Howe Amanda
University of East Anglia, Norwich, UK.
Med Educ. 2002 Apr;36(4):353-9. doi: 10.1046/j.1365-2923.2002.01168.x.
One of the most pressing requirements for contemporary medical education is to develop a framework for theory and practice of professional development which results in the attainment of professional competencies suitably robust for a lifetime's practice. The proposed content of a professional development curriculum may be reasonably straightforward to establish from policy documents and public expectations, but the process of achieving the desired outcomes is more complex, because professional development is largely based on attitudinal learning. Attitudes are at the interface between the personal and public psyche, relying more on individual experience and the accumulated impact of social and cultural interpretations than on propositional knowledge, and are therefore less amenable to factual or didactic teaching.
The purpose of this discussion paper is to develop thinking on the conceptual frameworks which need to underpin curriculum decision-making for professional development, especially in undergraduate medical training where models of good practice are less well-established. It brings together work from educational, sociological and psychological perspectives to elucidate the key principles which are most likely to result in acquisition of desirable professional attributes.
The literature suggests that successful professional development needs to be based on explicit values, which are repeatedly demonstrated in the learning environment, and modelled by senior colleagues and tutors; that the curriculum should incorporate a clear model of emotional as well as cognitive development; should be a major component of summative assessment; and needs to include formative mentorship at all stages of training.
当代医学教育最迫切的要求之一是建立一个专业发展的理论与实践框架,以培养出足以支撑终身行医的专业能力。从政策文件和公众期望出发,制定专业发展课程的提议内容或许相对直接,但要实现预期成果的过程则更为复杂,因为专业发展很大程度上基于态度学习。态度处于个人与公众心理的交汇点,更多依赖个人经历以及社会和文化解读的累积影响,而非命题知识,因此较难通过事实性或说教式教学来培养。
本讨论文件的目的是深入思考那些支撑专业发展课程决策的概念框架,尤其是在本科医学培训中,因为良好实践模式尚不完善。它整合了教育、社会学和心理学等方面的研究成果,以阐明最有可能促使学生获得理想专业素养的关键原则。
文献表明,成功的专业发展需要基于明确的价值观,这些价值观要在学习环境中反复体现,并由资深同事和导师示范;课程应包含情感和认知发展的清晰模式;应成为总结性评估的主要组成部分;并且在培训的各个阶段都需要有形成性指导。