Zahra F Smyth, Dunton K
Periodontology Department and PG student KLI MACE programme, King's College London Dental Institute, Guy's Hospital, Great Maze Pond London, SE1 9RT.
Cultural Institute, King's College London, Room1, 12 Somerset House, East Wing, Strand, London, WC2R 1LA.
Br Dent J. 2017 Feb 10;222(3):147-150. doi: 10.1038/sj.bdj.2017.109.
By its nature, clinical teaching involves supporting small groups of dental students at the chairside as they treat their own patients. Scaffolding their learning in this way enables observation at close quarters of the various stages of development from early novice, just commencing clinical treatment of patients, to those approaching qualification. The students' main concerns throughout are not primarily with the technical skills required, which they have already been taught in the clinical skills laboratories, but dealing with the complex realities and ambiguities of clinical practice; the 'hidden curriculum' of decision making, judgement calls, issues of communication and what it actually means to be professional. Yet, in an already packed curriculum little time is spent helping the students develop these higher order skills. In an effort to improve clinical reasoning and interpretative skills, many medical schools in the US and a number of leading medical schools here in the UK now incorporate arts and humanities-based initiatives into their curricula. This allows for a greater balance between the objectivity of evidence-based medicine and the pluralism and subjectivity of the arts and humanities, providing a more holistic, patient-centred education that promotes a tolerance of ambiguity. In this paper, we describe a pilot programme which sought to explore the value of this approach in the context of dental education, and share early indicators that balancing interventions of this type with clinical sciences can enhance dental students' capabilities in their professional and personal development. We conclude that in today's complex world we must educate not just for competence, but for capability and that the interdisciplinarity afforded by the 'clinical humanities' is both a promising area for further educational research and potentially a valuable addition to the curriculum.
从本质上讲，临床教学包括在牙科学生治疗自己的患者时，在治疗椅旁为一小群学生提供支持。以这种方式为他们的学习搭建支架，能够近距离观察从刚开始临床治疗患者的早期新手到接近资格认证阶段的各个发展阶段。在此过程中，学生们主要关心的并非他们在临床技能实验室已经学过的所需技术技能，而是应对临床实践中复杂的现实情况和模糊性；决策、判断、沟通问题以及成为专业人员的实际意义等“隐性课程”。然而，在已经安排得很满的课程中，几乎没有时间帮助学生培养这些高阶技能。为了提高临床推理和解释技能，美国的许多医学院以及英国这里的一些顶尖医学院现在将基于艺术和人文的举措纳入其课程。这使得循证医学的客观性与艺术和人文的多元性及主观性之间能有更大的平衡，提供更全面、以患者为中心的教育，促进对模糊性的容忍。在本文中，我们描述了一个试点项目，该项目试图在牙科教育背景下探索这种方法的价值，并分享早期指标，即这种类型的平衡干预与临床科学相结合可以提高牙科学生在专业和个人发展方面的能力。我们得出结论，在当今复杂的世界中，我们不仅要培养能力，还要培养才能，并且“临床人文学科”所提供的跨学科性既是进一步教育研究的一个有前景的领域，也可能是课程中一项有价值的补充。
