通过引导学生和教师关注社区医学来改变医学院的文化。

Changing the culture of a medical school by orienting students and faculty toward community medicine.

机构信息

Dr. Duffy is Steven Landgarten Professor of Medical Leadership and former dean, University of Oklahoma College of Medicine, School of Community Medicine, Tulsa, Oklahoma. Dr. Miller-Cribbs is professor and director, Anne and Henry Zarrow School of Social Work, University of Oklahoma-Tulsa, Tulsa, Oklahoma. Dr. Clancy is president, University of Oklahoma-Tulsa, where he is professor of psychiatry. He holds the Morningside Chair in the University of Oklahoma College of Medicine's School of Community Medicine, Tulsa, Oklahoma. Dr. Van De Wiele is assistant professor, Department of Surgery and Integrative Immunology Center, University of Oklahoma College of Medicine, School of Community Medicine, Tulsa, Oklahoma. Dr. Teague is associate professor, Departments of Surgery and Psychiatry, James Carter Todd Chair of Cancer Research, and director, Integrative Immunology Center, University of Oklahoma College of Medicine, School of Community Medicine, Tulsa, Oklahoma. Dr. Crow holds the George Kaiser Family Foundation Chair in Medical Education. She is also assistant dean for curriculum and faculty affairs and is associate professor, Department of Pediatrics, University of Oklahoma College of Medicine, School of Community Medicine, Tulsa, Oklahoma. Ms. Kollaja is project manager and research assistant, University of Oklahoma College of Medicine, School of Community Medicine, Tulsa, Oklahoma. Dr. Fox, an associate professor of internal medicine and pediatrics, holds the Julian Rothbaum Chair in Community Health Research and is associate dean for community health and research development, University of Oklahoma College of Medicine, School of Community Medicine, Tulsa, Oklahoma.

出版信息

Acad Med. 2014 Dec;89(12):1630-5. doi: 10.1097/ACM.0000000000000463.

DOI:10.1097/ACM.0000000000000463

PMID:25162616

Abstract

Oklahoma's health status has been ranked among the worst in the country. In 1972, the University of Oklahoma established the Tulsa branch of its College of Medicine (COM) to expand the physician workforce for northeastern Oklahoma and to provide care for the uninsured patients of the area. In 2008, the Tulsa branch launched a distinct educational track, the University of Oklahoma COM's School of Community Medicine (SCM), to prepare providers equipped and committed to addressing prevalent health disparities.The authors describe the Tulsa branch's Summer Institute (SI), a signature program of the SCM, and how it is part of SCM's process of institutional transformation to align its education, service, and research missions toward improving the health status of the entire region. The SI is a weeklong, prematriculation immersion experience in community medicine. It brings entering medical and physician assistant students together with students and faculty from other disciplines to develop a shared culture of community medicine. The SI uses an unconventional curriculum, based on Scharmer's Theory U, which emphasizes appreciative inquiry, critical thinking, and collaborative problem solving. Also, the curriculum includes Professional Meaning conversations, small-group sessions to facilitate the integration of students' observations into their professional identities and commitments. Development of prototypes of a better health care system enables participants to learn by doing and to bring community medicine to life.The authors describe these and other curricular elements of the SI, present early evaluation data, and discuss the curriculum's incremental evolution. A longitudinal outcomes evaluation is under way.

摘要

俄克拉荷马州的健康状况一直位居全美最差之列。1972 年，俄克拉荷马大学（University of Oklahoma）在塔尔萨设立了其医学院（COM）的分校，以扩大俄克拉荷马州东北部的医生队伍，并为该地区的未参保患者提供医疗服务。2008 年，塔尔萨分校开设了一个独特的教育轨道，即俄克拉荷马大学 COM 的社区医学学院（SCM），旨在培养具备并致力于解决普遍存在的健康差异的医疗服务提供者。本文作者介绍了 SCM 的标志性项目——塔尔萨分校暑期学院（Summer Institute，SI），以及它如何成为 SCM 机构转型过程的一部分，以使其教育、服务和研究使命与改善整个地区的健康状况保持一致。SI 是为期一周的社区医学预入学沉浸体验。它将即将入学的医学生和医师助理学生与来自其他学科的学生和教师聚集在一起，培养社区医学的共同文化。SI 采用了一种非传统的课程，基于 Scharmer 的 U 型理论，强调欣赏式探询、批判性思维和协作解决问题。此外，课程还包括专业意义对话，以小组形式进行，以促进学生将观察融入其专业身份和承诺。开发更好的医疗体系原型使参与者能够通过实践学习，并使社区医学变得生动。本文作者描述了 SI 的这些和其他课程要素，展示了早期评估数据，并讨论了课程的逐步演变。一项纵向结果评估正在进行中。