Brigley S, Young Y, Littlejohns P, McEwen J
Faculty of Public Health Medicine, London, UK.
Postgrad Med J. 1997 Jan;73(855):23-6. doi: 10.1136/pgmj.73.855.23.
The Royal Colleges and their Faculties have moved continuing professional development up the agenda of doctors in the UK. The low educational value and failure to change professional practice of much continuing medical education has led to criticism of its emphasis on formal, didactic teaching and academic knowledge. The ubiquitous scientific or technical bias in medical education makes questionable assumptions about the nature of professional knowledge, how professionals learn, and the linkage of theory and practice in professional work. Given its narrow conception of professional knowledge, it is hardly surprising that the effectiveness of continuing medical education has proven difficult to evaluate. These points of criticism suggest that a more systematic and coherent approach to continuing education is required. The adoption of the concept of continuing professional development, which draws on learning by reflective practice, marks an important step in this direction. Continuing professional development emphasises self-directed learning, professional self-awareness, learning developed in context, multidisciplinary and multilevel collaboration, the learning needs of individuals and their organisations, and an inquiry-based concept of professionalism. It also involves a widening of accountability to patients, the community, managers and policymakers, and a form of evaluation which is internal, participatory and collaborative rather than external and scientific in character.
英国皇家医学院及其各学院已将继续职业发展提上英国医生的议程。许多继续医学教育的教育价值低且未能改变专业实践，这导致了对其强调正规的、说教式教学和学术知识的批评。医学教育中普遍存在的科学或技术偏见，对专业知识的本质、专业人员如何学习以及专业工作中理论与实践的联系做出了可疑的假设。鉴于其对专业知识的狭隘理解，继续医学教育的有效性难以评估也就不足为奇了。这些批评点表明，需要一种更系统、连贯的继续教育方法。采用基于反思性实践学习的继续职业发展概念，标志着朝着这个方向迈出了重要一步。继续职业发展强调自主学习、职业自我意识、在实际情境中发展的学习、多学科和多层次协作、个人及其组织的学习需求，以及基于探究的职业精神概念。它还涉及将责任范围扩大到患者、社区、管理人员和政策制定者，以及一种内部的、参与性和协作性而非外部科学性的评估形式。
