Monnat R J
Department of Pathology, University of Washington, Seattle 98195.
J Pathol. 1989 Dec;159(4):345-9. doi: 10.1002/path.1711590414.
I have provided a brief overview of our experience teaching undergraduate general pathology at the University of Washington School of Medicine. Our course is part of a pathology curriculum that is somewhat unusual in light of the amount of time we devote to general, as opposed to organ system pathology. We think this makes sense in relation to the way medical teaching and practice are changing. Resources and curriculum time needed to teach an extensive, morphology-based organ system pathology curriculum are no longer available. In addition, experimental biology and medicine are beginning to improve the way human diseases are diagnosed and treated. Many of these advances are the result of new information on disease aetiology and pathogenesis. Students and practitioners of medicine need an understanding of disease processes that will allow them to rapidly assimilate and rationally apply this new information. The particular strengths of our course, as we view them, are an opportunity to discuss the small number of processes that underlie most human disease in some depth, and thus to emphasize general pathology as a conceptual and practical foundation for the practice of medicine; our laboratory sessions, which in a sense illustrate and summarize the course; and early placement of the course in the curriculum, which allows us to capitalize on concurrent basic science courses and a high level of interest among students in applying basic science knowledge to understanding human disease. Problems we face include the need for more 'active' learning exercises in the lecture and laboratory format we are bound to; the need, given the scope of general pathology, to present more 'take home messages' and fewer systematic reviews of evidence than we would like; the limited clinical knowledge of first year students, which restricts the scope of our laboratory and disease example presentations; and an inability to consistently challenge the abilities of the best students in each class. Organizing and teaching the course described above has been in large part satisfying and stimulating. I hope this overview has provided useful ideas for others teaching or contemplating courses in general pathology.
我已简要概述了我们在华盛顿大学医学院教授本科普通病理学的经验。我们的课程是病理学课程的一部分，鉴于我们在普通病理学而非器官系统病理学上投入的时间量，这一课程设置有些不同寻常。我们认为，这与医学教学和实践的变化方式是相符的。用于教授广泛的、基于形态学的器官系统病理学课程所需的资源和课程时间已不复存在。此外，实验生物学和医学正开始改进人类疾病的诊断和治疗方式。其中许多进展是关于疾病病因学和发病机制的新信息带来的结果。医学专业的学生和从业者需要了解疾病过程，以便他们能够迅速吸收并合理应用这些新信息。我们认为，我们课程的独特优势在于有机会深入讨论构成大多数人类疾病基础的少数几个过程，从而强调普通病理学作为医学实践的概念和实践基础；我们的实验课程，从某种意义上说，它阐释并总结了课程内容；以及该课程在课程体系中的早期设置，这使我们能够利用同期的基础科学课程以及学生将基础科学知识应用于理解人类疾病的高度积极性。我们面临的问题包括，在我们所采用的讲座和实验形式中，需要更多“主动式”学习练习；鉴于普通病理学的范围，需要呈现更多“关键要点”，而不是像我们希望的那样进行较少的证据系统综述；一年级学生临床知识有限，这限制了我们实验课程和疾病实例展示的范围；以及无法始终如一地挑战每个班级中最优秀学生的能力。组织和教授上述课程在很大程度上是令人满意且富有启发性的。我希望这一概述为其他教授普通病理学课程或考虑开设此类课程的人提供了有用的思路。
