Urschel J D, Urschel D M, Mannella S M, Antkowiak J G, Horan T A, Bennett W F
Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Ann Thorac Surg. 2001 Jan;71(1):337-9. doi: 10.1016/s0003-4975(00)02331-6.
Medical knowledge changes rapidly, so current medical education approaches emphasize the development of life-long learning skills ("teaching the learner to learn") as opposed to the simple acquisition of contemporary medical knowledge. Because there are no data on the rapidity of change of general thoracic surgical knowledge, we do not know whether this trend in medical education is appropriate for thoracic surgical trainees. We undertook a study to assess the duration of knowledge in general thoracic surgery.
The first general thoracic surgery article from each issue of The Annals of Thoracic Surgery between 1965 and 1997 was abstracted into a summary statement. A form, made up of 360 summary statements in random order, was assessed by 6 general thoracic surgeons. They assessed statement validity on a 5-point scale (1 = statement false; 5 = statement true). Average statement validity scores for 30 time intervals were calculated. The relationship between time of publication and statement validity was analyzed.
Average validity scores ranged from 2.24 (represents 1965 to 1966) to 4.32 (represents 1969 to 1970). Validity scores increased with time (y = 3.46 + 0.017x, where y is validity score and x is time), and this was significant (r = 0.40; p = 0.027). However, the absolute change in average validity scores over the 33-year study period was only 0.52 or 13.1% of the "modern" era scores.
The assumption that medical knowledge changes quickly may not be true in general thoracic surgery. Although life-long learning skills are important, general thoracic surgery training programs should continue to emphasize fundamental knowledge in the specialty.
医学知识更新迅速，因此当前的医学教育方法强调培养终身学习技能（“教会学习者如何学习”），而非单纯获取当代医学知识。由于尚无关于普通胸外科知识更新速度的数据，我们并不清楚医学教育中的这一趋势是否适用于胸外科住院医师。我们开展了一项研究，以评估普通胸外科知识的有效期。
将1965年至1997年期间《胸外科年鉴》每期的第一篇普通胸外科文章提炼成总结陈述。由6位普通胸外科医生对一份由360条随机排列的总结陈述组成的表格进行评估。他们根据5分制（1 = 陈述错误；5 = 陈述正确）对陈述的有效性进行评分。计算30个时间间隔的平均陈述有效性得分。分析发表时间与陈述有效性之间的关系。
平均有效性得分范围为2.24（代表1965年至1966年）至4.32（代表1969年至1970年）。有效性得分随时间增加（y = 3.46 + 0.017x，其中y为有效性得分，x为时间），且具有显著性（r = 0.40；p = 0.027）。然而，在33年的研究期内，平均有效性得分的绝对变化仅为0.52，即“现代”时期得分的13.1%。
医学知识变化迅速这一假设在普通胸外科可能并不成立。虽然终身学习技能很重要，但普通胸外科培训项目应继续强调该专业的基础知识。
