Division of General Internal Medicine, Department of Medicine, University of California San Francisco, 1545 Divisadero Street, San Francisco, CA 94115, USA.
Med Educ. 2010 Dec;44(12):1194-202. doi: 10.1111/j.1365-2923.2010.03713.x.
Undergraduate medical education programmes universally struggle with overfull curricula that make curricular changes quite challenging. Final content decisions are often influenced by available faculty staff, vocal champions or institutional culture. We present a multi-modal process for identifying 'need-to-know' content while leveraging curricular change, using the social and behavioural sciences (SBS) as an exemplar.
Several multi-modal approaches were used to identify and triangulate core SBS curricula, including: a national survey of 204 faculty members who ranked the content importance of each of the SBS content areas; a comprehensive review of leading medical SBS textbooks; development of an algorithm to assess the strength of evidence for and potential clinical impact of each SBS construct; solicitation of student input, and review of guidelines from national advocacy organisations. To leverage curricular change, curriculum mapping was used to compare the school's 'actual' SBS curriculum with an 'ideal' SBS curriculum to highlight educational needs and areas for revision. Clinical clerkship directors assisted in translating core SBS content into relevant clinical competencies.
Essential SBS content areas were identified along with more effective and efficient ways of teaching SBS within a medical setting. The triangulation of several methods to identify content raised confidence in the resulting content list. Mapping actual versus ideal SBS curricula highlighted both current strengths and weaknesses and identified opportunities for change.
This multi-modal, several-stage process of generating need-to-know curricular content and comparing it with current practices helped promote curricular changes in SBS, a content area that has been traditionally difficult to teach and is often under-represented. It is likely that this process can be generalised to other emerging or under-represented topic areas.
本科医学教育课程普遍存在课程过于饱满的问题，这使得课程改革颇具挑战性。最终的内容决策通常受到可用的教职员工、有声望的拥护者或机构文化的影响。我们提出了一种多模式的方法，用于在利用课程改革的同时确定“必须知道”的内容，以社会和行为科学（SBS）为例。
使用了几种多模式方法来识别和三角剖分核心 SBS 课程，包括：对 204 名教师进行的全国性调查，他们对 SBS 内容领域的每个内容的重要性进行了排名；对领先的医学 SBS 教科书进行了全面审查；制定了一种算法，以评估每个 SBS 结构的证据强度和潜在的临床影响；征求学生的意见，并审查国家倡导组织的指南。为了利用课程改革，课程映射被用来比较学校的“实际”SBS 课程与“理想”SBS 课程，以突出教育需求和修订领域。临床实习主任协助将核心 SBS 内容转化为相关的临床能力。
确定了必要的 SBS 内容领域，以及在医学环境中更有效地教授 SBS 的方法。通过几种方法来识别内容的三角剖分提高了对最终内容列表的信心。映射实际的 SBS 课程与理想的 SBS 课程突出了当前的优势和劣势，并确定了变革的机会。
这种生成必需课程内容并将其与当前实践进行比较的多模式、多阶段过程有助于推动 SBS 课程的改革，SBS 是一个传统上难以教授且经常代表性不足的内容领域。该过程很可能可以推广到其他新兴或代表性不足的主题领域。
