基于科学引文数据库的临床思维研究分析

Analysis of the current status and development trend of clinical thinking research based on web of science

目的检索基于科学引文数据库(Web of Science,WOS)的临床思维研究文献,描绘其外部特征并揭示其研究主题,为我国临床思维教学与评价改革提供参考。方法采用HistCite文献计量分析软件,以WOS核心合集中从数据库建立到2022年12月31日相关文献为研究对象,以“clinical thinking”或“clinical reasoning”为检索主题词,对数据库中相关文章数量、机构分布、研究方向与前沿主题等进行分析,梳理临床思维研究总体态势。结果共检索到3094篇文献,临床思维研究的发文量可以大致划分为3个发展阶段:起步期(1966至1990年,年发文量维持在个位数)、上升期(1991至2011年,年发文量在50至100篇)、陡升期(2012年至今,2022年发文量达341篇)。发文量排在第一的机构是加拿大蒙特利尔大学,共发表80篇。高频关键词有教学(teaching)、一致性(concordance)和脚本(script)等。研究前沿主题集中于临床思维的本质,对临床思维的评估和如何开展临床思维教学这3个方面,出现对普适性指南制定的呼吁。结论临床思维研究发文量不断增长,中国发文量较低;发文机构多集中于英美两国,研究内容多集中在对临床思维综合性分析和思考,实证研究不足;逐步出现对脚本、教学和评价等专题的研究。未来我国应该重视对临床思维的理论研究,重点关注构建临床思维的教学和评价体系、新兴技术在临床思维的应用以及制定普适性的指南与规范,并提高研究的国际展示度及影响力。

Objective To explore the current status and development trend of clinical thinking research based on Web of Science(WOS).Methods Using the HistCite software,the literature from the WOS database established up to December 31,2022 is taken as the research object.″Clinical thinking″or″clinical reasoning″are used as search keywords to analyze the number of related articles in the database,institutional distribution,research directions,and frontier topics,in order to outline the overall trend of research on clinical thinking.Results A total of 3,094 articles were retrieved.The research on clinical thinking can be roughly divided into three development stages:an initial stage(1966 to 1990,with an annual publication volume in single digits),a rising stage(1991 to 2011,with an annual publication volume between 50 and 100),and a steep rise stage(2012 to the present,with 341 articles published in 2022).The institution with the highest number of publications is McGill University in Canada,with the number of 80.High-frequency keywords include teaching,concordance,and script.The forefront topics of research are focused on the nature of clinical thinking,assessment of clinical thinking,and how to conduct clinical thinking teaching,with calls for the formulation of universal guidelines.Conclusions The volume of publications on clinical thinking research continues to grow.China has a low publication volume,with most publications coming from institutions in the United Kingdom and the United States.Research content mainly focuses on comprehensive analysis and reflection on clinical thinking,with insufficient empirical research.Specialized studies on scripts,teaching,and evaluation are gradually emerging.In the future,China should focus on theoretical research on clinical thinking,with emphasis on building teaching and evaluation systems for clinical thinking,as well as the application of emerging technologies in clinical thinking and the formulation of universal guidelines and standards.Additionally,efforts should be made to increase the international visibility and impact of research.