Institute for General Practice and Interprofessional Care, Universitätsklinikum Tübingen, Tubingen, Germany
Institute for General Practice and Interprofessional Care, Universitätsklinikum Tübingen, Tubingen, Germany.
BMJ Glob Health. 2022 Mar;7(3). doi: 10.1136/bmjgh-2021-008369.
Health systems need medical professionals who can and will work in outpatient settings, such as general practitioner practices or health centres. However, medical students complete only a small portion of their medical training there. Furthermore, this type of training is sometimes seen as inferior to training in academic medical centres and university hospitals. Hence, the healthcare system's demand and the execution of medical curricula do not match. Robust concepts for better alignment of both these parts are lacking. This study aims to (1) describe decentral learning environments in the context of traditional medical curricula and (2) derive ideas for implementing such scenarios further in existing curricula in response to particular medicosocietal needs.This study is designed as qualitative cross-national comparative education research. It comprises three steps: first, two author teams consisting of course managers from Brazil and Germany write a report on change management efforts in their respective faculty. Both teams then compare and comment on the other's report. Emerging similarities and discrepancies are categorised. Third, a cross-national analysis is conducted on the category system.Stakeholders of medical education (medical students, teaching faculty, teachers in decentral learning environments) have differing standards, ideals and goals that are influenced by their own socialisation-prominently, Flexner's view of university hospital training as optimal training. We reiterate that both central and decentral learning environments provide meaningful complementary learning opportunities. Medical students must be prepared to navigate social aspects of learning and accept responsibility for communities. They are uniquely positioned to serve as visionaries and university ambassadors to communities. As such, they can bridge the gap between university hospitals and decentral learning environments.
卫生系统需要能够并且愿意在门诊环境中工作的医疗专业人员，例如全科医生诊所或健康中心。然而，医学生在这些地方只完成了一小部分医学培训。此外，这种类型的培训有时被视为不如在学术医疗中心和大学附属医院的培训。因此，医疗保健系统的需求和医学课程的执行并不匹配。缺乏更好地协调这两个部分的强大概念。本研究旨在：（1）描述传统医学课程背景下的分散学习环境；（2）根据特定的医学社会需求，从现有课程中得出实施此类场景的想法。本研究旨在设计为定性的跨国比较教育研究。它包括三个步骤：首先，由来自巴西和德国的课程管理人员组成的两个作者团队，就他们各自学院的变革管理工作撰写报告。然后，两个团队比较并评论对方的报告。出现的相似之处和差异进行分类。第三，对分类系统进行跨国分析。医学教育的利益相关者（医学生、教学人员、分散学习环境中的教师）具有不同的标准、理想和目标，这些标准、理想和目标受到他们自身社会化的影响，突出表现为 Flexner 对大学医院培训的看法，即最佳培训。我们重申，集中和分散的学习环境都提供有意义的互补学习机会。医学生必须准备好应对学习的社会方面，并为社区承担责任。他们处于独特的地位，可以作为社区的理想主义者和大学的大使。因此，他们可以弥合大学医院和分散学习环境之间的差距。
