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英国医学院校当前基于社区的教学情况:一项在线调查与系统评价

The current provision of community-based teaching in UK medical schools: an online survey and systematic review.

作者信息

Lee Sandra W W, Clement Naomi, Tang Natalie, Atiomo William

机构信息

School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK.

Clinical Sub-Dean, School of Medicine, University of Nottingham, Nottingham, UK.

出版信息

BMJ Open. 2014 Dec 1;4(12):e005696. doi: 10.1136/bmjopen-2014-005696.

Abstract

OBJECTIVE

To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools.

DESIGN AND DATA SOURCES

An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation.

STUDY SELECTION

Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included.

RESULTS

Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors' knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE.

CONCLUSIONS

Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for 'Tomorrow's Doctors', a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE.

STRENGTHS AND LIMITATIONS OF THIS STUDY

This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from online medical school prospectuses. This means the data may be incomplete or out of date. Data in the literature review may also be skewed by publication bias.

摘要

目的

评估英国医学院校基于社区的教育(CBE)的当前提供情况及成果。

设计与数据来源

对英国医学院校网站和课程手册进行在线调查,并对来自PubMed和科学网的文章进行系统综述。系统综述中的文章采用罗西、利普西和弗里曼的项目评估方法进行评估。

研究选择

纳入1998年11月至2013年期间包含本科医学课程中社区教学相关信息的出版物。

结果

在英国32所本科医学院校中,有一所因网上缺乏课程规范而被排除。对其余31所医学院校的分析表明,英国各地的医学院校采用了多种CBE模式。28所医学院校(90.3%)在本科培训的第一学年末以某种形式提供CBE,29所医学院校(93.5%)在第二学年末提供。从识别出的1378篇参考文献中,29篇论文符合评估的纳入标准。研究发现,CBE大多给学生以及其他参与者带来益处,包括全科医生导师和患者。然而,对于全科医生导师在专业领域知识的缺乏、CBE可能对教育环境中的医疗服务提供产生的负面影响以及CBE的成本存在一些担忧。

结论

尽管实施情况差异很大,但社区教学大多是有益的。为确保CBE与“明日医生”的相关性,应建立一个国家框架,并寻求解决方案以减少CBE中各种挑战的影响。

本研究的优势与局限性

这是第一项回顾英国医学院校目前如何提供基于社区的教育的研究。采用罗西、利普西和弗里曼的项目评估方法意味着对文献进行了一致且全面的分析。然而,一个弱点是在线调查的数据来自医学院校的在线手册。这意味着数据可能不完整或过时。文献综述中的数据也可能因发表偏倚而有偏差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca94/4256542/f9d73ad32079/bmjopen2014005696f01.jpg

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