Weeks W B, Robinson J L, Brooks W B, Batalden P B
Department of Family and Community Medicine, Dartmouth Medical School, Hanover, New Hampshire, USA.
Acad Med. 2000 Jan;75(1):81-4. doi: 10.1097/00001888-200001000-00020.
Health care providers are delivering care in an increasingly complex environment; this requires that providers develop new competencies to better understand their work and to design changes that can help them succeed. Recognizing these new educational requirements, Dartmouth Medical School created a model two-pronged program for teaching quality improvement to its medical students. The goal of the program is to provide students with an active learning experience as well as an education in the theory and application of continuous quality improvement. The program includes two educational experiences: one curriculum is for all medical students and the other is for selected, highly motivated students. The first curriculum is incorporated in Dartmouth's required "On Doctoring" course, in which students spend time with community-based physician preceptors. The quality-improvement curriculum is designed around an improvement project developed at the students' preceptor sites. The second curriculum for students with a special interest in quality improvement is offered as an elective summer program between the first and second years of medical school. Working in groups of two, students identify an area for improvement within a preceptor's practice, assist the practice in articulating an improvement plan, help implement that plan, and write up their experiences. The authors describe the two curricula, factors associated with their successful implementation, and lessons learned.
医疗服务提供者正在一个日益复杂的环境中提供护理；这就要求他们培养新的能力，以便更好地理解自己的工作，并设计有助于他们取得成功的变革。认识到这些新的教育要求，达特茅斯医学院为其医学生创建了一个双管齐下的教学质量改进示范项目。该项目的目标是为学生提供积极的学习体验以及持续质量改进理论与应用方面的教育。该项目包括两种教育体验：一种课程面向所有医学生，另一种面向经过挑选、积极性很高的学生。第一个课程纳入了达特茅斯医学院的必修课程“行医之道”，学生们在该课程中与社区医生带教老师一起学习。质量改进课程是围绕在学生带教老师所在机构开展的一个改进项目设计的。第二个课程面向对质量改进特别感兴趣的学生，作为医学院第一年和第二年之间的暑期选修课程提供。学生两人一组，在带教老师的诊所内确定一个有待改进的领域，协助诊所制定改进计划，帮助实施该计划，并撰写他们的经历。作者描述了这两种课程、与它们成功实施相关的因素以及所吸取的经验教训。
