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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Vestnik dermatologii i venerologii</journal-id><journal-title-group><journal-title xml:lang="en">Vestnik dermatologii i venerologii</journal-title><trans-title-group xml:lang="ru"><trans-title>Вестник дерматологии и венерологии</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0042-4609</issn><issn publication-format="electronic">2313-6294</issn><publisher><publisher-name xml:lang="en">Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">16793</article-id><article-id pub-id-type="doi">10.25208/vdv16793</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>GUIDELINES FOR PRACTITIONERS</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>В ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">A difficult patient and a complicated diagnosis: gnoseological and didactic issues</article-title><trans-title-group xml:lang="ru"><trans-title>Сложный пациент и трудный диагноз: гносеологические и дидактические вопросы</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7610-6061</contrib-id><contrib-id contrib-id-type="scopus">23669241000</contrib-id><contrib-id contrib-id-type="researcherid">AAL-7772-2020</contrib-id><contrib-id contrib-id-type="spin">6807-7137</contrib-id><name-alternatives><name xml:lang="en"><surname>Sokolovskiy</surname><given-names>Evgeny V.</given-names></name><name xml:lang="ru"><surname>Соколовский</surname><given-names>Евгений Владиславович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор</p></bio><email>s40@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2539-8639</contrib-id><contrib-id contrib-id-type="spin">2988-6310</contrib-id><name-alternatives><name xml:lang="en"><surname>Telnyuk</surname><given-names>Irina V.</given-names></name><name xml:lang="ru"><surname>Тельнюк</surname><given-names>Ирина Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Ped.), Assistant Professor</p></bio><bio xml:lang="ru"><p>кандидат пед. наук, доцент</p></bio><email>itelnuk@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6378-8582</contrib-id><contrib-id contrib-id-type="scopus">56730990100</contrib-id><contrib-id contrib-id-type="researcherid">AAL-7963-2020</contrib-id><contrib-id contrib-id-type="spin">9094-9688</contrib-id><name-alternatives><name xml:lang="en"><surname>Araviiskaia</surname><given-names>Elena R.</given-names></name><name xml:lang="ru"><surname>Аравийская</surname><given-names>Елена Роальдовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор</p></bio><email>arelenar@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8211-1665</contrib-id><contrib-id contrib-id-type="spin">1837-2098</contrib-id><name-alternatives><name xml:lang="en"><surname>Monakhov</surname><given-names>Konstantin N.</given-names></name><name xml:lang="ru"><surname>Монахов</surname><given-names>Константин Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор</p></bio><email>knmonakhov@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8670-7223</contrib-id><contrib-id contrib-id-type="scopus">55535994400</contrib-id><contrib-id contrib-id-type="spin">4377-8101</contrib-id><name-alternatives><name xml:lang="en"><surname>Khobeysh</surname><given-names>Marianna M.</given-names></name><name xml:lang="ru"><surname>Хобейш</surname><given-names>Марианна Михайловна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Assistant Professor</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, доцент</p></bio><email>mkhobeysh@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2278-5393</contrib-id><contrib-id contrib-id-type="scopus">23390046900</contrib-id><contrib-id contrib-id-type="researcherid">T-5370-2018</contrib-id><contrib-id contrib-id-type="spin">1214-8876</contrib-id><name-alternatives><name xml:lang="en"><surname>Krasnoselskikh</surname><given-names>Tatiana V.