Beyond Compliance: Growth as the Guiding Value in Undergraduate Medical Education.

Autor:	Woodruff JN; J.N. Woodruff is professor of medicine, Department of Medicinedean of students, Pritzker School of Medicine, University of Chicago, Chicago, Illinois., Lee WW; W.W. Lee is associate professor, Department of Medicineassociate dean of students and professional development, Pritzker School of Medicine, University of Chicago, Chicago, Illinois., Vela M; M. Vela is professor of medicine, Department of Medicinedirector, Hispanic Center for Excellence, University of Illinois College of Medicine, Chicago, Illinois., Davidson AI; A.I. Davidson is distinguished professor of humanities, Faculty of the Humanities, The Hebrew University of Jerusalem, Mt. Scopus, Jerusalem, Israel.
Jazyk:	angličtina
Zdroj:	Academic medicine : journal of the Association of American Medical Colleges [Acad Med] 2023 Jun 01; Vol. 98 (6S), pp. S39-S45. Date of Electronic Publication: 2023 May 23.
DOI:	10.1097/ACM.0000000000005190
Abstrakt:	Adhering to the paradigm of the natural sciences, much of undergraduate medical education (UME) in the United States remains committed to objectivity, compliance, and standardization in its approach to teaching, evaluation, student affairs, and accreditation practices. The authors argue that, while these simple and complicated problem solving (SCPS) approaches may be valid for some highly controlled environments of UME, they lack rigor in complex, real-world environments where optimal care and education is not standardized but is tailored to context and individual needs. This argument is supported by evidence that "systems" approaches, characterized by complex problem solving (CPS, differentiated from complicated problem solving), lead to better outcomes in patient care and student academic performance. Examples of interventions implemented at the University of Chicago Pritzker School of Medicine from 2011 to 2021 further illustrate this point. Interventions in student well-being that emphasize personal and professional growth have led to student satisfaction that is 20% higher than the national average on the Association of American Medical Colleges Graduation Questionnaire (GQ). Career advising interventions that augment the use of adaptive behaviors in place of rules and guidelines have yielded 30% fewer residency applications per student than the national average while simultaneously yielding residency "unmatched" rates that are one-third of the national average. Regarding diversity, equity, and inclusion, an emphasis on civil discourse around real-world problems has been associated with student attitudes toward diversity that are 40% more favorable than the national average on the GQ. In addition, there has been an increase in the number of matriculating students who are underrepresented in medicine to 35% of the incoming class. The article concludes with a review of philosophic barriers to incorporating the CPS paradigm into UME and of notable pedagogic differences between CPS and SCPS approaches. (Copyright © 2023 by the Association of American Medical Colleges.)
Databáze:	MEDLINE
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