교육자들을 교육시키기: 교육과정 통합의 열쇠 (Academic Medicine, 2015)

교육자들을 교육시키기: 교육과정 통합의 열쇠

Educating the Educators: A Key to Curricular Integration

Aviad Haramati, PhD

Hopkins 등에 따르면 지금까지 기초의학을 임상의학과 통합하는 교육과정을 만드려는 노력의 결과는 기껏해야 '조금의 향상(incremental)' 정도였다. 진정한 교육의 탈바꿈(transformative change)는 일어난 적이 없으며, 이는 통합의 중심에 있는 개개인들, 즉 기초의학자들에게 초점을 두는데 실패했기 때문이다. 저자들은 교육의 변화를 주도하는 사람들은 교육의 구조적 문제를 해결하려기보다는 개개 기초의학자들에게 교육과정 개선이 가지는 의미를 이해하려고 노력해야함을 강조한다. 이러한 관점을 눈여겨 볼 필요가 있으며, 여기서는 세 가지 리더십의 필요성을 강조하고자 한다.

• (1) Offer opportunities to help interested basic science teaching faculty gain the necessary expertise to become skilled educators; 
• (2) establish institutional programs and structures that foster a community of medical educators across departments and schools; and 
• (3) align institutional priorities and incentives to promote, rather than hinder, integration in medical education. 

According to Hopkins and colleagues, integration of basic science and clinical practice in the medical curriculum has been "incremental" at best, rather than transformative, in part because of a lack of focus on the individuals central to the integration-basic science educators. These authors maintain that those who lead change in education should not only address the systemic structure but also understand the meaning of integration for individual basic scientists at different levels of change. Their view has merit, and this Commentary author suggests three concrete steps that institutions should undertake to engage basic scientists who are interested in becoming "educationally literate" and assuming leadership roles in curriculum integration: (1) Offer opportunities to help interested basic science teaching faculty gain the necessary expertise to become skilled educators; (2) establish institutional programs and structures that foster a community of medical educators across departments and schools; and (3) align institutional priorities and incentives to promote, rather than hinder, integration in medical education. 

본질적으로, 교육과정의 통합은 '교육의 언어'를 제대로 이해하지 않고는 성공할 수 없다. 또한 학과나 센터, 대학을 막론하고 교육에 초점을 맞춘 커리어에 관심이 있는 교수들이 하나의 커뮤니티를 이루게 도와주어야 한다. 마지막으로 각 의과대학의 리더들은 적절한 인센티브와 기관의 인정, 기회 등을 제공하여서 이러한 교육자들이 진정한 의미의 교육과정 변혁을 이끌 수 있도록 지원해야 한다.

In essence, curricular integration cannot succeed if the participants do not understand the "language of education." Furthermore, faculty who opt for an education-focused career path should be brought together from across departments, centers, and schools to create a community of educators within the academic health center. Finally, institutional leaders should place high value and proper incentives in terms of recognition and opportunities for faculty advancement to ensure that those opting to gain additional training as skilled educators will drive innovation and help move curricular reform from incremental change to transformation.

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진정한 교육의 탈바꿈이 일어나지 않은 것은 '구조적 측면'에 주로 관심을 두었을 뿐 '과정상의 핵심 요소'에 무관심했기 때문이다. Significant transformation has not occurred due, in their view, to efforts being focused primarily on the structural aspects of integration and largely ignoring a key element in the process—namely, the basic science educator.

이들 선생님들을 지원해기 위해서는 어떤 것들이 필요할까?  Their recommendation is to study the experiences of basic scientists during the process of curricular reform and, hereby, determine what elements are necessary to support these teachers, individually and collectively, during periods of transition and reform.1

'우리가 통합하려는 대상이 누구인가'에 관심을 두는 것이 중요하다. Indeed, regarding the authors’ final point—to focus attention on “who we are integrating”1—my sense is that several components should be included within an overall institutional strategy to involve basic science faculty in integrating the curriculum and reforming medical education on an institutional level. Here I will outline three:

1. Offering opportunities to help interested basic science teaching faculty gain the necessary expertise to become skilled educators;
2. Establishing institutional programs and structures that foster a community of medical educators across departments and schools;
3. Aligning institutional priorities and incentives to promote, rather than hinder, curriculum integration in medical education.

교육과정 개혁의 시기에 의과대학은 '교육된' 기초의학자들이 'critical mass'가 되어 교육과정의 개혁을 이끌어나가는 흥미진진한 기간이 될 수 있다. 더 많은 교수들이 '교육의 언어'를 배울수록 교육과정 통합의 노력이 보다 효과적이고 지속가능해질 것이다.

Thus, the academic medicine community is in an exciting period during which “educated” basic scientists at each medical school are becoming a critical mass and may be ready to take the lead in moving curricular reform forward. As additional medical school faculty begin to learn the “language of education,” efforts at curricular integration are likely to become even more effective and sustainable.

