Goldman Stuart
Harvard Medical School, Boston, Massachusetts 02115, USA.
Acad Med. 2009 Jul;84(7):927-34. doi: 10.1097/ACM.0b013e3181a8177b.
The author reviews the many forces that have driven contemporary medical education approaches to evaluation and places them in an adult learning theory context. After noting their strengths and limitations, the author looks to lessons learned from manufacturing on both efficacy and efficiency and explores how these can be applied to the process of trainee assessment in medical education.Building on this, the author describes the rationale for and development of the Educational Kanban (EK) at Children's Hospital Boston--specifically, how it was designed to integrate adult learning theory, Japanese manufacturing models, and educator observations into a unique form of teacher-student collaboration that allows for continuous improvement. It is a formative tool, built on the Accreditation Council for Graduate Medical Education's six core competencies, that guides educational efforts to optimize teaching and learning, promotes adult learner responsibility and efficacy, and takes advantage of the labor-intensive clinical educational setting. The author discusses how this model, which will be implemented in July 2009, will lead to training that is highly individualized, optimizes faculty and student educational efforts, and ultimately conserves faculty resources. A model EK is provided for general reference.The EK represents a novel approach to adult learning that will enhance educational effectiveness and efficiency and complement existing evaluative models. Described here in a specific graduate medical setting, it can readily be adapted and integrated into a wide range of undergraduate and graduate clinical educational environments.
作者回顾了推动当代医学教育评估方法的多种力量，并将其置于成人学习理论的背景下。在指出这些力量的优势和局限性后，作者借鉴了制造业在效能和效率方面的经验教训，并探讨如何将其应用于医学教育中的学员评估过程。在此基础上，作者描述了波士顿儿童医院教育看板（EK）的基本原理和发展过程——具体而言，它是如何设计的，旨在将成人学习理论、日本制造模式和教育工作者的观察结果整合到一种独特的师生合作形式中，以实现持续改进。它是一种形成性工具，基于毕业后医学教育认证委员会的六项核心能力构建，指导教育工作以优化教学，促进成人学习者的责任感和效能，并利用劳动密集型的临床教育环境。作者讨论了将于2009年7月实施的该模式将如何带来高度个性化的培训，优化教师和学生的教育工作，并最终节省教师资源。文中提供了一个EK示例供一般参考。EK代表了一种新颖的成人学习方法，将提高教育的有效性和效率，并补充现有的评估模式。本文在特定的毕业后医学环境中进行了描述，它可以很容易地进行调整并整合到广泛的本科和研究生临床教育环境中。
