University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Acad Med. 2010 Feb;85(2):356-62. doi: 10.1097/ACM.0b013e3181c87f73.
In the century since the initial publication of the Flexner Report, medical education has emphasized a broad knowledge of science and a fundamental understanding of the scientific method, which medical educators believe are essential to the practice of medicine. The enormous growth of scientific knowledge that underlies clinical practice has challenged medical schools to accommodate this new information within the curricula. Although innovative educational modalities and new curricula have partly addressed this growth, the authors argue for a systematic restructuring of the content and structure of science education from the premedical setting through clinical practice. The overarching goal of science education is to provide students with a broad, solid foundation applicable to medicine, a deep understanding of the scientific method, and the attitudes and skills needed to apply new knowledge to patient care throughout their careers. The authors believe that to accomplish this successfully, the following changes must occur across the three major stages of medical education: (1) a reshaping of the scientific preparation that all students complete before medical school, (2) an increase in individualized science education during medical school, and (3) an emphasis on knowledge acquisition skills throughout graduate medical education and beyond to assure lifelong scientific learning. As students progress through the educational continuum, the balance of standardized and personalized scientific knowledge will shift toward personalization. Greater personalization demands that physicians possess well-refined skills in information acquisition, interpretation, and application for optimal lifelong learning and effective clinical practice.
自《弗莱克斯纳报告》首次发表以来的一个世纪里,医学教育强调广泛的科学知识和对科学方法的基本理解,医学教育工作者认为这对医学实践至关重要。临床实践所依据的科学知识的巨大增长,使得医学院校不得不将这些新信息纳入课程。虽然创新的教育模式和新课程在一定程度上解决了这一问题,但作者主张从预科医学教育到临床实践,对科学教育的内容和结构进行系统的重构。科学教育的总体目标是为学生提供广泛、坚实的医学基础,深入理解科学方法,以及在整个职业生涯中应用新知识进行患者护理所需的态度和技能。作者认为,要成功实现这一目标,必须在医学教育的三个主要阶段发生以下变化:(1)重塑所有学生在进入医学院之前完成的科学预备知识,(2)增加医学生阶段的个性化科学教育,(3)强调获取知识的技能,贯穿整个研究生医学教育及以后,以确保终身科学学习。随着学生在教育连续体中的进步,标准化和个性化科学知识的平衡将向个性化转变。更大的个性化要求医生具备良好的信息获取、解释和应用技能,以实现最佳的终身学习和有效的临床实践。