GlaxoSmithKline, King of Prussia, PA 19406, USA.
Am J Med. 2011 Sep;124(9):806-12. doi: 10.1016/j.amjmed.2011.03.007.
Concerned with the quality of internal medicine training, many leaders in the field assembled to assess the state of the residency, evaluate the decline in interest in the specialty, and create a framework for invigorating the discipline. Although many external factors are responsible, we also found ourselves culpable: allowing senior role models to opt out of important training activities, ignoring a progressive atrophy of bedside skills, and focusing on lock-step curricula, lectures, and compiled diagnostic and therapeutic strategies. The group affirmed its commitment to a vision of internal medicine rooted in science and learned with mentors at the bedside. Key factors for new emphasis include patient-centered small group teaching, greater incorporation of clinical epidemiology and health services research, and better schedule control for trainees. Because previous proposals were weakened by lack of evidence, we propose to organize the Cooperative Educational Studies Group, a pool of training programs that will collect a common data set describing their programs, design interventions to be tested rigorously in multi-methodological approaches, and at the same time produce knowledge about high-quality practice.
关注内科培训的质量，该领域的许多领导者聚集在一起评估住院医师的现状，评估对该专业兴趣的下降，并为振兴该学科制定框架。尽管许多外部因素是造成这种情况的原因，但我们也有责任：允许资深榜样人物退出重要的培训活动，忽视床边技能的逐渐萎缩，以及专注于按部就班的课程、讲座和编制的诊断及治疗策略。该组织肯定了其对以科学为基础并在床边与导师一起学习的内科的承诺。新重点的关键因素包括以患者为中心的小组教学、更多地纳入临床流行病学和卫生服务研究，以及更好地控制学员的时间表。由于以前的提议因缺乏证据而被削弱，我们建议组织合作教育研究小组，该小组将汇集一系列培训计划，收集描述其计划的通用数据集，设计干预措施，以严谨的多方法途径进行测试，同时产生关于高质量实践的知识。
