Phillips Susan P
Departments of Family Medicine & Community Health Epidemiology, Queen's University, Kingston, Canada.
Med Teach. 2008;30(7):705-9. doi: 10.1080/01421590802061134.
The universal goal of medical education is to train excellent physicians, able to maintain the health of individuals and communities. The route to achieving this goal has shifted over time. This paper describes the absolutes and ambiguities of philosophical vision, responsiveness to stakeholders, curriculum content and delivery, and assessment of trainees and training programs across much of the developed world.
Traditional medical education is content focused and organized by organ systems. Newer curricula, informed by current learning theories, emphasize a competencies based approach, with clinical scenarios at the centre of teaching and assessment of students. Associated with this is a shift from the in-depth knowledge of the specialist to a 'what must a generalist know' approach. These models are explored as are options for curriculum delivery, input from governments, students, the public and faculty, and methods and importance of accreditation.
The goals and the process of training physicians to achieve these exhibit numerous commonalities across time and place throughout the developed world while still allowing for cultural or national adaptations. All models and content aim for minimum basic knowledge, while emphasizing communication skills, cultural awareness and professionalism amongst future physicians.
医学教育的普遍目标是培养优秀的医生,使其能够维护个人和社区的健康。实现这一目标的途径随时间而变化。本文描述了在许多发达国家,哲学愿景的确定性与模糊性、对利益相关者的响应、课程内容与授课方式,以及对学员和培训项目的评估。
传统医学教育以内容为重点,按器官系统进行组织。受当前学习理论影响的新的课程体系强调基于能力的方法,以临床情景为学生教学和评估的核心。与此相关的是,从对专科医生的深入知识要求转向“通才必须知道什么”的方法。本文探讨了这些模式以及课程授课方式的选择、政府、学生、公众和教师的投入,以及认证的方法和重要性。
在发达国家,培养医生以实现这些目标的过程和目标在不同时间和地点展现出众多共性,同时仍允许文化或国家层面的调整。所有模式和内容都以最低基础知识为目标,同时强调未来医生的沟通技巧、文化意识和专业素养。