Harden R M
Centre for Medical Education, University of Dundee, UK.
Med Educ. 1995;29 Suppl 1:79-82. doi: 10.1111/j.1365-2923.1995.tb02898.x.
Progress in implementing the World Federation for Medical Education Edinburgh Recommendations in all three phases of education--undergraduate, postgraduate and continuing--is dependent upon recognition of the need to manage dissatisfaction with the present, to have appropriate visions for the future, to have a management strategy for implementing change and to be cost-effective. The extent to which progress can be anticipated is reflected in the formula: Change = (Dissatisfaction x Vision x Process) > Cost We have to aim for a curriculum that will be more convenient, relevant, individualized to the need of each student or trainee, diagnostic--emphasizing self-assessment, interesting--taking account of motivation of students and doctors, systematic or planned and allowing for speculation and a consideration of the grey areas or uncertainties of medicine as well as the certainties.
在医学教育的三个阶段——本科、研究生和继续医学教育——实施世界医学教育联合会《爱丁堡建议》的进展，取决于是否认识到有必要应对对现状的不满，对未来有恰当的愿景，有实施变革的管理策略，并具备成本效益。进步可预期的程度体现在这个公式中：变革 =（不满×愿景×过程）＞成本。我们必须致力于打造这样一个课程体系，它更便捷、更具相关性、能根据每个学生或学员的需求进行个性化设置，注重诊断——强调自我评估，有趣味性——考虑到学生和医生的学习动机，系统或有规划，并允许进行推测，既要考虑医学中的确定性，也要考虑灰色地带或不确定性。
