Komasawa Nobuyasu, Yokohira Masanao
Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Miki-cho, JPN.
Department of Medical Education, Kagawa University, Miki-cho, JPN.
Cureus. 2025 Aug 11;17(8):e89772. doi: 10.7759/cureus.89772. eCollection 2025 Aug.
Modern healthcare faces unprecedented complexity, driven by aging populations, chronic diseases, global health threats, and widening health disparities. These challenges are deeply embedded in social, institutional, and environmental systems, demanding a shift from isolated clinical practice to dynamic, multi-layered collaboration. Yet, current medical education, both in Japan and globally, often underprepares learners for the relational, interprofessional, and systemic demands of real-world healthcare. This narrative review explores how medical education must be reimagined to cultivate "collaborative intelligence," the ability to engage across disciplinary, generational, institutional, and community boundaries. Drawing on educational theories such as Vygotsky's social constructivism, we advocate for a connection-centered, practice-oriented curriculum that embeds relational learning across all stages of training. Through redesigned clinical clerkships, interprofessional simulations, community-based rotations, and structured mentorship, students can develop not only communication and teamwork skills but also the ethical reasoning and adaptive leadership required in complex care environments. We also examine structural barriers, including institutional silos, hierarchical cultures, and outdated assessment systems, that continue to impede meaningful collaboration. We argue that embedding connection into the core of medical education is both a pedagogical necessity and a moral imperative. Ultimately, the goal is not only to adapt to the complexity of healthcare systems but also to empower future professionals to transform them toward resilience, equity, and human-centered care. In doing so, medical education can become a catalyst for sustainable health systems and inclusive communities.
现代医疗保健面临着前所未有的复杂性,这是由人口老龄化、慢性病、全球健康威胁以及日益扩大的健康差距所驱动的。这些挑战深深植根于社会、机构和环境系统之中,要求从孤立的临床实践转向动态的、多层次的协作。然而,目前日本乃至全球的医学教育往往使学习者在应对现实世界医疗保健中的人际关系、跨专业和系统性需求方面准备不足。这篇叙述性综述探讨了医学教育必须如何重新构想,以培养“协作智慧”,即跨越学科、代际、机构和社区界限进行互动的能力。借鉴诸如维果茨基的社会建构主义等教育理论,我们倡导以联系为中心、以实践为导向的课程,将关系学习融入培训的各个阶段。通过重新设计临床实习、跨专业模拟、社区轮转和结构化指导,学生不仅可以培养沟通和团队合作技能,还可以发展复杂护理环境所需的道德推理和适应性领导力。我们还审视了包括机构壁垒、等级文化和过时的评估系统在内的结构性障碍,这些障碍继续阻碍有意义的协作。我们认为,将联系融入医学教育的核心既是教学上的必要,也是道德上的要求。最终目标不仅是适应医疗保健系统的复杂性,而且是使未来的专业人员有能力将其转变为具有复原力、公平性和以人 为中心的护理。这样做,医学教育可以成为可持续健康系统和包容性社区的催化剂。