Department of Pathology, Keck School of Medicine of University of Southern California, Los Angeles, California 90011, USA.
Acad Med. 2010 Mar;85(3):507-11. doi: 10.1097/ACM.0b013e3181cc8f56.
In discussing the major curricular reform at one medical school and the subsequent challenges in identifying which changes contributed to outcome, the author argues for the practice of evidence-based education, which could allow a systematic examination of medical training by applying principles similar to evidence-based medicine in clinical practice. Although the medical school accreditation process provides general oversight of medical education at the national level, the faculty at each medical school has local responsibility over content and design. Therefore, curricular evolution has proceeded separately at different schools, and published cross-institutional studies are few because most schools' experiments with reform do not incorporate data generation for outcomes analysis. The author believes it is time to ask the hard questions, to design the studies, and to seek objective answers on which to base informed decisions concerning the future construct of medical training in the United States and elsewhere.
在讨论一所医学院的主要课程改革以及随后在确定哪些改革有助于取得成果方面所面临的挑战时，作者主张采用循证教育实践，通过应用类似于临床实践中循证医学的原则，可以对医学培训进行系统检查。尽管医学院认证过程为全国范围内的医学教育提供了总体监督，但每所医学院的教师都对内容和设计负有地方责任。因此，课程改革在不同的学校分别进行，而且由于大多数学校的改革实验都没有纳入结果分析的数据生成，因此很少有跨机构的研究发表。作者认为，现在是提出难题、设计研究并寻求客观答案的时候了，这些答案将为美国和其他地方的医学培训的未来结构做出明智决策提供依据。
