어렵게 배운 것: 학부교육과정 개발의 10가지 교훈(Med Educ, 2016)

어렵게 배운 것: 학부교육과정 개발의 10가지 교훈(Med Educ, 2016)

Learning the hard way: 10 lessons for developing undergraduate curricula

Hannah Jacob1 & Caroline R Fertleman2

도입

INTRODUCTION

현상 유지를 바꾸는 문제와 저항하는 사람들을이기는 기술은 잘 기록되어 있습니다 .1

The challenges of changing the status quo and techniques for winning round those who resist are well documented.1

전문가를 조심하라!

BEWARE THE SPECIALIST

다양한 커리큘럼 및 학계에 커리큘럼에 포함되어야 할 내용을 묻는 것은 최종 제품이 균형 있고 유용 할 수 있도록하는 한 가지 방법입니다. 그러나 이것의 위험은 모두가 자신의 세부전공이 가장 중요하다고 생각한다는 것입니다.

Asking a range of clinicians and academics about what should be included in the curriculum is one way of ensuring that the final product is balanced and useable. The danger of doing this, however, is that everyone thinks their subspecialty is the most important.

사람들은 앓는 소리 하기를 좋아한다

PEOPLE LOVE TO MOAN

교과 과정 개발에 대한 inclusive한 접근법의 또 다른 단점은 많은 사람들의 견해를 경청해야한다는 것입니다. 대부분 부정적인 것 : '이것들을 너무 많이 배웁니다.', '... 우리는 그것에 대해 충분한 노출을 얻지 못합니다 ...' 다른 사람들이 원하는 모든 것을 들을 준비를 하고, 다른 배출구가 없도록 하라.

Another downside of an inclusive approach to curriculum development is that you have to listen to the views of lots of people. Mostly negative ones: ‘They learn too much of this...’, ‘...we don’t get enough exposure to that...’, Brace yourself to be a sounding board for all the things people want to say and have no other outlet for.

학부 교육은 50년짜리 교육과정이 아니다

UNDERGRADUATE TRAINING CANNOT TAKE 50 YEARS

어떤 사람들의 바람과 달리, 어떤 시점에서 의대생은 졸업하고 실제로 일자리를 얻어야합니다. 5 주 안에 학습 목표 50 페이지 모두를 다룰 수 있다면 정말 좋겠지 만, 실제로는 일어나지 않을 것이며 중요한 것을 우선 순위로 정해야합니다.

Despite what some people might want, at some point medical students have to graduate and actually get jobs. It would be lovely if they covered all 50 pages of those learning objectives in 5 weeks, but it’s probably not going to happen and we need to prioritise what is important.

영원한 것은 없다.

NOTHING IS FOREVER

우리는 커리큘럼이 그 시대의 아이이고 그 맥락이 모든 것이라는 것을 압니다. 의심 할 여지없이 대학원 교육과 아동 건강 서비스 구성이 인식 할 수 없을 정도로 다른 경우 10 년 내에 완전히 옛날 것이 될 것입니다.

We know that a curriculum is a child of its time and that context is everything. No doubt it will be completely obsolete in 10 years when postgraduate training and the configuration of child health services are unrecognisably different.

상향식 방법은 도움이 된다.

BOTTOM UP HAS SOMETHING TO OFFER

의대생, 주니어 의사 및 학부모가 커리큘럼 개발에 참여한 것에 대한 상당한 비판이 있지만, 그들의 통찰력이 종종 가장 유용하고 실용적이며 관련성이 있다는 것은 놀랄 일이 아닙니다. 고객을 무시하는 것은 위험을 감수해야 한다.

Despite considerable criticism of the involvement of medical students, junior doctors and parents in developing our curriculum, it is no surprise that their insights were often the most useful, pragmatic and relevant. Ignore the punters at your peril.

모두가 자신만의 의제를 가지고 있다.

