本文简要介绍了美国医学教育体系,并以哈佛医学院、斯坦福大学医学院、约翰·霍普金斯医学院为例,探讨了美国医学院医学教育改革和课程创新特点,从培养目标、课程设置、临床实践和职业精神等方面进行了阐述。同时,针对我国目前医学教育存在的问题,就医学教育的本质特点、医学教育改革的关键点、课程改革和评估体系的创新点、医学院校人才培养目标的确立等多方面进行剖析并提出合理化建议,以期为我国医学教育改革提供参考。
Initiated with a brief introduction of the current medical education system in the United States, this article elaborates on pedagogy transformations and curriculum redesign based on Harvard Medical School, Stanford University School of Medicine and Johns Hopkins School of Medicine's reform. Gaining insight into the trainingObjectives, educational philosophy, clinical immersion and professionalism cultivation of these world-class medical schools may inspire us to explore more strategic and rational approaches. We highlight some key points such as to restore the medical education continuum, advocate the contemporary focus of reform, reconstruct the curriculum design and evaluation system, and to consolidate the training goals in medical schools., which will strengthen the medical education reform in China.
[1] 中华人民共和国国务院办公厅.国务院办公厅关于深化医教协同进一步推进医学教育改革与发展的意见[EB/OL]. [2020-01-20]. http://www.gov.cn/zhengce/content/2017-07/11/content_5209661.htm.
[2] 陈昕煜,秦怀金,武宁,等.我国医学教育中存在的问题和根源与策略分析[J]. 中华医学教育杂志, 2017, 37(5):641-648. DOI: 10.3760/cma.j.issn.1673-677X.2017.05.001.
[3] Thomas PD.The Flexner Report - 100years later[J]. Yale J Biol Med, 2011,84(3): 269-276.
[4] Kaplan RM, Satterfield JM, Kington RS.Building a better physician-the case for the new MCAT[J]. N Engl J Med, 2012, 366(14):1265-1268. DOI: 10.1056/NEJMp1113274.
[5] Harvard Medical School.MD Program: Pahtways[EB/OL]. [2020-01-20]. https://meded.hms.harvard.edu/pathways.
[6] Stanford School of Medical.MD program: the discovery curriculum[EB/OL]. [2020-01-20]. http://med.stanford.edu/md/discovery-curriculum.html.
[7] Johns Hopkins School of Medicine.Genes to society: a curriculum for the Johns Hopkins University School of Medicine[EB/OL]. [2020-01-20]. https://www.hopkinsmedicine.org/som/curriculum/genes_to_society/index.html.
[8] Wiener CM, Thomas PA, Goodspeed E, et al.“Genes to society”- the logic and process of the new curriculum for the Johns Hopkins University School of Medicine[J]. Acad Med.2010,85(3):498-506. DOI: 10.1097/ACM.0b013e3181ccbebf.
[9] Harvard Medical School.MD program objectives[EB/OL]. [2020-01-20]. https://medstudenthandbook.hms.harvard.edu/md-program-objectives.
[10] Aristotle.The Nicomachean Ethics[M]. London: Penguin Classics, 2004:144-166.
[11] Hovdenak SS, Wiese EF.Promoting professional development in medical education: perspectives from the Norwegian medical school in Tromsoe[J/OL]. [2020-01-20]. DOI:10.1080/20021518.2018.1451174.
[12] ABIM Foundation, American Board of Internal Medicine, ACP-ASIM Foundation, et al.Medical professionalism in the new millennium: a physician charter [J]. Ann Intern Med, 2002, 136(3):243-246. DOI:10.7326/0003-4819-136-3-200202050-00012.
[13] Rosenberg ME.An outcome-based approach across the medical education continuum[J]. Trans Am Clin Climatol Assoc, 2018, 129: 325-340.
[14] 赵峻,张荣华,罗林枝,等.美国哈佛医学院课程体系改革对中国医学教育的启示[J]. 基础医学与临床,2016, 36(6):865-868. DOI:10.16352/j.issn.1001-6325.2016.06.029.
[15] What constitutes the practice of medicine?[J]. JAMA, 1908,50:368-369.
