Cauley K, Canfield A, Clasen C, Dobbins J, Hemphill S, Jaballas E, Walbroehl G
School of Medicine, Wright State University, Dayton, OH 45402, USA.
Educ Health (Abingdon). 2001;14(2):173-81. doi: 10.1080/13576280110057563.
Health professions education is directly effected by changes in health care service delivery and financing systems. In the United States, as the health care industry increasingly shifts to a market economy, service delivery venues are moving away from acute care facilities and into community-based settings. Additionally, there is increased emphasis on primary prevention programs, often provided in public health settings. For health professions programs that traditionally provide clinical training in hospitals and long-term care facilities, there are unique challenges associated with identifying new venues in order to insure that students are exposed to a wide variety of patients with a range of chronic to acute disease conditions. One set of tools that has demonstrated usefulness during these kinds of transitions is service learning. This teaching methodology emphasizes increased partnership with clinical training sites, extensive orientation to patient populations and community resources, structured reflection and instilling the ethic of service in future health care providers. Although this article describes utilization of service learning in the context of current conditions in the United States, we hope that the principles presented here can be readily adapted in any setting.
卫生专业教育直接受到医疗服务提供和融资系统变化的影响。在美国，随着医疗行业日益转向市场经济，服务提供场所正从急症护理设施转向社区环境。此外，人们越来越重视通常在公共卫生环境中提供的初级预防项目。对于传统上在医院和长期护理设施中提供临床培训的卫生专业项目而言，在确定新场所方面存在独特挑战，以确保学生接触到患有各种慢性至急性疾病的广泛患者群体。在这类转变过程中已证明有用的一组工具是服务学习。这种教学方法强调加强与临床培训地点的合作关系、对患者群体和社区资源进行广泛介绍、进行结构化反思以及向未来的医疗服务提供者灌输服务伦理。尽管本文描述了在美国当前情况下服务学习的应用，但我们希望这里提出的原则能在任何环境中轻松适用。
