Dr. Mehta is associate professor of medicine and director of education technology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio. Dr. Hull is professor of medicine and associate dean for curricular affairs, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio. Dr. Young is professor of medicine and executive dean, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio. Dr. Stoller is Jean Wall Bennett Professor of Medicine and Chairman, Education Institute, Cleveland Clinic, Cleveland, Ohio.
Acad Med. 2013 Oct;88(10):1418-23. doi: 10.1097/ACM.0b013e3182a36a07.
For all its traditional successes, the current model of medical education in the United States and Canada is being challenged on issues of quality, throughput, and cost, a process that has exposed numerous shortcomings in its efforts to meet the needs of the nations' health care systems. A radical change in direction is required because the current path will not lead to a solution.The 2010 publication Educating Physicians: A Call for Reform of Medical School and Residency identifies several goals for improving the medical education system, and proposals have been made to reform medical education to meet these goals. Enacting these recommendations practically and efficiently, while training more health care providers at a lower cost, is challenging.To advance solutions, the authors review innovations that are disrupting higher education and describe a vision for using these to create a new model for competency-based, learner-centered medical education that can better meet the needs of the health care system while adhering to the spirit of the above proposals. These innovations include collaboration amongst medical schools to develop massive open online courses for didactic content; faculty working in small groups to leverage this online content in a "flipped-classroom" model; and digital badges for credentialing entrustable professional activities over the continuum of learning.
尽管美国和加拿大的传统医学教育模式取得了诸多成功,但在质量、效率和成本方面仍面临挑战,这一过程暴露出其在满足国家医疗体系需求方面的诸多不足。需要进行彻底的改革,因为目前的道路不会带来解决方案。2010 年发表的《培养医生:医学院校和住院医师培训改革呼吁》为改善医学教育体系确定了若干目标,并提出了改革医学教育以实现这些目标的建议。切实有效地实施这些建议,同时以更低的成本培训更多的医疗服务提供者,具有挑战性。为了推进解决方案,作者回顾了正在颠覆高等教育的创新,并描述了一个愿景,即利用这些创新来创建一个新的基于能力、以学习者为中心的医学教育模式,在遵循上述建议精神的同时更好地满足医疗体系的需求。这些创新包括医学院校之间的合作,开发大规模在线开放课程以提供理论教学内容;教师以小组形式合作,利用“翻转课堂”模式中的在线内容;以及数字徽章,用于在学习的整个过程中对可委托的专业活动进行认证。