통합은, 그 정의상, 팀 스포츠이다. 

Although having basic science teaching faculty obtain additional training in education is an important step in advancing the medical curriculum, it is not the entire solution because integration is, by definition, a team sport. 

교육과정 통합에서 기초의학자들이 느끼는 불만

Hopkins and colleagues correctly point out that the resistance to curricular integration is related, in part, 

• to the discomfort basic scientists may experience when challenged with placing their subject matter in a clinical context, due to a knowledge gap; many may not feel confident about the clinical content.1 
• Others may perceive most integration initiatives as unidirectional—encroaching on the first- and second-year curricula with inadequate reciprocation in the third and fourth years.1

서로 어떤 일을 하고 무슨 노력을 기울이는지 모르는게 보통이다.

In large academic health centers, it is not unusual for faculty involved in education to be unaware of the work and efforts of others from different departments—hence, a “mentality of silos.”

정말로 전 기관적 차원의 일이라면, 그 'silo'를 무너뜨리는 일이 필요하다.

If curricular integration of the basic and clinical sciences is truly an institutional goal, then breaking down silos must be an institutional imperative.

각 교수와 학과에서는 교육과정에 '족적'을 남기고 더 많은 강의를 하는 것에 의미를 두고, 학교도 여기에 지원을 하고 예산을 투입하는 것이 보통이다.

Admittedly, developing such incentives is easier said than done. In the past, an individual or department took great pride

in its “footprint” within the curriculum, whether its contribution was large numbers of lectures or hundreds of total contact hours. In many institutions, the hours, perceived to represent the value to the school’s curriculum, translated into dollars and budgets.

교육의 트렌드는 '무대 위의 현자(the sage on the stage)'에서 '곁에서 안내해주기(guides on the side)'로 옮겨가고 있다.

In contrast, current educational trends are moving away from “the sage on the stage” toward, instead, “guides on the side”9 (i.e., faculty facilitating learning).

교육과정 통합이 성공하기 위해서는 분명한 인센티브가 있어서 강의 외에 다른 교육방식을 도입함으로써 학습을 촉진하고 과간 협력을 증진시킬 유인을 제공해야 한다.

For curricular integration to be successful, there must be clear incentives, in terms of recognition and promotion, for basic science educators to adopt teaching formats (other than the lecture) that both facilitate learning and encourage collaboration, partnering, and experimenting with fellow educators from other departments.

대학도 강의를 권장하고 혁신/협력/통합을 가로막는 융통성 없는 '강의별 수가제(fee-for-lecture)'에서 벗어나야 한다.

Schools, therefore, should uncouple department budgets from a strict “fee-for-lecture” service that rewards lecturing and discourages innovation, collaboration, and integration.

연구와 진료에서 점점 학제간 협력이 중요해지는 것과 마찬가지로, 교육 또한 마찬가지로 팀 단위 접근법으로 진화하는 중이며그 팀은 교육자로서 필요한 기술을 갖춘 기초의학자들과 임상의사들이 함께해야 한다.

Just as the conduct of scientific research and the provision of clinical care are shifting from the individual to the team, so too the effective teaching of science and medicine is evolving into a team approach—a team that must include basic scientists and clinicians who have all obtained additional training to become skilled educators.

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Acad Med. 2015 Feb;90(2):133-5. doi: 10.1097/ACM.0000000000000444.

Educating the educators: a key to curricular integration.

Haramati A1.

Author information

• 1Dr. Haramati is professor, Department of Biochemistry and Molecular & Cellular Biology, and Department of Medicine, and director, Center for Innovation and Leadership in Education (CENTILE), Georgetown University School of Medicine, Washington, DC.

Abstract

According to Hopkins and colleagues, integration of basic science and clinical practice in the medical curriculum has been "incremental" at best, rather than transformative, in part because of a lack of focus on the individuals central to the integration-basic science educators. These authors maintain that those who lead change in education should not only address the systemic structure but also understand the meaning of integration for individual basic scientists at different levels of change. Their view has merit, and this Commentary author suggests three concrete steps that institutions should undertake to engage basic scientists who are interested in becoming "educationally literate" and assuming leadership roles in curriculum integration: (1) Offer opportunities to help interested basic science teaching faculty gain the necessary expertise to become skillededucators; (2) establish institutional programs and structures that foster a community of medical educators across departments and schools; and (3) align institutional priorities and incentives to promote, rather than hinder, integration in medical education. In essence, curricular integration cannot succeed if the participants do not understand the "language of education." Furthermore, faculty who opt for an education-focused career path should be brought together from across departments, centers, and schools to create a community of educators within the academic health center. Finally, institutional leaders should place high value and proper incentives in terms of recognition and opportunities for faculty advancement to ensure that those opting to gain additional training as skilled educators will drive innovation and help move curricular reform from incremental change to transformation.

PMID:

 

25140531

 

[PubMed - in process]