Operationalising generalism in medical education: a narrative review of international policy and mission documents.

Autor:	Ramanathan A; Department of Primary Care and Population Health, University College London, London, UK., Clarke N; Department of Primary Care and Population Health, University College London, London, UK., Foster M; Department of Primary Care and Population Health, University College London, London, UK., Pope L; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK., Hart N; School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Belfast, UK., Cheung S; Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada., Kelly M; Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada., Park S; Department of Primary Care and Population Health, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors [Educ Prim Care] 2024 May-Jul; Vol. 35 (3-4), pp. 81-91. Date of Electronic Publication: 2023 Dec 19.
DOI:	10.1080/14739879.2023.2275262
Abstrakt:	Introduction: Despite moves across medical education to increase learning of generalist principles, a lack of clarity about what generalism means and how we should train doctors as 'generalists', has remained. This study explores how international, undergraduate and postgraduate, policy and educational mission documents characterise the practice and learning of generalism and how this can inform physician training. Methods: A narrative literature review was conducted based on policy and mission documents identified through grey literature searches and a wider systematic review looking at empirical texts. Texts published between 1999 and present and related to 'generalism' were eligible for inclusion. Texts were coded and codes were reviewed and grouped into key themes. Results: Thirty-four documents were included. Definitions vary: some described generalism as a basic skill, whilst others emphasised expertise. Factors which support learning generalism include: favourable financial outcomes; ageing populations; coordination of multidisciplinary care; demand for doctors with transferable skills; and patient expectations. Barriers to learning about generalism include: preference for specialisation; structure of undergraduate teaching and assessment; and the hidden curriculum. Solutions may include re-imagining generalists and specialists as being on a continuum as well as increasing exposure throughout medical education. Discussion: Whilst generalism is consistently positioned as valuable, less clarity exists about how best to operationalise this in medical education. Fundamental ideological and structural changes within teaching curricula and assessment, are necessary to improve generalist learning and to promote sustainable practice. Medical education needs careful, considered planning to ensure workforce expertise is meeting population needs.
Databáze:	MEDLINE
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