Using Complexity Theory to Guide Medical School Evaluations
Using Complexity Theory to Guide Medical School Evaluations
复制标题
DOI：
10.1097/acm.0000000000001828
复制
发表时间：
2018-03-01
影响因子：
7.4
通讯作者：
Roberts, Chris
中科院分区：
文献类型：
--
作者：
Jorm, Christine;Roberts, Chris
当代医学院校的评估是狭隘的重点，往往不考虑学习和教学，研究，临床护理和社区参与之间的关系更广泛的系统的影响。其结果是毕业生缺乏必要的知识和技能，现代医疗保健系统和教育系统，是有限的，在其学习和change.To解决这个问题，作者应用复杂性理论的医学院评估，使用四个关键因素嵌套，多样性，自组织，和紧急结果。为了帮助医学教育工作者在他们自己的环境中应用这种评估方法，作者提供了两种工具修改后的程序逻辑模型和意义建构。在意义建构中，他们使用医学院作为位于复杂神经网络中的神经元的有机隐喻，使医学教育工作者能够重新构建他们对项目评估的思考方式。然后，作者为应用这种模式提供了实际指导，包括描述解决毕业生参与医疗保健系统的例子。作者认为教师的投入，文化和课程的作用，以及临床护理系统在这个例子中，医学院的评价被重新定义为一个复杂的社会干预（医学院是这样一个干预）的改进科学在这个模型中。随着复杂性理论对紧急结果的关注，评估有了一个新的重点，重新想象医学生作为变革推动者发挥他们未来的潜力，改变卫生系统和患者的生活。
Contemporary medical school evaluations are narrow in focus and often do not consider the wider systems implications of the relationship between learning and teaching, research, clinical care, and community engagement. The result is graduates who lack the necessary knowledge and skills for the modern health care system and an educational system that is limited in its ability to learn and change.To address this issue, the authors apply complexity theory to medical school evaluation, using four key factors-nesting, diversity, self-organization, and emergent outcomes. To help medical educators apply this evaluation approach in their own settings, the authors offer two tools-a modified program logic model and sensemaking. In sensemaking, they use the organic metaphor of the medical school as a neuron situated within a complex neural network to enable medical educators to reframe the way they think about program evaluation. The authors then offer practical guidance for applying this model, including describing the example of addressing graduates' engagement in the health care system. The authors consider the input of teachers, the role of culture and curriculum, and the clinical care system in this example.Medical school evaluation is reframed as an improvement science for complex social interventions (medical school is such an intervention) in this model. With complexity theory's focus on emergent outcomes, evaluation takes on a new focus, reimagining medical students as reaching their future potential as change agents, who transform health systems and the lives of patients.