Westberg J, Jason H
Department of Family Medicine, University of Colorado Health Sciences Center, Denver.
Fam Med. 1994 May;26(5):278-82.
In most medical schools and residency programs, little or no attention is given to fostering learners' reflection or self-assessment. Yet learners who do not value or who are not effective at these skills are unlikely to extract the maximum benefit from their education. They are at risk of becoming unsafe physicians. To be optimally helpful, teachers need access to the diagnostic information about learners that is provided by their reflections and self-assessments. There are major barriers to learners being reflective and self-assessing. Medicine is dominated by unreflective doing. In the fiercely competitive environment of many teaching programs, many learners correctly perceive that it is unsafe to reveal their fears and deficiencies. Learners often retain this cautious posture even after moving to programs where it is unnecessary. Many learners and teachers have grown accustomed to authoritarian educational approaches in which teachers decide what the learners need and unilaterally evaluate their performance. In this review of the available literature, we summarize the compelling reasons for fostering reflection and self-assessment and for helping learners become their own coaches. Specific strategies and tools for creating programs that foster these values and activities are presented.
在大多数医学院校和住院医师培训项目中，对培养学习者的反思能力或自我评估能力几乎没有给予关注。然而，那些不重视这些技能或在这些技能方面表现不佳的学习者不太可能从他们的教育中获得最大收益。他们有成为不安全医生的风险。为了提供最佳帮助，教师需要获取学习者通过反思和自我评估所提供的诊断信息。学习者进行反思和自我评估存在重大障碍。医学领域以不假思索的行动为主导。在许多教学项目竞争激烈的环境中，许多学习者正确地意识到暴露自己的恐惧和不足是不安全的。即使在转到不需要如此谨慎的项目后，学习者往往仍保持这种谨慎的态度。许多学习者和教师已经习惯了专制的教育方式，即教师决定学习者的需求并单方面评估他们的表现。在对现有文献的综述中，我们总结了培养反思和自我评估以及帮助学习者成为自己教练的令人信服的理由。我们还介绍了创建促进这些价值观和活动的项目的具体策略和工具。
