Stearns Jeffrey A, Stearns Marjorie A, Paulman Paul M, Chessman Alexander W, Davis Ardis K, Sherwood Roger A, Sheets Kent J, Steele David J, Matson Christine C
Department of Family Medicine, University of Wisconsin, Milwaukee 53233, USA.
Fam Med. 2007 Jan;39(1):53-6.
Under contract to the Health Resources and Services Administration (HRSA), the Society of Teachers of Family Medicine (STFM) created an undergraduate medical education curricular resource designed to train physicians to practice in the 21st century. An interdisciplinary group of more than 35 educators worked for 4 years to create the Family Medicine Curriculum Resource (FMCR). By consensus, the Accreditation Council for Graduate Medical Education (ACGME) competencies were adopted as the theoretical framework for this project. The FMCR provides materials for the preclerkship years, the third-year family medicine clerkship, the postclerkship year, and faculty development, as well as guidance for integrating topics of special interest to the federal government (such as, geriatrics, Healthy People 2010, genetics, informatics) into a 4-year continuum of medical education. There are challenges inherent in implementing each component of the FMCR. For example, can the ACGME competency-based approach be adapted to undergraduate medical education? Can the densely packed preclerkship years be adapted to include more focused effort on developing these competencies, and whose job is it anyway? What is "core" to being a competent clinician, and what information can be obtained when needed from medical informatics sources? Will family medicine educators embrace the FMCR recommendations for their third-year clerkships? Will exit assessment of the competency levels of graduating medical students be achieved, and can it make them more capable residents? Can faculty in different clinical and educational settings integrate the teaching of "how to learn" into their repertoire? How will faculty development innovation progress in a time of increasing emphasis on clinical productivity? Developing a common language and adoption of core competencies for all levels of medical education is imperative in a society that is focusing on improving health care quality and outcomes. The FMCR Project has developed a curricular resource to assist medical educators in this task. The challenge for the future is to measure how the FMCR is used and to ascertain if it has an influence on better patient and system outcomes.
根据与卫生资源与服务管理局(HRSA)签订的合同,家庭医学教师协会(STFM)创建了一个本科医学教育课程资源,旨在培养能在21世纪行医的医生。一个由35多名教育工作者组成的跨学科团队花了4年时间创建了家庭医学课程资源(FMCR)。经协商一致,毕业后医学教育认证委员会(ACGME)的能力标准被用作该项目的理论框架。FMCR提供了临床前几年、三年级家庭医学实习、实习后一年以及教师发展的相关材料,还为将联邦政府特别关注的主题(如老年医学、《健康人民2010》、遗传学、信息学)融入四年连贯的医学教育提供了指导。实施FMCR的每个组成部分都存在一些固有挑战。例如,基于ACGME能力标准的方法能否适用于本科医学教育?临床前几年课程紧凑,能否进行调整以便更有针对性地培养这些能力,而这到底是谁的工作?成为一名合格临床医生的“核心”是什么,以及在需要时从医学信息学来源能获取哪些信息?家庭医学教育工作者会接受FMCR对其三年级实习的建议吗?能否实现对毕业医学生能力水平的结业评估,以及这能否使他们成为更有能力的住院医生?不同临床和教育环境中的教师能否将“如何学习”的教学纳入其教学内容?在越来越强调临床生产力的时代,教师发展创新将如何推进?在一个致力于提高医疗质量和成果的社会中,为各级医学教育制定通用语言并采用核心能力标准势在必行。FMCR项目已开发出一种课程资源来协助医学教育工作者完成这项任务。未来的挑战是衡量FMCR的使用情况,并确定它是否对改善患者和系统结果产生影响。