On pandemics and pivots: a COVID-19 reflection on envisioning the future of medical education
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The required adjustments precipitated by the coronavirus disease 2019 crisis have been challenging, but also represent a critical opportunity for the evolution and potential disruptive and constructive change of medical education. Given that the format of medical education is not fixed, but malleable and in fact must be adaptable to societal needs through ongoing reflexivity, we find ourselves in a potentially transformative learning phase for the field. An Association for Medical Education in Europe ASPIRE Academy group of 18 medical educators from seven countries was formed to consider this opportunity, and identified critical questions for collective reflection on current medical education practices and assumptions, with the attendant challenge to envision the future of medical education. This was achieved through online discussion as well as asynchronous collective reflections by group members. Four major themes and related conclusions arose from this conversation: Why we teach: the humanitarian mission of medicine should be reinforced; what we teach: disaster management, social accountability and embracing an environment of complexity and uncertainty should be the core; how we teach: open pathways to lean medical education and learning by developing learners embedded in a community context; and whom we teach: those willing to take professional responsibility. These collective reflections provide neither fully matured digests of the challenges of our field, nor comprehensive solutions; rather they are offered as a starting point for medical schools to consider as we seek to harness the learning opportunities stimulated by the pandemic.
Abstract
The required adjustments precipitated by the coronavirus disease 2019 crisis have been challenging, but also represent a critical opportunity for the evolution and potential disruptive and constructive change of medical education. Given that the format of medical education is not fixed, but malleable and in fact must be adaptable to societal needs through ongoing reflexivity, we find ourselves in a potentially transformative learning phase for the field. An Association for Medical Education in Europe ASPIRE Academy group of 18 medical educators from seven countries was formed to consider this opportunity, and identified critical questions for collective reflection on current medical education practices and assumptions, with the attendant challenge to envision the future of medical education. This was achieved through online discussion as well as asynchronous collective reflections by group members. Four major themes and related conclusions arose from this conversation: Why we teach: the humanitarian mission of medicine should be reinforced; what we teach: disaster management, social accountability and embracing an environment of complexity and uncertainty should be the core; how we teach: open pathways to lean medical education and learning by developing learners embedded in a community context; and whom we teach: those willing to take professional responsibility. These collective reflections provide neither fully matured digests of the challenges of our field, nor comprehensive solutions; rather they are offered as a starting point for medical schools to consider as we seek to harness the learning opportunities stimulated by the pandemic.
참고문헌 (51)
- "Fresh out of medical school, young Italian doctors are being fast-tracked to the coronavirus frontline" (2020)[URL]
- Gibbs T, "The COVID-19 pandemic: provoking thought and encouraging change", Med Teach, 42(7), pp.738~740 (2020)
- Frenk J, "Health professionals for a new century: transforming education to strengthen health systems in an interdependent world", Lancet, 376(9756), pp.1923~1958 (2010)
- Giddens A, "Modernity and self-identity: self and society in the late modern age" (1991), Polity Press
- Mezirow J, "Learning as Transformation Critical Perspectives on a Theory in Progress", pp.3~33 (2000), Jossey-Bass
- Harden RM, "ASPIRE: international recognition of excellence in medical education", Lancet, 385(9964), pp.230~ (2015)
- Hunt D, "The ASPIRE-to-Excellence Program: a global effort to improve the quality of medical education", Acad Med, 93(8), pp.1117~1119 (2018)
- "Growing costs and shrinking revenues squeeze hospitals as they brace for coronavirus" (2020)[URL]
- Bleakley A, "Invoking the medical humanities to develop a #MedicineWeCanTrust", Acad Med, 94(10), pp.1422~1424 (2019)
- Suleiman AB, "The untapped potential of Telehealth", Int J Med Inform, 61(2-3), pp.103~112 (2001)
- Tuckson RV, "Telehealth", N Engl J Med, 377(16), pp.1585~1592 (2017)
- Rush KL, "The efficacy of telehealth delivered educational approaches for patients with chronic diseases: a systematic review", Patient Educ Couns, 101(8), pp.1310~1321 (2018)
- Norcini J, "Is it time for a new model of education in the health professions?", Med Educ, 54(8), pp.687~690 (2020)
