Quill Timothy E, Dannefer Elaine, Markakis Kathryn, Epstein Ronald, Greenlaw Jane, McGrail Kathy, Milella Maria
Palliative Care Program, University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York 14642, USA.
J Palliat Med. 2003 Jun;6(3):365-80. doi: 10.1089/109662103322144682.
In 1996 the University of Rochester School of Medicine, Rochester, New York, began a major curricular reform called the Double Helix Curriculum, integrating basic science and clinical training over 4 years of medical school. This transition provided a unique opportunity to develop and implement a fully integrated, comprehensive palliative care curriculum. In this three-part paper, we will describe: (1) our process of finding curricular time, setting priorities, and deciding on pedagogical strategies; (2) an overview of how palliative care teaching was integrated into the general curriculum, including examples of different teaching opportunities; and (3) our evaluation process, and some ongoing challenges. Because palliative care is a core element in the care of all seriously ill patients, we chose to integrate our teaching into multiple courses over 4 years of undergraduate medical education, and not isolate it in a particular course. We view this report not as an ideal curriculum to be emulated in its entirety but as a work in progress that may be somewhat unique to our institution. We intend to illustrate a process of incremental curriculum building, and to generate some fresh teaching ideas from which palliative care educators can select depending on their own curricular needs and objectives.
1996年，纽约罗切斯特大学医学院启动了一项名为“双螺旋课程”的重大课程改革，在医学院的四年学习中整合基础科学与临床培训。这一转变为开发和实施一门完全整合的、全面的姑息治疗课程提供了独特的机会。在这篇分三部分的论文中，我们将描述：（1）我们寻找课程时间、确定优先事项以及决定教学策略的过程；（2）姑息治疗教学如何融入总体课程的概述，包括不同教学机会的示例；（3）我们的评估过程以及一些持续存在的挑战。由于姑息治疗是所有重症患者护理的核心要素，我们选择在本科医学教育的四年中将教学融入多门课程，而不是将其孤立于某一特定课程。我们认为这份报告并非一份可供完全效仿的理想课程，而是一项仍在进行中的工作，可能在我们机构中具有一定独特性。我们旨在阐述一个逐步构建课程的过程，并产生一些新的教学理念，姑息治疗教育工作者可根据自身课程需求和目标从中进行选择。
