Marks S C
Department of Cell Biology, University of Massachusetts Medical School, Worcester 01655, USA.
Clin Anat. 2000;13(6):448-52. doi: 10.1002/1098-2353(2000)13:6<448::AID-CA10>3.0.CO;2-U.
The purposes of medical education can be summarized as learning how to take an effective history, perform a physical examination, and perform diagnostic and therapeutic procedures with minimal risk and maximal benefit to patients. Because patients are three-dimensional (3-D) objects, health care and medical education involve learning and applying 3-D information. The foundation begins in anatomy where students form and confirm or reform their own 3-D ideas and images of the development and structure of the human body at all levels of organization. Students go on to understand the interdependence of structure and function in health and disease. The basic questions for those teaching anatomy are "How do we learn and use 3-D information?" and "How is it taught most effectively?" These are not easy questions for teachers and are rarely asked by those who currently defend or reframe curricula. Unfortunately, there is little information on how we learn 3-D information and no evidence-based literature on the relative long-term vocational effectiveness of methods for teaching it. It is clear that we learn in several distinct modalities and that our students represent a spectrum of learning styles. To support the 3-D learning essential to both medical education and health care, anatomical societies need to provide answers to the following questions: Do the opportunities of dissection (visual, tactile, time, discovery, group process, mentoring) contribute to short- and long-term learning of 3-D information? If so, how? Does dissection offer significant advantages over other methods for learning, confirming, and using 3-D information in anatomy? Answers to these questions will provide a rational basis for decisions about curricular changes in anatomy courses (if, where, and when dissection should occur). This, in turn, will link these changes to society's ultimate purposes for medical education and health care rather than to the fiscal concerns of the businesses of health care and medical education, which is the current practice.
医学教育的目的可以概括为学习如何进行有效的病史采集、体格检查，以及实施诊断和治疗程序，同时将对患者的风险降至最低并使其受益最大化。由于患者是三维（3-D）个体，医疗保健和医学教育涉及学习和应用三维信息。这一基础始于解剖学，在那里学生形成并确认或重塑他们自己关于人体在各个组织层面的发育和结构的三维概念和图像。学生进而理解健康和疾病状态下结构与功能的相互依存关系。对于那些讲授解剖学的人来说，基本问题是“我们如何学习和使用三维信息？”以及“如何最有效地教授它？” 这些问题对教师而言并不容易，而目前捍卫或重新设计课程的人很少会问这些问题。不幸的是，关于我们如何学习三维信息的资料很少，也没有基于证据的文献探讨教授三维信息的方法在长期职业效能方面的相对优劣。显然，我们通过几种不同的方式学习，而且我们的学生代表了一系列的学习风格。为了支持医学教育和医疗保健所必需的三维学习，解剖学协会需要回答以下问题：解剖的机会（视觉、触觉、时间、发现、小组过程、指导）是否有助于三维信息的短期和长期学习？如果是，如何发挥作用？与其他学习、确认和使用解剖学三维信息的方法相比，解剖是否具有显著优势？这些问题的答案将为解剖学课程的课程改革决策（如果、在何处以及何时进行解剖）提供合理依据。反过来，这将把这些改革与社会对医学教育和医疗保健的最终目标联系起来，而不是像目前这样与医疗保健和医学教育行业的财政问题联系起来。
