning and avoid missing important diagnoses. This paper introduces a model to explore uncertainty by considering management options, easily remembered as the '3Rs': review; refer; and Rx (treat). This model complements the diagnostic model and reflects that a general practitioner must still decide what to do when a diagnosis cannot be made.

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做或不做:教授在面对不确定性时决定做什么的技能。
背景:不确定性管理是临床实践中最好学习的核心全科技能。目的:本文概述了一般实践主管可以实施的策略,以帮助注册商获得管理和应对不确定性的技能。讨论:医学教育文献建议主管明确在初级保健中操作的不同范式,并使不确定性的存在和容忍正常化。应展示在管理不确定性方面所使用的基本协商技巧。其中包括共同决策、安全网和安排后续行动。在教学过程中,可以使用Murtagh的诊断模型来探索问题案例,以培养临床推理能力,避免遗漏重要诊断。本文介绍了一个模型,通过考虑管理选择来探索不确定性,很容易记住为“3r”:审查;参考;Rx(治疗)。这个模型是对诊断模型的补充,反映了全科医生在无法做出诊断时仍然必须决定该怎么做。
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来源期刊
Australian Journal of General Practice
Australian Journal of General Practice Medicine-Family Practice
CiteScore
2.80
自引率
4.50%
发文量
284
期刊介绍: The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.
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