Riegelman Richard K, Garr David R
George Washington University Medical Center, Washington, DC 20037, USA.
Acad Med. 2008 Apr;83(4):321-6. doi: 10.1097/ACM.0b013e318166abe7.
The Institute of Medicine has recommended that all undergraduates have access to public health education. An evidence-based public health framework including curricula such as "Public Health 101" and "Epidemiology 101" was recommended for all colleges and universities by arts and sciences, public health, and clinical health professions educators as part of the Consensus Conference on Undergraduate Public Health Education. These courses should foster critical thinking whereby students learn to broadly frame options, critically analyze data, and understand the uncertainties that remain. College-level competencies or learning outcomes in research literature reading, determinants of health, basic understanding of health care systems, and the synergies between health care and public health can provide preparation for medical education. Formally tested competencies could substitute for a growing list of prerequisite courses. Grounded in principles similar to those of evidence-based medicine, evidence-based public health includes problem description, causation, evidence-based recommendations for intervention, and implementation considering key issues of when, who, and how to intervene. Curriculum frameworks for structuring "Public Health 101" and "Epidemiology 101" are provided by the Consensus Conference that lay the foundation for teaching evidence-based public health as well as evidence-based medicine. Medical school preparation based on this foundation should enable the Clinical Prevention and Population Health Curriculum Framework, including the evidence base for practice and health systems and health policy, to be fully integrated into the four years of medical school. A faculty development program, curriculum guide, interest group, and clear student interest are facilitating rapid acceptance of the need for these curricula.
美国医学研究所建议所有本科生都能接受公共卫生教育。作为本科公共卫生教育共识会议的一部分，文理学院、公共卫生和临床健康专业的教育工作者建议所有高校采用基于证据的公共卫生框架，包括“公共卫生基础”和“流行病学基础”等课程。这些课程应培养批判性思维，使学生学会广泛地构建选项、批判性地分析数据，并理解仍然存在的不确定性。大学层面在研究文献阅读、健康决定因素、对医疗保健系统的基本理解以及医疗保健与公共卫生之间协同作用方面的能力或学习成果可为医学教育做好准备。经过正式测试的能力可以替代越来越多的先修课程。基于与循证医学相似的原则，循证公共卫生包括问题描述、因果关系、基于证据的干预建议以及考虑何时、何人以及如何干预等关键问题的实施。共识会议提供了构建“公共卫生基础”和“流行病学基础”的课程框架，为循证公共卫生以及循证医学的教学奠定了基础。基于这一基础的医学院校准备工作应能使临床预防和人群健康课程框架，包括实践、卫生系统和卫生政策的证据基础，全面融入医学院校的四年学习中。一个教师发展项目、课程指南、兴趣小组以及学生的明确兴趣正在促进对这些课程需求的迅速接受。
