Wilson M, Kahn N, Wartman S
Department of Committees and Sections, American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098, USA.
Acad Med. 2001 Apr;76(4 Suppl):S19-25. doi: 10.1097/00001888-200104001-00006.
Implementation of the Interdisciplinary Generalist Curriculum (IGC) Project involved complex processes that reflect structural, funding, and intervention design considerations. Among structural considerations, the IGC Project benefited from a national structure above the level of the demonstration schools. Governance by committee was highly effective because it harnessed and balanced power. At the national level, governance by committee was enhanced by strong central coordination, and it had a role-modeling effect for governance at the school level. The IGC experience over the seven-year course of the project suggests that it is important to revisit the role of a national advisory committee over time and to revise that role as warranted. Funding considerations, including the importance of funding evaluation for a period of time long enough to measure intended impacts and the length and amount of funding to demonstration schools, are discussed. Prescription of the IGC intervention and the focus on years one and two of medical education are critical design considerations. The authors conclude that the IGC Project used relatively few federal dollars to demonstrate a highly prescribed intervention in a limited number of medical schools toward a clear and limited goal. IGC lessons apply to programs specifically targeting primary care education, but also to other medical school curricular innovations, and perhaps, to a larger framework of multi-site educational interventions.
跨学科通才课程（IGC）项目的实施涉及复杂的过程，这些过程反映了结构、资金和干预设计等方面的考量。在结构方面，IGC项目受益于示范学校层面之上的国家架构。委员会治理非常有效，因为它能够驾驭和平衡权力。在国家层面，强有力的中央协调加强了委员会治理，并且对学校层面的治理起到了示范作用。该项目七年的实施经验表明，随着时间的推移重新审视国家咨询委员会的作用并在必要时进行修订很重要。文中讨论了资金方面的考量，包括进行足够长时间的资金评估以衡量预期影响的重要性，以及向示范学校提供资金的时长和金额。IGC干预措施的规定以及对医学教育第一年和第二年的关注是关键的设计考量因素。作者得出结论，IGC项目使用了相对较少的联邦资金，在少数医学院针对明确且有限的目标进行了高度规定性的干预。IGC的经验不仅适用于专门针对初级保健教育的项目，也适用于其他医学院课程创新，甚至可能适用于更大的多地点教育干预框架。
