Steele D, Steyer T, Nowalk A
Year 1 Curriculum Director, College of Medicine, University of Nebraska Medical Center, 983075 Nebraska Medical Center, Omaha, NE 68198-3075, USA.
Acad Med. 2001 Apr;76(4 Suppl):S61-7. doi: 10.1097/00001888-200104001-00012.
There was student and faculty backlash against the Interdisciplinary Generalist Curriculum (IGC) Project innovations at all ten schools involved. Students may react strongly to requirements and experiences they find onerous, and often reacted to being "preached at" and being told what they should value and believe. Backlash was not limited to students. A complaint heard in virtually all schools was that the basic science faculty barely had enough time to adequately cover their topics as it was, and now they were being asked to give up time for clinical experiences and topics. Despite the backlash, the authors point out that the vast majority of students endorsed the value of the preceptorship experience and that reaction to the IGC Project did not necessarily translate into negative perceptions of primary care medicine. Each IGC Project school made strategic decisions in response to backlash. Among the various efforts undertaken were enhanced communication and clarification, persistence and "watchful waiting," programmatic changes, and elimination of program components that were not working. These various efforts appear to have paid off, as most schools reported that backlash diminished over time. Lessons learned about backlash against new curricular innovations were that (1) backlash, however defined, is inevitable; (2) communication, coordination, and cooperation are essential; (3) flexibility, compromise, and willingness to change are essential; and (4) "watchful waiting" can be an effective response to some forms of backlash.
在所有参与的十所学校中，学生和教师都对跨学科通才课程（IGC）项目的创新举措产生了抵触情绪。学生可能会对他们认为繁重的要求和经历做出强烈反应，并且常常对被“说教”以及被告知应该重视和相信什么而产生抵触。抵触情绪并不局限于学生。几乎在所有学校都能听到的一种抱怨是，基础科学教师原本就几乎没有足够的时间充分讲授他们的课程内容，而现在又被要求抽出时间用于临床实习和相关主题。尽管存在抵触情绪，但作者指出，绝大多数学生认可导师指导经历的价值，并且对IGC项目的反应并不一定转化为对初级保健医学的负面看法。每所IGC项目学校都针对抵触情绪做出了战略决策。所采取的各种措施包括加强沟通与阐释、坚持和“静观其变”、课程调整，以及取消不起作用的课程组成部分。这些各种努力似乎已经取得了成效，因为大多数学校报告称，随着时间的推移，抵触情绪有所减少。关于对新课程创新举措产生抵触情绪所吸取的教训是：（1）无论如何定义，抵触情绪都是不可避免的；（2）沟通、协调与合作至关重要；（3）灵活性、妥协和愿意改变至关重要；（4）“静观其变”可能是应对某些形式抵触情绪的有效对策。
