Inui Thomas S
T.S. Inui is professor, Department of Medicine, Indiana University School of Medicine, and senior investigator, Regenstrief Institute, Inc., Indianapolis, Indiana.
Acad Med. 2015 Nov;90(11):1442-4. doi: 10.1097/ACM.0000000000000915.
A collection of articles in this issue examine the concept of mastery learning, underscoring that our journey is from a 19th-century construct for assuring skill development (i.e., completing a schedule of rotations driven by the calendar) to a 21st-century sequence of learning opportunities focused on acquiring mastery of special key competencies within clerkships or other activities. Mastery learning processes and standards have the potential to clarify learning goals and competency measurement issues in medical education. Although mastery learning methods originally focused on developing learners' competency with skillful procedures, the author of this Commentary posits that mastery learning methods may be usefully applied more extensively to broader domains of skillful practice, especially those practices that can be linked to outcomes of care. The transition to mastery-focused criteria for educational advancement is laudatory, but challenges will be encountered in the journey to mastery education. The author examines several of these potential challenges, including expansion of mastery learning approaches to effective but relational clinician advice-giving and counseling behaviors, developing criteria for choosing critical competencies that can be linked to outcomes, avoiding a excessively fragmented approach to mastery measurement, and dealing with "educational comorbidity."
本期的一组文章探讨了掌握式学习的概念，强调我们正从19世纪用于确保技能发展的模式（即按照日历安排完成轮转计划）迈向21世纪以获取在临床实习或其他活动中对特定关键能力的掌握为重点的一系列学习机会。掌握式学习过程和标准有可能厘清医学教育中的学习目标和能力评估问题。尽管掌握式学习方法最初侧重于培养学习者在熟练操作程序方面的能力，但本评论文章的作者认为，掌握式学习方法可能更广泛地有效应用于更广泛的熟练实践领域，尤其是那些可与护理结果相联系的实践。向以掌握为重点的教育进步标准的转变值得称赞，但在迈向掌握式教育的过程中会遇到挑战。作者审视了其中一些潜在挑战，包括将掌握式学习方法扩展到有效但涉及人际关系的临床医生给予建议和咨询行为、制定可与结果相联系的关键能力选择标准、避免掌握度测量方法过于碎片化以及应对“教育共病”。