</given-names></name><name xml:lang="ru"><surname>Красносельских</surname><given-names>Татьяна Валерьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>доктор медицинских наук, профессор</p></bio><email>tatiana.krasnoselskikh@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Academician I.P. Pavlov First Saint Petersburg State Medical University</institution></aff><aff><institution xml:lang="ru">Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Saint Petersburg Research Institute of Pedagogics and Psychology of Higher Education</institution></aff><aff><institution xml:lang="ru">Санкт-Петербургский научно-исследовательский институт педагогики и психологии высшего образования</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2024-07-28" publication-format="electronic"><day>28</day><month>07</month><year>2024</year></pub-date><pub-date date-type="pub" iso-8601-date="2024-08-26" publication-format="electronic"><day>26</day><month>08</month><year>2024</year></pub-date><volume>100</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>78</fpage><lpage>84</lpage><history><date date-type="received" iso-8601-date="2024-05-25"><day>25</day><month>05</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2024-07-13"><day>13</day><month>07</month><year>2024</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Sokolovskiy E.V., Telnyuk I.V., Araviiskaia E.R., Monakhov K.N., Khobeysh M.M., Krasnoselskikh T.V.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2024, Соколовский Е.В., Тельнюк И.В., Аравийская Е.Р., Монахов К.Н., Хобейш М.М., Красносельских Т.В.</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Sokolovskiy E.V., Telnyuk I.V., Araviiskaia E.R., Monakhov K.N., Khobeysh M.M., Krasnoselskikh T.V.</copyright-holder><copyright-holder xml:lang="ru">Соколовский Е.В., Тельнюк И.В., Аравийская Е.Р., Монахов К.Н., Хобейш М.М., Красносельских Т.В.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://vestnikdv.ru/jour/article/view/16793">https://vestnikdv.ru/jour/article/view/16793</self-uri><abstract xml:lang="en"><p>The ability and skills of clinical diagnostics are formed not only during training at a medical school, but subsequently in the clinical practice of each physician. During the process of education, there are often cases of contradictions, didactic errors in methods of presenting information, and difficulties in students acquiring knowledge, skills and abilities. The article discusses the reasons leading to the formation of the concepts of «difficult patient» and «complicated diagnosis» among dermatologists. The philosophical and psychological categories of a physician’s work are discussed, as well as possible problems of introducing artificial intelligence into the practical work of a physician.</p></abstract><trans-abstract xml:lang="ru"><p>Умение и навыки клинической диагностики формируются не только в процессе обучения в медицинском вузе, но и в дальнейшем в условиях клинической практики каждого врача. В процессе получения знаний нередки случаи противоречий, дидактических ошибок приемов подачи информации, сложности в обретении обучающимися знаний, навыков и умений. В статье рассматриваются причины, приводящие к формированию у врачей-дерматологов понятий «сложный пациент» и «трудный диагноз». Обсуждаются философские и психологические категории работы врача, возможные проблемы внедрения искусственного интеллекта в его практику.</p></trans-abstract><kwd-group xml:lang="en"><kwd>patient</kwd><kwd>diagnosis</kwd><kwd>medical education</kwd><kwd>psychology</kwd><kwd>artificial intelligence</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>пациент</kwd><kwd>диагноз</kwd><kwd>медицинское образование</kwd><kwd>психология</kwd><kwd>искусственный интеллект</kwd></kwd-group><funding-group><funding-statement xml:lang="en">Academician I.P. Pavlov First Saint Petersburg State Medical University, Saint Petersburg Research Institute of Pedagogics and Psychology of Higher Education</funding-statement><funding-statement xml:lang="ru">Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, Санкт-Петербургский научно-исследовательский институт педагогики и психологии высшего образования</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Тельнюк И.В. Роль педагогики в повышении квалификации врачей на этапе постдипломного обучения. Человек и образование. 2013;37(4):63–65. [Telnyuk IV. The role of pedagogy in improving the qualifications of doctors at the stage of postgraduate education. Man and education. 2013;37(4):63–65. (In Russ.)] URL: https://www.elibrary.ru/item.asp?id=21057100</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Худик В.А., Тельнюк И.В. Вопросы психологии и педагогики учебного процесса в медицинском вузе: учеб. пособие для преподавателей медицинского вуза. СПбГМУ; 2011. 105 с. [Khudik VA., Telnyuk IV. Issues of psychology and pedagogy of the educational process at a medical university: a textbook for teachers of a medical university. 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