tailieunhanh - Achieving Excellence in Medical Education - part 2

Khoa y tế trường học thành viên có thể hỗ trợ một lần tiền lương của họ thông qua thực hành lâm sàng bán thời gian chịu áp lực ngày càng tăng để cống hiến tất cả thời gian để chăm sóc bệnh nhân. | Education Matters 5 Medical school faculty members who could once support their salaries through part-time clinical practice found themselves under increasing pressure to devote all their time to patient care. Ludmerer warns that medical education is returning to the proprietary model that Flexner decried at the beginning of the century. The fast pace of contemporary clinical work threatens to marginalize medical students and residents. If we are not careful they will once again become largely passive observers of healthcare rather than active participants in it. The focus on clinical productivity tends to diminish both the frequency and intensity of educational interactions. The demands of clinical throughput sweep aside opportunities for hands-on experience and student learning suffers. We can attempt to implement high-tech substitutes but from Flexner s point of view there is no substitute for learning by doing. Medicine cannot be learned at a distance. Not only is formal teaching under threat but the opportunity for faculty members to serve as advisors mentors and role models is also suffering. Ludmerer criticizes managed care as grounded in false assumptions about human biology. For one thing the practice of medicine requires more than a science of health and disease. It also requires artfulness in negotiating with uncertainty. In particular cases we cannot be certain that we have the right diagnosis or that we are prescribing the right therapy. If we attempt to provide medical care according to the same model we use for fast food we will undermine the trust on which a sound patient-physician relationship needs to be based. Without that trust both patient care and the education of future physicians who need to experience it firsthand will suffer. If every patient arrived with a complete diagnosis and plan for therapy then increasing throughput in our hospitals and clinics would not be a problem. But if that were the case we would not need doctors either. .