D.A. Novak is assistant professor of clinical medical education, Department of Medical Education, Keck School of Medicine of the University of Southern California, Los Angeles, California. R. Hallowell is assistant professor of clinical medical education, Department of Medical Education, Keck School of Medicine of the University of Southern California, Los Angeles, California. R. Ben-Ari is associate professor of clinical medicine, associate dean for continuing medical education, and associate dean for curriculum, Keck School of Medicine of the University of Southern California, Los Angeles, California. D. Elliott is professor of clinical pediatrics and medical education, vice dean for medical education, and chair, Department of Medical Education, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Acad Med. 2019 Nov;94(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 58th Annual Research in Medical Education Sessions):S79-S85. doi: 10.1097/ACM.0000000000002909.
Since 2010, medical schools across the United States have engaged in a new cycle of curricular revision and renewal for their undergraduate medical curricula. But what structures, features, and trends have emerged in U.S. medical schools as a result of deliberate curricular redesign efforts? An analysis of the ways that medical schools have approached the reorganization of their curricula to prepare their students for the growing complexity of medical practice is presented.
This study drew a total pool of 40 U.S. MD-granting programs, of which 25 met the inclusion criteria for the study. The authors used a qualitative coding approach to materials from the undergraduate medical education (UME) program websites to identify 4 dimensions of strategies that these programs used to renew their curricula.
The analysis of the curricular maps and website content of the UME programs provided evidence for a continuum approach to the description of innovation strategies: 96% of schools employed a cohort-based linear pathway, 80% of schools used thematic basic science blocks, 47% placed their Step 1 exams outside of the second year, and 68% moved their clerkships to the second year.
The Continuum of Innovation strategies will enable programs to renew their curricula in ways that promote deliberate curricular changes that are consistent with emerging needs in the field. This study and future research may be useful for UME programs with limited resources by providing consensus practices that enable them to plan curricular changes in ways that best serve their institutions.
自 2010 年以来，美国的医学院校一直在对其本科医学课程进行新一轮的课程修订和更新。但是，由于精心设计的课程重新设计工作，美国医学院校出现了哪些结构、特点和趋势？本文分析了医学院校为了让学生为日益复杂的医学实践做好准备而对课程进行重组的方式。
本研究共抽取了 40 所美国 MD 授予项目，其中 25 所符合研究纳入标准。作者使用定性编码方法对本科医学教育（UME）项目网站上的材料进行分析，以确定这些项目用于更新课程的 4 种策略维度。
对 UME 项目的课程图和网站内容的分析为创新策略的描述提供了连续体方法的证据：96%的学校采用了基于队列的线性途径，80%的学校使用了主题基础科学模块，47%将 Step 1 考试安排在第二年之外，68%将实习安排在第二年。
连续体创新策略将使项目能够以促进精心设计的课程改革的方式更新课程，这些改革与该领域的新需求一致。这项研究和未来的研究可能对资源有限的 UME 项目有用，为他们提供共识实践，使他们能够以最适合机构需求的方式规划课程改革。
