Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California 94143-1732, USA.
Acad Med. 2010 Feb;85(2):310-7. doi: 10.1097/ACM.0b013e3181c887f7.
In his 1910 report on medical education, Flexner emphasized the importance of competency in basic sciences. Less widely recognized is that he also emphasized the necessity of liberal education. On the Flexner Report's 100th anniversary, medicine is challenged to realize Flexner's full vision for medical education to ensure that physicians are prepared to lead lives of compassion and service as well as to perform with technical proficiency. To meet the complex medical and social challenges of the next century, medical educators must continue to promote cognitive expertise while concurrently supporting "professional formation"-the moral and professional development of students, their ability to stay true to their personal service values and the core values of the profession, and the integration of their individual maturation with growth in clinical competency. The goal of professional formation is to anchor students to foundational principles while helping them navigate the inevitable moral conflicts in medical practice. The consequences of inadequate support for professional formation are profound, impacting individual learners, patients, the profession, and society at large. Among the many successful professional formation projects nationally, two long-standing programs are described in modest detail to identify common elements that might guide future developments elsewhere. Key elements include experiential and reflective processes, use of personal narratives, integration of self and expertise, and candid discussion within a safe community of learners. Committing to professional formation within medical education will require transformation of formal and informal curricula and will necessitate a rebalancing of attention and financial support within schools of medicine.
在他 1910 年关于医学教育的报告中，Flexner 强调了基础科学能力的重要性。不那么广为人知的是，他还强调了自由教育的必要性。在 Flexner 报告发布 100 周年之际，医学面临着实现 Flexner 对医学教育的全面愿景的挑战，以确保医生有能力既能过上富有同情心和服务精神的生活，又能熟练地运用技术。为了应对下一个世纪复杂的医疗和社会挑战，医学教育工作者必须继续促进认知专长，同时支持“专业形成”——学生的道德和专业发展、他们坚守个人服务价值观和专业核心价值观的能力，以及他们个人成熟与临床能力增长的融合。专业形成的目标是在帮助学生应对医学实践中不可避免的道德冲突的同时，使他们扎根于基本原则。未能充分支持专业形成的后果是深远的，影响到个体学习者、患者、整个专业和整个社会。在全国许多成功的专业形成项目中，详细描述了两个长期存在的项目，以确定可能指导其他地方未来发展的共同要素。关键要素包括体验式和反思式过程、使用个人叙事、自我与专业知识的融合，以及在安全的学习者社区中进行坦诚讨论。在医学教育中致力于专业形成将需要对正式和非正式课程进行转型，并需要在医学院校内部重新平衡注意力和财政支持。
