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生物伦理学教育中的基于团队的学习:在“课程压缩”时代为住院医师创建成功的课程

Team-Based Learning in Bioethics Education: Creating a Successful Curriculum for Residents in an Era of "Curricular Squeeze".

作者信息

Fernandes Ashley K, Wilson Sheria, Kasick Rena, Humphrey Lisa, Mahan John, Spencer Sandra

机构信息

Division of Ambulatory Medicine, Nationwide Children's Hospital, Columbus, USA.

Division of Neonatology, Nationwide Children's Hospital, Columbus, USA.

出版信息

Med Sci Educ. 2019 Nov 7;30(1):649-658. doi: 10.1007/s40670-019-00836-9. eCollection 2020 Mar.

Abstract

BACKGROUND

Team-based learning has been utilized inside and outside of medical education with success. Its use in bioethics education-particularly in graduate medical education-has been limited, despite its proven pedagogical strength and the critical importance of ethics and professionalism.

ACTIVITY

From 2015-2018, we created and administered 10 TBL bioethics modular exercises using L. Dee Fink's "Principles of Significant Learning" and the evidence-based methodology of TBL (with some modifications, given the nature of graduate medical education) to pediatric residents. We evaluated the TBL curriculum and report satisfaction scores and qualitative thematic analysis of strengths and weaknesses.

RESULTS AND DISCUSSION

Pediatric residents, despite a perception of "curricular squeeze" and lack of interest in ethics, were highly engaged and satisfied with a TBL-only-based bioethics curriculum. We were able to successfully adapt the TBL structure to the situational factors surrounding the rigors and unpredictable nature of clinical graduate education. We offer four "Lessons Learned" for creating and implementing TBL exercises in graduate medical education. TBL can be used in bioethics education successfully, not just for individual exercises, but also to create a comprehensive ethics curriculum.

摘要

背景

基于团队的学习在医学教育内外均有成功应用。尽管其教学优势已得到证实,且伦理与职业素养至关重要,但它在生物伦理学教育中的应用,尤其是在毕业后医学教育中的应用却很有限。

活动

2015年至2018年,我们依据L. 迪伊·芬克的“有意义学习原则”以及基于团队的学习的循证方法(鉴于毕业后医学教育的性质,做了一些修改),为儿科住院医师创建并实施了10次基于团队的学习生物伦理学模块练习。我们对基于团队的学习课程进行了评估,并报告了满意度得分以及对优缺点的定性主题分析。

结果与讨论

儿科住院医师尽管感觉“课程紧张”且对伦理学缺乏兴趣,但对仅基于团队的学习的生物伦理学课程高度投入并感到满意。我们能够成功地将基于团队的学习结构适应于临床毕业后教育的严格性和不可预测性所带来的情境因素。我们为在毕业后医学教育中创建和实施基于团队的学习练习提供了四点“经验教训”。基于团队的学习可成功用于生物伦理学教育,不仅适用于个别练习,还可用于创建全面的伦理学课程。

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