Irby David M, Cooke Molly, Lowenstein Daniel, Richards Boyd
Office of Medical Education, School of Medicine, University of California, San Francisco, 521 Parnassus Avenue, Room C-254, San Francisco, CA 94143-0410, USA.
Acad Med. 2004 Aug;79(8):729-36. doi: 10.1097/00001888-200408000-00003.
Despite its fundamental importance, the educational mission of most medical schools receives far less recognition and support than do the missions of research and patient care. This disparity is based, in part, on the predominance of discipline-based departments, which focus on the more sustainable enterprises of research and patient care. Where departmental teaching is emphasized, it tends to center on trainees directly associated with the department-leaving medical students unsupported. The authors argue that the ongoing erosion of the educational mission will never be reversed unless there are changes in the underlying structure of medical schools. Academies of medical educators are developing at a number of medical schools to advance the school-wide mission of education. The authors describe and compare key features of such organizations at eight medical schools, identified through an informal survey of the Society of Directors of Research in Medical Education, along with direct contacts with specific schools. Although these entities are relatively new, initial assessments suggest that they have already had a major impact on the recognition of teaching efforts by the faculty, fueled curricular reform, promoted educational scholarship, and garnered new resources to support teaching. The academy movement, as a structural approach to change, shows promise for reinvigorating the educational mission of academic medicine.
尽管医学教育使命至关重要,但与研究使命和患者护理使命相比,大多数医学院的教育使命所获得的认可和支持要少得多。这种差距部分源于以学科为基础的院系占主导地位,这些院系专注于更具可持续性的研究和患者护理事业。在强调院系教学的地方,教学往往以与该系直接相关的学员为中心,而让医学生得不到支持。作者认为,除非医学院的基础结构发生变化,否则教育使命的持续削弱将永远无法扭转。一些医学院正在发展医学教育学院,以推进全校范围的教育使命。作者描述并比较了八所医学院这类组织的关键特征,这些特征是通过对医学教育研究主任协会的非正式调查以及与特定学校的直接联系确定的。尽管这些实体相对较新,但初步评估表明,它们已经对教师教学工作的认可度产生了重大影响,推动了课程改革,促进了教育学术研究,并获得了新的资源来支持教学。作为一种结构性变革方法,学院运动有望重振学术医学的教育使命。