EVERYONE HAS AN AGENDA

그것이 의과 대학의 뿌리깊은 전통에 기반을 둔 것이든, 자기 전공으로 무언가를 더 가져오기 위한 지옥을 향한 욕망이든 모두는 무엇인가를 원합니다. 이것은 반드시 문제가되는 것은 아니지만 누군가가 '결코 작동하지 않을 것'또는 '이 일을 할 때 요점을 볼 수 없다'라고 말한다면 기억해 둘 가치가 있습니다. 변화 관리 분야의 전문가들은 현상 유지에 가장 유리한 사람들은 변화를 포용하는 것을 가장 꺼려하며 잃을 것을 두려워한다고 경고합니다.

Whether it is based in deep-rooted traditions in a medical school or a hell-bent desire to improve recruitment to the specialty, everyone wants something. This is not necessarily a problembut is worth remembering in those moments when someone says ‘It will never work’ or ‘I can’t see the point in doing this’. Experts in change management warn that those who are best off with the status quo may be the most reluctant to embrace change, fearing that they stand to lose.

모두가 공유하기를 좋아하는 것은 아니다.

SHARING IS NOT EVERYONE’S CUP OF TEA

우리는 의도적으로 커리큘럼의 다양한 이해 관계자로부터 대화를 시작하고 바이 인을 달성하기 위해 착수했습니다. 전반적으로 이것은 많은 호응을 얻었으며 사람들은 기꺼이 기존의 커리큘럼이나 이전에했던 일에 대한 접근성을 기꺼이 제공했습니다. 우리는 이미 수행 된 작업을 기반으로하여 중복을 피할 수있었습니다. 그러나 불가피하게, 자신의 것을 공유하기를 즐기지 않고, 단지 다른 사람이 한 것만 보길 원하는 사람들이 있다.

We deliberately set out to start conversations and achieve buy-in from a wide range of stakeholders in the curriculum. By and large this was well received and people were willing to give us access to their existing curricula or to previous work they had done. We were able to build on what had already been done and avoid duplication. Inevitably, there were some who did not fancy sharing and just wanted to see our stuff without offering theirs.

내용을 줄인다고 학생이 멍청해지지 않는다

BEING FOCUSED IS NOT THE SAME AS DUMBING DOWN

많은 (시니어) 임상의와 학자들은 전국적인 아동 건강 커리큘럼이 시간 낭비이며, 최소공통분모만을 수용 할 것이라고 말했습니다. 그들은 아동 건강의 핵심 구성 요소에 초점을 맞추면 의대생이 모두 바보가 되고, 기초 과학에 대한 지식이나 이해가 없어질 것이라 느꼈습니다.

A number of (senior) clinicians and academics told us that a national child health curriculum was a waste of time and would cater for only the lowest common denominator. They felt that focusing on the core components of child health would mean medical students would all end up stupid and have no knowledge or understanding of basic science.

다른 사람의 문제로 만들라

MAKE IT SOMEONE ELSE’S PROBLEM

어떤 커리큘럼과 마찬가지로 우리는 아동 건강과보다 일반적인 능력 사이의 균형을 맞추어야했습니다. 모든 사람은 다른 누군가가 일반 기술을 가르치고, 자신은 전문가 영역을 가르치길 원한다. 그러나 일은 그렇게 작동하지 않습니다. 우리 모두는 이러한 것들을 가르치기 위해 시간과 자원을 투입 할 책임이 있으며, 교육과정에서 그것이 반영되도록 기꺼이 노력해야 한다.

As with any curriculum, we had to strike a balance between competencies specific to child health and more generic ones. Everyone wants someone in another specialty to teach the generic skills so they can get on with teaching about their specialist area. It doesn’t work like that though. we all have a responsibility to commit time and resources to teaching them these things so you have to be willing for your curriculum to reflect that.

시대와 함께 움직여라

LET’S MOVE WITH THE TIMES

의대생은 우리가 의대에서 배우고 있었던 것을 배울 수도, 배워서도 안됩니다.

Medical students cannot and should not be learning the stuff we were learning at medical school.

학부생들이 어린 시절 예방 접종 스케줄을 배우는 것은 20 세기에 확고하게 뿌리를 내린 아이디어입니다. 그들은 모두 스마트 폰을 가지고 있으며 Google은 0.41 초 안에 일정을 알려줍니다 (우리는 확인했습니다).

