O'Neill P A, Metcalfe D, David T J
Department of Geriatric Medicine, University of Manchester, UK.
Med Educ. 1999 Feb;33(2):121-9. doi: 10.1046/j.1365-2923.1999.00342.x.
To identify the core content for the new undergraduate medical curriculum in Manchester.
The initial step was to produce a list of 'index clinical situations' (ICSs), for which a newly graduated doctor must have a required level of competence. Using repeated consultation with consultants and general practitioners involved in medical education in the North-West of England, a list of 215 ICSs was agreed. Specialists and generalists were then asked to identify the components of the knowledge base and the performance (skills) base for each ICS. The knowledge base was divided into technical (biomedical facts/concepts) and contextual (effect/management of disease within the individual, family and society) domains. The performance base was divided into intellectual (problem solving and decision making) and interpersonal (history, examination, communication and procedural skills) domains.
Forty specialties were consulted and 11,021 items (defined as a piece of knowledge, a concept or a skill) were identified. There was considerable overlap in the items listed, such that when the returns for each ICS were amalgamated, the 215 ICSs contained 6434 items with a mean of 34 +/- 14.2 per situation (range 6-85). UTILISATION: We have used the defined ICSs in the design of the trigger material used in the weekly problem-based learning sessions. Over 4 years almost all (207/215, 96%) of the ICS are covered, with many being revisited at several points in the curriculum.
确定曼彻斯特新的本科医学课程的核心内容。
第一步是列出“索引临床情况”(ICSs)清单,新毕业的医生必须具备达到规定水平的能力。通过与英格兰西北部参与医学教育的顾问和全科医生反复协商,确定了一份包含215种ICSs的清单。然后要求专科医生和全科医生确定每种ICSs的知识库和表现(技能)库的组成部分。知识库分为技术(生物医学事实/概念)和背景(个体、家庭和社会层面疾病的影响/管理)领域。表现库分为智力(解决问题和决策)和人际(病史采集、检查、沟通和操作技能)领域。
咨询了40个专业,确定了11021项内容(定义为一条知识、一个概念或一项技能)。列出的项目有相当多的重叠,因此当合并每种ICSs的反馈时,215种ICSs包含6434项内容,每种情况平均34±14.2项(范围6 - 85项)。应用:我们已将确定的ICSs用于每周基于问题的学习课程中使用的触发材料的设计。在4年多的时间里,几乎涵盖了所有(207/215,96%)的ICSs,许多内容在课程的多个阶段被反复提及。