Fasel J, Eitel F
Département de Morphologie, Centre Médical Universitaire, Genf.
Unfallchirurg. 1995 Nov;98(11):587-91.
The background problem this article addresses is the need to reduce the quantity of medical information to a standard core of knowledge relative to the overwhelming amount of scientific information to be learned in the limited amount of time students have available. The article is part of a study the aim of which is to define a core students, independent of their further medical specialization. The design of this study is a survey of a representative sample of Swiss general practitioners who were asked to identify in the list of Nomina Anatomica the most prevalent anatomical entities (terms) occurring in their practice. To assure the representativeness of the sample the identified terms were compared to prevalent diagnoses of all Swiss general practitioners and to the incidence of cases in German hospitals. From the list of International Anatomical Nomenclature (IANC) 280 anatomical terms could be identified with respect to arthrology. Of these, 250 were judged uniformly by the physicians: 52 terms were considered relevant, while it was not though necessary for 198 terms to be relevant, while it is was not thought necessary for 198 terms to be learned, i.e. general practitioners agreed on 89.3% of the terms. Only 29.7% of the terms in the IANC list belong to anatomical core knowledge in arthrology. There is evidence for the representativeness of these findings when compared to the prevalence of diagnoses made by general practitioners and to the incidence of cases in German hospitals. The method of using criteria of prevalence in a survey to identify a core of knowledge in medicine is suited for the definition of learning content necessary for professional purposes.
本文所探讨的背景问题是,在学生可利用的有限时间内,面对海量的科学信息,需要将医学信息量缩减至标准的核心知识。本文是一项研究的一部分,该研究旨在定义一个核心内容,而不考虑学生未来的医学专业方向。本研究的设计是对瑞士全科医生的代表性样本进行调查,要求他们在《解剖学名词》列表中找出其临床实践中最常见的解剖学实体(术语)。为确保样本的代表性,将所确定的术语与所有瑞士全科医生的常见诊断以及德国医院的病例发生率进行比较。从国际解剖学命名法(IANC)列表中,就关节学而言可确定280个解剖学术语。其中,250个术语得到了医生们的一致判断:52个术语被认为是相关的,而198个术语则被认为没有必要学习,即全科医生对89.3%的术语达成了一致。IANC列表中只有29.7%的术语属于关节学的解剖学核心知识。与全科医生做出的诊断患病率以及德国医院的病例发生率相比,这些发现具有代表性的证据确凿。在调查中使用患病率标准来确定医学知识核心的方法,适用于定义专业目的所需的学习内容。