E.M. Miloslavsky is assistant professor of medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
H.C. Besche is lecturer in cell biology, Harvard Medical School, Boston, Massachusetts.
Acad Med. 2022 Oct 1;97(10):1467-1473. doi: 10.1097/ACM.0000000000004612. Epub 2022 Feb 1.
Scientific research has been changing medical practice at an increasing pace. To keep up with this change, physicians of the future will need to be lifelong learners with the skills to engage with emerging science and translate it into clinical care. How medical schools can best prepare students for ongoing scientific change remains unclear. Adding to the challenge is reduced time allocated to basic science in curricula and rapid expansion of relevant scientific fields. A return to science with greater depth after clinical clerkships has been suggested, although few schools have adopted such curricula and implementation can present challenges. The authors describe an innovation at Harvard Medical School, the Advanced Integrated Science Courses (AISCs), which are taken after core clerkships. Students are required to take 2 such courses, which are offered in a variety of topics. Rather than factual content, the learning objectives are a set of generalizable skills to enable students to critically evaluate emerging research and its relationship to medical practice. Making these generalizable skills the defining principle of the courses has several important advantages: it allows standardization of acquired skills to be combined with diverse course topics ranging from basic to translational and population sciences; students can choose courses and projects aligned with their interests, thereby enhancing engagement, curiosity, and career relevance; schools can tailor course offerings to the interests of local faculty; and the generalizable skills delineate a unique purpose of these courses within the overall medical school curriculum. For the 3 years AISCs have been offered, students rated the courses highly and reported learning the intended skill set effectively. The AISC concept addresses the challenge of preparing students for this era of rapidly expanding science and should be readily adaptable to other medical schools.
科学研究正在以前所未有的速度改变着医学实践。为了跟上这种变化，未来的医生需要成为终身学习者，具备与新兴科学接轨并将其转化为临床护理的技能。医学院校如何才能最好地让学生为持续的科学变化做好准备，目前仍不清楚。课程中基础科学的分配时间减少，以及相关科学领域的快速扩张，使情况更加复杂。有人建议在临床实习后重新深入学习科学，但很少有学校采用这种课程，而且实施起来可能会面临挑战。本文作者描述了哈佛医学院的一项创新，即高级综合科学课程（AISCs），这些课程在核心实习后开设。学生必须修读 2 门此类课程，提供多种主题供学生选择。这些课程的学习目标不是事实内容，而是一套可推广的技能，使学生能够批判性地评估新出现的研究及其与医学实践的关系。将这些可推广的技能作为课程的定义原则有几个重要的优势：它允许将获得的技能标准化，同时结合从基础到转化和人群科学的各种课程主题；学生可以选择与自己的兴趣相关的课程和项目，从而提高参与度、好奇心和职业相关性；学校可以根据当地教师的兴趣来调整课程设置；可推广的技能明确了这些课程在整个医学院课程中的独特目的。自 AISCs 开设以来的 3 年里，学生对这些课程的评价很高，并报告说有效地学习了预期的技能集。AISC 概念解决了为学生做好准备迎接这个科学快速扩张时代的挑战，并且应该很容易适应其他医学院校。
