Watmough Simon
Medical Education, School of Medicine, University of Liverpool, UK.
Educ Prim Care. 2012 Nov;23(6):385-90. doi: 10.1080/14739879.2012.11494149.
In 1996 Liverpool University reformed its MBChB programme from a traditional course to a reformed curriculum based on the recommendations in Tomorrow's Doctors. Liverpool community-based undergraduate medical education increased significantly.
Research comprised questionnaires and interviews six years after graduation with the final two cohorts to graduate from the traditional curriculum and the first two cohorts to graduate from the reformed curriculum, to ascertain their views on their undergraduate medical education. Two of the questionnaire variables and some of the interview questions were directly related to their community-based undergraduate medical education.
Reformed curriculum graduates felt better prepared for understanding the relationship between primary and hospital care than traditional graduates. This was statistically significant. When assessing the amount of GP teaching they received, 64% of the traditional graduates felt their GP teaching was less than 'about right' compared with only 8% of reformed curriculum graduates. During the interviews the traditional graduates were divided about whether there should have been more GP exposure in their course and many said they had little knowledge about the relationship between primary and secondary care. Generally, the reformed curriculum graduates thought it was beneficial to have a larger amount of community teaching and it was useful for developing clinical skills and they understood the relationship between primary and secondary care.
An increase in exposure to community-based undergraduate medical education can change the way graduates perceive and understand general practice.
1996年，利物浦大学根据《明日医生》中的建议，将其医学学士课程从传统课程改革为经过改革的课程体系。利物浦以社区为基础的本科医学教育显著增加。
研究包括在毕业六年后对从传统课程体系毕业的最后两届学生以及从改革后的课程体系毕业的头两届学生进行问卷调查和访谈，以确定他们对本科医学教育的看法。问卷中的两个变量和一些访谈问题与他们以社区为基础的本科医学教育直接相关。
与传统课程体系毕业的学生相比，改革后的课程体系毕业的学生在理解初级保健与医院护理之间的关系方面感觉准备更充分。这具有统计学意义。在评估他们接受的全科医生教学量时，64%的传统课程体系毕业的学生认为他们接受的全科医生教学少于“大致合适”，而改革后的课程体系毕业的学生中这一比例仅为8%。在访谈中，传统课程体系毕业的学生对于他们的课程中是否应该增加全科医生接触机会存在分歧，许多人表示他们对初级保健与二级保健之间的关系了解甚少。总体而言，改革后的课程体系毕业的学生认为大量的社区教学是有益的，对培养临床技能很有用，并且他们理解初级保健与二级保健之间的关系。
增加以社区为基础的本科医学教育接触机会可以改变毕业生对全科医疗的认知和理解方式。
