Gonzalo Jed D, Lucey Catherine, Wolpaw Terry, Chang Anna
J.D. Gonzalo is assistant professor of medicine and public health sciences and associate dean for health systems education, Penn State College of Medicine, Hershey, Pennsylvania. C. Lucey is professor of medicine and vice dean for education, University of California, San Francisco School of Medicine, San Francisco, California. T. Wolpaw is professor of medicine and vice dean for educational affairs, Penn State College of Medicine, Hershey, Pennsylvania. A. Chang is professor of medicine and Gold-headed Cane Endowed Education Chair in Internal Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
Acad Med. 2017 May;92(5):602-607. doi: 10.1097/ACM.0000000000001346.
To ensure physician readiness for practice and leadership in changing health systems, an emerging three-pillar framework for undergraduate medical education integrates the biomedical and clinical sciences with health systems science, which includes population health, health care policy, and interprofessional teamwork. However, the partnerships between medical schools and health systems that are commonplace today use health systems as a substrate for learning. Educators need to transform the relationship between medical schools and health systems. One opportunity is the design of authentic workplace roles for medical students to add relevance to medical education and patient care. Based on the experiences at two U.S. medical schools, the authors describe principles and strategies for meaningful medical school-health system partnerships to engage students in value-added clinical systems learning roles. In 2013, the schools began large-scale efforts to develop novel required longitudinal, authentic health systems science curricula in classrooms and workplaces for all first-year students. In designing the new medical school-health system partnerships, the authors combined two models in an intersecting manner-Kotter's change management and Kern's curriculum development steps. Mapped to this framework, they recommend strategies for building mutually beneficial medical school-health system partnerships, including developing a shared vision and strategy and identifying learning goals and objectives; empowering broad-based action and overcoming barriers in implementation; and generating short-term wins in implementation. Applying this framework can lead to value-added clinical systems learning roles for students, meaningful medical school-health system partnerships, and a generation of future physicians prepared to lead health systems change.
为确保医生在不断变化的卫生系统中做好执业和领导准备,一个新兴的本科医学教育三支柱框架将生物医学和临床科学与卫生系统科学相结合,后者包括人群健康、医疗保健政策和跨专业团队合作。然而,如今医学院与卫生系统之间常见的伙伴关系将卫生系统用作学习的基础。教育工作者需要改变医学院与卫生系统之间的关系。一个机会是为医学生设计真实的职场角色,以使医学教育和患者护理更具相关性。基于美国两所医学院的经验,作者描述了建立有意义的医学院 - 卫生系统伙伴关系的原则和策略,以使学生参与增值临床系统学习角色。2013年,这两所学校开始大规模努力,为所有一年级学生在课堂和工作场所开发全新的必修纵向真实卫生系统科学课程。在设计新的医学院 - 卫生系统伙伴关系时,作者以交叉的方式结合了两种模式——科特的变革管理和克恩的课程开发步骤。映射到这个框架上,他们推荐了建立互利的医学院 - 卫生系统伙伴关系的策略,包括制定共同愿景和战略以及确定学习目标;推动广泛行动并克服实施中的障碍;以及在实施中取得短期成果。应用这个框架可以为学生带来增值临床系统学习角色、有意义的医学院 - 卫生系统伙伴关系,并培养出一代准备好引领卫生系统变革的未来医生。