Jones R, Higgs R, de Angelis C, Prideaux D
Guy's, King's and St Thomas' School of Medicine, London, UK.
Lancet. 2001 Mar 3;357(9257):699-703. doi: 10.1016/S0140-6736(00)04134-9.
The changing role of medicine in society and the growing expectations patients have of their doctors means that the content and delivery of medical curricula also have to change. The focus of health care has shifted from episodic care of individuals in hospitals to promotion of health in the community, and from paternalism and anecdotal care to negotiated management based on evidence of effectiveness and safety. Medical training is becoming more student centred, with an emphasis on active learning rather than on the passive acquisition of knowledge, and on the assessment of clinical competence rather than on the ability to retain and recall unrelated facts. Rigid educational programmes are giving way to more adaptable and flexible ones, in which student feedback and patient participation have increasingly important roles. The implementation of sustained innovation in medical education continues to present challenges, especially in terms of providing institutional and individual incentives. However, a continuously evolving, high quality medical education system is needed to assure the continued delivery of high quality medicine.
医学在社会中角色的转变以及患者对医生期望的不断提高，意味着医学课程的内容和授课方式也必须改变。医疗保健的重点已从医院中对个体的阶段性护理转向社区中的健康促进，从家长式和经验性护理转向基于有效性和安全性证据的协商式管理。医学培训正变得更加以学生为中心，强调主动学习而非被动获取知识，强调临床能力评估而非记忆和回忆无关事实的能力。僵化的教育计划正让位于更具适应性和灵活性的计划，在这些计划中，学生反馈和患者参与发挥着越来越重要的作用。医学教育持续创新的实施仍然面临挑战，尤其是在提供机构和个人激励方面。然而，需要一个不断发展的高质量医学教育系统来确保持续提供高质量的医疗服务。
