The do's, don'ts and don't knows of establishing a sustainable longitudinal integrated clerkship
The do's, don'ts and don't knows of establishing a sustainable longitudinal integrated clerkship
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DOI：
10.1007/s40037-019-00558-z
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发表时间：
2020-01-17
影响因子：
3.6
通讯作者：
Worley, Paul
中科院分区：
文献类型：
--
作者：
Bartlett, Maggie;Couper, Ian;Worley, Paul
纵向综合见习是临床医学教育的一种模式，越来越多地被世界各地的医学院所采用。这些指导方针是对文献的叙述性审查的结果，该文献考虑了如何最大限度地提高新的纵向综合职员计划的可持续性。方法四位作者都有建立纵向综合见习项目的实践经验。每位作者都各自构建了自己的“该做”、“不该做”和“不该知道”，以及支撑这些原则的文献。在讨论中汇编和修订了清单，并商定了最后一套准则。每个指南都包含证据强度的声明。结果最后列出了18条“该做、不该做和不该知道”的建议，并对每条建议的证据进行了评估。结论实施纵向综合办案制度是一个复杂的过程，需要医院和社区中广泛的利益相关者的参与。变更管理过程的复杂性需要仔细和持续的关注，特别关注学生和他们学习的社区的项目结果。有效和一致的领导和充足的资源是重要的。有必要仔细选择教学地点，让学生和教师参与分配学生到教学地点，并在实施阶段及以后为学生和教师提供支持。需要努力解决不知道的问题，特别是如何最好地衡量成本效益的问题。
Introduction The longitudinal integrated clerkship is a model of clinical medical education that is increasingly employed by medical schools around the world. These guidelines are a result of a narrative review of the literature which considered the question of how to maximize the sustainability of a new longitudinal integrated clerkship program. Method All four authors have practical experience of establishing longitudinal integrated clerkship programs. Each author individually constructed their Do's, Don'ts and Don't Knows and the literature that underpinned them. The lists were compiled and revised in discussion and a final set of guidelines was agreed. A statement of the strength of the evidence is included for each guideline. Results The final set of 18 Do's, Don'ts and Don't Knows is presented with an appraisal of the evidence for each one. Conclusion Implementing a longitudinal integrated clerkship is a complex process requiring the involvement of a wide group of stakeholders in both hospitals and communities. The complexity of the change management processes requires careful and sustained attention, with a particular focus on the outcomes of the programs for students and the communities in which they learn. Effective and consistent leadership and adequate resourcing are important. There is a need to select teaching sites carefully, involve students and faculty in allocation of students to sites and support students and faculty though the implementation phase and beyond. Work is needed to address the Don't Knows, in particular the question of how cost-effectiveness is best measured.