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An Introduction to the medical education domain (Tensions (Abrupt…
An Introduction to the medical education domain
Medical
Promote health and relieve suffering
Complex system
Education
At the heart experience in context
Mutual trust required
Ability to bear the vulnerability of other and therefore oneself
Lifelong learning
Continuum with nodes
Summative assessments
Transition points
Undergraduate
Admission
Undergrad or grad entry
Popular and demanding training resulting in high academic thresholds
Selection tension between competence and humanity
Variable length
Early years transitioning to clinical
Identity changes from university student to student doctor
Student to professional
theory to practice
Knowledge to skills
Role models
Humanistic
Arrogant and uncaring
Psychology
Increase in anxiety and depression
Increased cynicism and decreased empathy
Tension between amount of time given to each specialty
Curriculum
Integrated v non-integrated
Vertical v horizontal
PBL the new orthodoxy
Student centred with active learning
Poorly defined
Does not align with clinical practice which tends not to be integrated
Healthcare systems influence curricula
Assessment
Postgraduate
Learners are not spectators or peripheral. They are key components
Highly variable curricula, assessment, instructional methods
Continuing medical education
Continuing professional development
Least developed
Rest of chapter outlines the book
Historical context
Humanist orientation
Med ed as social good
Experience and context
Pedagogy
Subject matter
Learning environment and social interaction
Material aspects
Social aspects
Communities of practice
Developing human capital
Quality assurance/improvement
Tensions
Abrupt transition points
Learner selection
Learning a skill as an onlooker
Science v art
Humane art v hidden curriculum of cynicism
Range of experience v sufficient immersion time
Primary care v specialties
Low stakes v high stakes assessment
Work v learning
Regulation v empowerment
Tensions 2
Competency based education
Self-direction and self-assessment
Uniprofessionalism or interprofessionalism
Simulation v reality
What is the truth and how do we learn it?