Designing health professional education curricula using systems thinking perspectives.
Designing health professional education curricula using systems thinking perspectives.
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DOI：
10.1186/s12909-020-02442-5
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发表时间：
2021-01-06
影响因子：
3.6
通讯作者：
Lane AS
中科院分区：
文献类型：
--
作者：
Khanna P;Roberts C;Lane AS
医学生从进入医学院，通过教育计划，并进入终身实践复杂的个人学习途径。然而，许多利益相关者呼吁对当代课程进行实质性改革，理由是担心新毕业的医生缺乏在复杂的医疗环境中工作的关键能力。尽管教育工作者需要专注于课程设计，但缺乏总体观点，可以将各种课程元素以一种方式进行综合，从而在满足当前课程要求及其他方面为学生提供有意义和欣赏。如果没有这样的指导，教育工作者就有可能创建支离破碎的项目设计，这可能会给学生和课程设计者带来意想不到且无法采取行动的结果。使用系统思维，我们着手解决这一差距，提供一个总体的角度为课程设计人员欣赏的关系和各种课程元素的相互作用，通知和影响学生的准备实践。通过将课程构建为一个复杂的适应系统，我们使用软系统思维开发了一个概念性课程工具包的初始原型，并以卫生专业教育和更广泛的教育背景下的相关文献评估为基础。在作者与各种国家和国际同事通过海报，简短的通信和几次会议上的研讨会以及通过社交媒体进行批判性反思后，原型得到了进一步的反复完善。我们描述了3 P-6Cs工具包如何捕捉学习者的个人旅程，通过一个教育计划到实践领域的逻辑连接的三个关键要素：个人，程序和实践。我们展示了它的应用在三个例子有关当代卫生专业教育课程。这些是：创建综合教育设计，以捕捉学生的发展连续，概念化沉浸式临床实习在非传统的设置，和课程干预的复杂性一致的评价。将3 P-6Cs课程工具包应用于课程（重新）设计问题可以提供总体视角，使教育工作者能够更好地了解教育计划中的元素如何整合，并影响学生为终身实践做好准备。
Medical students navigate complex personal learning pathways from entry into medical school, through an educational program, and into life-long practice. However, many stakeholders have called for substantive reforms in contemporary curricula, citing concerns about the lack of key abilities amongst newly graduated doctors to work in complex healthcare environments. Despite the need for educators to focus on curricula design, there is a paucity of overarching perspectives that allow synthesis of the various curricular elements in a way that lends meaningfulness and appreciation to the students in terms of navigating the immediate program requirements and beyond. Without such guidance, educators risk creating fragmented program designs that can lead to both unintended and unactionable outcomes for students as well as curriculum designers. Using systems thinking, we set out to address this gap by providing an overarching perspective for curriculum designers to appreciate the relationships and the interactions of the various curricular elements that inform and impact student’s preparedness for practice. By framing a curriculum as a complex adaptive system, we used soft systems thinking to develop an initial prototype of a conceptual curricular toolkit, underpinned by an appraisal of relevant literature within health professional education and the broader educational context. The prototype was further refined iteratively after critical reflection by the authors with a diverse range of national and international colleagues via posters, short communications, and workshops at several conferences, and through social media. We describe how the 3P-6Cs toolkit captures a learner’s personal journey through an educational program into a field of practice by logically linking the three key elements: the personal, the program, and the practice. We demonstrate its application in three examples related to contemporary health profession education curricula. These are: creating integrated educational designs to capture students’ developmental continua, conceptualising immersive clinical placements in non-traditional settings, and complexity-consistent evaluation of curricular interventions. Applying the 3P-6Cs curricular toolkit to problems of curricula (re)design can provide overarching perspectives that enable educators to have a better understanding of how integration of elements within education programs can inform and impact student’s preparation for lifelong practice.
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