Robinson L A, Spencer J A, Jones R H
Department of Primary Health Care, University of Newcastle upon Tyne.
Br J Gen Pract. 1994 Nov;44(388):489-91.
In 1991, the General Medical Council suggested the development of a new undergraduate curriculum, on a 'core plus electives' basis. The combination of National Health Service reforms and the rising profile of academic departments of general practice had led to a consideration of general practice as an alternative teaching environment. These departments now face escalating expectations from their medical schools of their ability to provide additional community based teaching.
The aim of this study was to investigate the present contribution of academic departments of general practice to undergraduate teaching and their plans for curriculum development, including the introduction of community-based clinical skills teaching.
A questionnaire was circulated in June 1993 to all academic departments of general practice in the United Kingdom and Eire.
Twenty seven out of 28 questionnaires were returned. Twenty two departments provided pre-clinical teaching and all provided a clinical practice attachment. Eight medical schools were organizing community-based clinical skills teaching, and in two this formed the basis for a community-based medical attachment. Eight planned to reduce the factual content of their curricula and introduce problem-based learning while nine were contemplating a 'core plus electives' option. Fourteen medical schools had primary care input in teaching basic clinical skills and an additional seven planned to introduce this. Problems encountered by the general practitioner tutors in teaching clinical skills included insufficient time and resources and poor self-esteem; they identified a need for good central and peripheral organization.
Compared with a 1988 study, academic departments of general practice are increasingly involved in teaching both general practice and general medical skills at undergraduate level. Curriculum change is occurring rapidly, with an increasing trend towards community teaching; the implications for both academic departments and general practitioner tutors are discussed.
1991年,英国医学总会建议在“核心课程加选修课程”的基础上开发新的本科课程。国民健康服务体系改革与全科医学学术部门地位的提升,促使人们考虑将全科医学作为另一种教学环境。这些部门如今面临着医学院对其提供更多社区教学能力的期望不断提高的情况。
本研究的目的是调查全科医学学术部门目前对本科教学的贡献及其课程开发计划,包括引入基于社区的临床技能教学。
1993年6月向英国和爱尔兰所有全科医学学术部门发放了调查问卷。
28份问卷中收回了27份。22个部门提供临床前教学,所有部门都提供临床实习。8所医学院正在组织基于社区的临床技能教学,其中两所以此为基础进行基于社区的医学实习。8个部门计划减少课程中的事实性内容并引入基于问题的学习,而9个部门正在考虑“核心课程加选修课程”的方案。14所医学院在基础临床技能教学中有初级保健方面的投入,另外7所计划引入这方面内容。全科医生导师在临床技能教学中遇到的问题包括时间和资源不足以及自信心不足;他们认为需要良好的中央和地方组织。
与1988年的一项研究相比,全科医学学术部门越来越多地参与本科阶段全科医学和普通医学技能的教学。课程改革正在迅速进行,社区教学的趋势日益增强;文中讨论了这对学术部门和全科医生导师的影响。