Division of Medical Humanism and Ethics, Department of Family and Geriatric Medicine, University of Louisville, Louisville, Kentucky 40202, USA.
Acad Med. 2010 Feb;85(2):318-23. doi: 10.1097/ACM.0b013e3181c85932.
Abraham Flexner was commissioned by the Carnegie Foundation for the Advancement of Teaching to conduct the 1910 survey of all U.S. and Canadian medical schools because medical education was perceived to lack rigor and strong learning environments. Existing proprietary schools were shown to have inadequate student scholarship and substandard faculty and teaching venues. Flexner's efforts and those of the American Medical Association resulted in scores of inadequate medical schools being closed and the curricula of the survivors being radically changed. Flexner presumed that medical students would already be schooled in the humanities in college. He viewed the humanities as essential to physician development but did not explicitly incorporate this position into his 1910 report, although he emphasized this point in later writings. Medical ethics and humanities education since 1970 has sought integration with the sciences in medical school. Most programs, however, are not well integrated with the scientific/clinical curriculum, comprehensive across four years of training, or cohesive with nationally formulated goals and objectives. The authors propose a reformation of medical humanities teaching in medical schools inspired by Flexner's writings on premedical education in the context of contemporary educational requirements. College and university education in the humanities is committed to a broad education, consistent with long-standing tenets of liberal arts education. As a consequence, premedical students do not study clinically oriented science or humanities. The medical school curriculum already provides teaching of clinically relevant sciences. The proposed four-year curriculum should likewise provide clinically relevant humanities teaching to train medical students and residents comprehensively in humane, professional patient care.
亚伯拉罕·弗莱克斯纳（Abraham Flexner）受卡内基教学促进基金会（Carnegie Foundation for the Advancement of Teaching）的委托，对所有美国和加拿大的医学院校进行了 1910 年的调查，因为当时人们认为医学教育缺乏严谨性和良好的学习环境。现有的私立学校被证明学生奖学金不足，师资和教学场所也达不到标准。弗莱克斯纳的努力和美国医学协会（American Medical Association）的努力导致数十所不合格的医学院关闭，幸存者的课程也发生了根本性的变化。弗莱克斯纳认为医学生在大学已经接受了人文学科的教育。他认为人文学科对医生的发展至关重要，但他并没有在 1910 年的报告中明确提出这一立场，尽管他在后来的著作中强调了这一点。自 1970 年以来，医学伦理和人文学科教育一直在寻求与医学院校的科学相结合。然而，大多数项目并没有很好地与人文学科的科学/临床课程相结合，没有全面涵盖四年的培训，也没有与人文学科的目标和目的相结合。作者提出，在当代教育要求的背景下，借鉴弗莱克斯纳关于医学预科教育的著作，对医学院的医学人文学科教学进行改革。人文科学的学院和大学教育致力于广泛的教育，与文科教育的长期原则相一致。因此，医学预科学生不学习以临床为导向的科学或人文学科。医学院的课程已经提供了与临床相关的科学教学。拟议的四年制课程也应该提供与临床相关的人文学科教学，全面培训医学生和住院医师进行人道、专业的患者护理。