Insisting undergraduates rote learn the childhood immunisation schedule is an idea rooted firmly in the 20th century. They all have smartphones and Google will give you the schedule in 0.41 seconds (we’ve checked).

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Med Educ. 2016 Dec;50(12):1186-1188. doi: 10.1111/medu.13094.

Learning the hard way: 10 lessons for developing undergraduate curricula.

Jacob H1, Fertleman CR2.

Author information

1

Institute of Child Health, University College London, London, UK.

2

Department of Paediatrics, Whittington Hospital National Health Service Trust, London, UK.

Abstract

The present study outlines key learning points derived from 2 years spent developing a national undergraduate curriculum for child health. Findings are sourced from analyses of a series of semi-structured musings by beleaguered educationalists and may serve to reassure others engaged in developing undergraduate curricula that it is possible to survive the process and even to produce something quite good. The authors' best advice is to do it, but don't say we didn't warn you.

PMID:

 

27873418

 

DOI:

 

10.1111/medu.13094

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Developing a pragmatic medical curriculum for the 21st century

Nicholas R Evans, Ben Warne & Diana F Wood

INTRODUCTION

Hippocrates. Galen. Harvey. Osler. Watson. The one played by George Clooney in ER. As newly- qualified doctors follow in the footsteps of these grandees of medicine they should begin their careers with a sense of amaze- ment, inquisitiveness and wonder. However, we must recognise the realities of modern medicine:

•  junior doctors are most amazed by the complexity of their labyrinthine ePortfolio; 

• their curiosity is immediately satisfied by a quick supervision from Dr Google; and 

• their wonder has turned to wondering how to extract their patient list from a jam in an apparently Neolithic hospital printer.

Traditional approaches based on the ‘doctor as a scholar and a scientist’, ‘doc- tor as a practitioner’ and ‘doctor as a professional’1 are insufficient. We propose that medical curricula could be improved by being FAR- CICAL: Fostering A Relevant Cur- riculum that Is Closer to Actual Life.

CURRICULUM CORE COMPETENCIES

The doctor as a bluffer

The doctor as a story-teller

The doctor as a negotiator

The doctor as an engineer

The doctor as a treasure hunter

ASSESSMENT

CURRICULUM EVALUATION

CONCLUSION

FINAL REFLECTIONS (FOR WE ARE EDUCATIONALISTS)

Of course, the medical profession, particularly its educators, can rarely be considered to be so cynical. The fact that learners (and indeed their teachers) are able to negotiate these real-world demands and pitfalls whilst covering the broad spectrum of clinical and scientific content should be applauded. Although hospitalbased medical training is fraught with such real-world challenges, it is by no means an aberration. Clinical education in communities, and primary and secondary care, in a range of health care services across the world will share many of these problems as well as having their own eccentricities (and some communities can be very eccentric). The test for medical education in the 21st century will be to embrace the challenges posed by evolving technology, increasingly complex service structures and changing views of the clinician’s role, whilst remaining true to our established commitment to teaching the learner the skills they need to thrive as clinicians. That is, once they’ve fixed the printer...

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Med Educ. 2016 Dec;50(12):1192-1194. doi: 10.1111/medu.13079.

Developing a pragmatic medical curriculum for the 21st century.

Evans NR1, Warne B1, Wood DF1.

Author information

1

School of Clinical Medicine, University of Cambridge, Cambridge, UK.

Abstract

Medical education within a hospital setting presents both opportunities and challenges. The range of educational experiences on offer is often vast, though may be lost in the overworked and convoluted environment of a tertiary centre. As our learners are increasingly consumed by the literal and figurative labyrinths of hospitals and electronic learning logs, are we failing to train them in the skills they need to deliver 21stcentury health care? In response to this problem we propose a FARCICAL approach: Fostering A Relevant Curriculum that Is Closer to Actual Life.

PMID:

 

27873426

 

DOI:

 

10.1111/medu.13079

[Indexed for MEDLINE]