- Dewan MJ, "We must graduate physicians, not doctors", Acad Med, 95(3), pp.336~339 (2020)
- Psychosocial consequences of disasters: prevention and management, "World Health Organization, Division of Mental Health", World Health Organization, ~ (1992)
- Sun QH, "The practice of cultivating medical students’ sense of social responsibility under the background of disaster rescue", Med Teach, 42(7), pp.834~ (2020)
- Yang DY, "Preparedness of medical education in China: lessons from the COVID-19 outbreak", Med Teach, 42(7), pp.787~790 (2020)
- James LE, "Integrating mental health and disaster preparedness in intervention: a randomized controlled trial with earthquake and flood-affected communities in Haiti", Psychol Med, 50(2), pp.342~352 (2020)
- Nasiri A, "Leadership in limbo: characteristics of successful incident commanders in health sector of a disaster-prone country", Int J Health Plann Manage, 34(4), pp.e1495~e1509 (2019)
- Wartman SA, "The empirical challenge of 21st-century medical education", Acad Med, 94(10), pp.1412~1415 (2019)
- Boyd VA, "Competency-based medical education: the discourse of infallibility", Med Educ, 52(1), pp.45~57 (2018)
- Tilburt J, "Viewpoint: the importance of worldviews for medical education", Acad Med, 82(8), pp.819~822 (2007)
- Pitama SG, "Implementation and impact of indigenous health curricula: a systematic review", Med Educ (2018)[DOI]
- Simon L, "A national survey of medical school curricula on criminal justice and health", J Correct Health Care, 25(1), pp.37~44 (2019)
- Ross BM, "Critical pedagogy as a means to achieving social accountability in medical education", Int J Crit Pedagog, 6(2), pp.169~186 (2015)
- Strasser R, "Putting communities in the driver’s seat: the realities of community-engaged medical education", Acad Med, 90(11), pp.1466~1470 (2015)
- Pitama S, "The role of social accountable medical education in addressing health inequity in Aotearoa New Zealand", J R Soc N Z, 49(sup1), pp.58~71 (2019)
- Choe Yon Ho, "Preparing for medical education after the COVID-19 pandemic: insightology in medicine", Korean Journal of Medical Education, 33(3), pp.163~170 (2021), 한국의학교육학회[DOI]
- Ilgen JS, "Comfort with uncertainty: reframing our conceptions of how clinicians navigate complex clinical situations", Adv Health Sci Educ Theory Pract, 24(4), pp.797~809 (2019)
- Mehra MR, "Retracted:Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis", Lancet (2020)[DOI]
- Zdravkovic M, "Scientific quality of COVID-19 and SARS CoV-2publications in the highest impact medical journals during the early phase of the pandemic: a case control study", PLoS One, 15(11), pp.e0241826~ (2020)
- Feng F, "Qigong for the prevention, treatment, and rehabilitation of COVID-19 infection in older adults", Am J Geriatr Psychiatry, 28(8), pp.812~819 (2020)
- Wayne DB, "Medical education in the time of COVID-19", Sci Adv, 6(31), pp.eabc7110~ (2020)
- Vogus TJ, "The affective foundations of high‐reliability organizing", J Organ Behav, 35(4), pp.592~596 (2014)
- Emanuel EJ, "The inevitable reimagining of medical education", JAMA, 323(12), pp.1127~1128 (2020)
- Han H, "Educational technology in medical education", Teach Learn Med, 25(Suppl 1), pp.S39~S43 (2013)
- Prober CG, "Medical education reimagined: a call to action", Acad Med, 88(10), pp.1407~1410 (2013)
- Boulet J, "An overview of the world's medical schools", Med Teach, 29(1), pp.20~26 (2007)
- Gruenewald DA, "The best of both worlds: a critical pedagogy of place", Environ Educ Res, 14(3), pp.308~324 (2008)
- Lave J, "Situated learning: legitimate peripheral participation" (1991), Cambridge University Press
- Dornan T, "Experience-based learning: a model linking the processes and outcomes of medical students’ workplace learning", Med Educ, 41(1), pp.84~91 (2007)
- Jacobs RL, "Structured on-the-job training: unleashing employee expertise in the workplace" (2003), Berrett-Koehler Publishers
- Han H, "Learning in the real place:medical students’ learning and socialization in clerkships at one medical school", Acad Med, 90(2), pp.231~239 (2015)
- Miller DG, "The role of medical students during the COVID-19 pandemic", Ann Intern Med, 173(2), pp.145~146 (2020)
- "MSC issues statement of expectation for medical student volunteers in the NHS" (2020)[URL]
- Compton S, "Medical students’ preference for returning to the clinical setting during the COVID-19 pandemic", Med Educ, 54(10), pp.943~950 (2020)
- Mahon KE, "Selecting tomorrow’s physicians: the key to the future health care workforce", Acad Med, 88(12), pp.1806~1811 (2013)
- Tarmey D, "Should medical schools relax academic admission criteria?", BMJ, 367, pp.l6456~ (2019)
- Talamantes E, "Closing the gap: making medical school admissions more equitable", N Engl J Med, 380(9), pp.803~805 (2019)
- Bhugra D, "Medicine’s contract with society", J R Soc Med, 107(4), pp.144~147 (2014)
- Poole KG Jr, "Mission drift: are medical school admissions committees missing the mark on diversity?", Acad Med, 95(3), pp.357~360 (2020)