Kim Jung G, Gonzalo Jed D, Chen Isabel, Vo Anne, Lupi Carla, Hyderi Abbas, Haidet Paul, DeWaters Ami, Blatt Barbara, Holmboe Eric, Thompson Lindsey R, Jimenez Jazmin, Madigosky Wendy, Chung Paul J
Acad Med. 2024 Apr 1;99(4):374-380. doi: 10.1097/ACM.0000000000005619. Epub 2023 Dec 28.
Health care delivery requires physicians to operate in teams to successfully navigate complexity in caring for patients and communities. The importance of training physicians early in core concepts of working in teams (i.e., "teaming") has long been established. Over the past decade, however, little evidence of team effectiveness training for medical students has been available. The recent introduction of health systems science as a third pillar of medical education provides an opportunity to teach and prepare students to work in teams and achieve related core competencies across the medical education continuum and health care delivery settings. Although educators and health care system leaders have emphasized the teaching and learning of team-based care, conceptual models and evidence that inform effective teaming within all aspects of undergraduate medical education (including classroom, clinical, and community settings) are needed to advance the science regarding learning and working in teams. Anchoring teaming through the core foundational theory of team effectiveness and its operational components could catalyze the empirical study of medical student teams, uncover modifiable factors that lead to the evidence for improved student learning, and improve the link among competency-based assessments between undergraduate medical education and graduate medical education. In this article, authors articulate several implications for medical schools through 5 conceptual areas: admissions, the design and teaching of team effectiveness in health systems science curricula, the related competency-based assessments, and course and program evaluations. The authors then discuss the relevance of the measurable components and intended outcomes to team effectiveness in undergraduate medical education as critical to successfully prepare students for teaming in clerkships and eventually residency and clinical practice.
医疗服务需要医生团队协作，以成功应对照顾患者和社区过程中的复杂性。长期以来，很早就对医生进行团队合作核心概念（即“团队协作”）培训的重要性已得到确立。然而，在过去十年中，几乎没有关于医学生团队效能培训的证据。最近将卫生系统科学作为医学教育的第三大支柱引入，为教导和培养学生在团队中工作并在整个医学教育连续过程和医疗服务环境中实现相关核心能力提供了机会。尽管教育工作者和医疗系统领导者强调基于团队的护理教学，但需要概念模型和证据来指导本科医学教育各个方面（包括课堂、临床和社区环境）的有效团队协作，以推进关于团队学习和工作的科学。通过团队效能的核心基础理论及其操作要素来锚定团队协作，可以促进对医学生团队的实证研究，发现可改变的因素，这些因素可为改善学生学习提供证据，并加强本科医学教育与研究生医学教育之间基于能力的评估联系。在本文中，作者通过五个概念领域阐述了对医学院校的若干启示：招生、卫生系统科学课程中团队效能的设计与教学、相关的基于能力的评估以及课程与项目评估。作者随后讨论了可衡量的要素和预期成果与本科医学教育中团队效能的相关性，这对于成功培养学生在实习阶段以及最终在住院医师培训和临床实践中的团队协作能力至关重要。
