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将医生培养成教师与治疗者、问题解决者与决策者。

Training physicians to be doctors--teachers and healers, problem-solvers and decision-makers.

作者信息

Farnsworth W E

机构信息

Chicago College of Osteopathic Medicine, IL.

出版信息

J Am Osteopath Assoc. 1991 Oct;91(10):1005-18.

PMID:1748581
Abstract

With the scientific advances made in medicine during the past 200 years, the training of physicians in America has changed from that of a mentor/apprenticeship relationship to one in which students are part of an impersonal, mass production process. From a historical perspective, it is contended that basic science and rote memorization of medical theory have subsumed the art of medicine. As a result, students are overloaded with irrelevant facts, few of which they carry over in their professional practice of medicine. To alter this teaching approach and, hence, the quality of physicians, medical school curricula should incorporate recommendations found in the General Professional Education of Physicians Report, among other sources. These recommendations, which have been incorporated successfully in the curriculum at the University of New Mexico School of Medicine, for example, include: establishing goals that may be coordinated interdepartmentally; reestablishing the physician/mentor for each student; using a small-group, interactive, problem-solving, clinically oriented approach to teaching; measuring each student's ability to not only retain knowledge but, more importantly, apply such information to actual clinical problem-solving and decision-making situations; admitting liberal arts graduates--not premedical students--to medical schools; and recruiting and training faculty members who have the time to each and the ability to emphasize biomedicine rather than their special discipline. These changes will make students more than physicians. They will be "real doctors," individuals who not only possess knowledge but can apply it in their daily practice of medicine.

摘要

随着过去200年医学领域取得的科学进步,美国医生的培养模式已从师徒/学徒关系转变为学生成为非个性化大规模生产过程一部分的模式。从历史角度来看,有人认为基础科学和医学理论的死记硬背已经取代了医学艺术。结果,学生们被无关紧要的事实所淹没,而在他们的医学专业实践中能记住的却寥寥无几。为了改变这种教学方法,进而提高医生的素质,医学院课程应纳入《医生一般专业教育报告》等资料中提出的建议。例如,这些建议已成功纳入新墨西哥大学医学院的课程,包括:制定可跨部门协调的目标;为每个学生重新配备医生导师;采用小组互动、解决问题、以临床为导向的教学方法;衡量每个学生不仅保留知识的能力,更重要的是,将这些信息应用于实际临床问题解决和决策情况的能力;录取文科毕业生而非医学预科学生进入医学院;招聘和培训有时间授课且有能力强调生物医学而非其特定学科的教师。这些改变将使学生不仅仅成为医生。他们将成为“真正的医生”,即不仅拥有知识,还能在日常医疗实践中应用知识的人。

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