Health professionals for a new century: transforming education to strengthen health systems in an interdependent world

This article argues that academic research related to the conduct of business and management has had some very significant and negative influences on the practice of management. These influences ha...

Bad Management Theories Are Destroying Good Management Practices

Much of what teachers need to know to be successful is invisible to lay observers, leading to the view that teaching requires little formal study and to frequent disdain for teacher education programs. The weakness of traditional program models that are collections of largely unrelated courses reinforce this low regard. This article argues that we have learned a great deal about how to create stronger, more effective teacher education programs. Three critical components of such programs include tight coherence and integration among courses and between course work and clinical work in schools, extensive and intensely supervised clinical work integrated with course work using pedagogies linking theory and practice, and closer, proactive relationships with schools that serve diverse learners effectively and develop and model good teaching. Also, schools of education should resist pressures to water down preparation, which ultimately undermine the preparation of entering teachers, the reputation of schools of education, and the strength of the profession.

CONSTRUCTING 21st-CENTURY TEACHER EDUCATION

Objectives This article reviews and critically evaluates historical and contemporary research on simulation-based medical education (SBME). It also presents and discusses 12 features and best practices of SBME that teachers should know in order to use medical simulation technology to maximum educational benefit.

Methods  This qualitative synthesis of SBME research and scholarship was carried out in two stages. Firstly, we summarised the results of three SBME research reviews covering the years 1969–2003. Secondly, we performed a selective, critical review of SBME research and scholarship published during 2003–2009.

Results  The historical and contemporary research synthesis is reported to inform the medical education community about 12 features and best practices of SBME: (i) feedback; (ii) deliberate practice; (iii) curriculum integration; (iv) outcome measurement; (v) simulation fidelity; (vi) skill acquisition and maintenance; (vii) mastery learning; (viii) transfer to practice; (ix) team training; (x) high-stakes testing; (xi) instructor training, and (xii) educational and professional context. Each of these is discussed in the light of available evidence. The scientific quality of contemporary SBME research is much improved compared with the historical record.

Conclusions  Development of and research into SBME have grown and matured over the past 40 years on substantive and methodological grounds. We believe the impact and educational utility of SBME are likely to increase in the future. More thematic programmes of research are needed. Simulation-based medical education is a complex service intervention that needs to be planned and practised with attention to organisational contexts.

Medical Education 2010: 44: 50–63

A critical review of simulation-based medical education research: 2003-2009

How can good educational practice move be~ond pockets of excellence to reach a much greater proportion of students and educators? While many children and young adults in school districts and communities around the countrt have long benefited from the tremendous accomplishments of successful teachers, schools, and programs, replicating this success on a larger scale has proven to be a diJficult and vexing issue. In this article, Richard Elmore addresses this problem by anal’tzing the role of school organ izat ion and incentive structures in thwarting large-scale adoption of in novative practices close to the “core” of educational practice. Elm ore then reviews evidence Jrom two attempts cit large-scale school reform in the past — the progressive movement and the

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Getting to Scale with Good Educational Practice

A REPORT TO THE CARNEGIE FOUNDATION FOR THE ADVANCEMENT OF TEACHING WITH AN INTRODUCTION BY HENRY S. PRITCHETT PRESIDENT OF THE FOUNDATION ... the trustees of the Carnegie Foundation at their meeting in November, 1908, authorized a study and report upon the schools of medicine and law in the United States and appropriated the money necessary for this undertaking. The present report upon medical education, prepared, under the direction of the Foundation, by Mr. Abraham Flexner, is the first result of that action. No effort has been spared to procure accurate and detailed information as to the facilities, resources, and methods of instruction of the medical schools. They have not only been separately visited, but every statement made in regard to each detail has been carefully checked with the data ill possession of the American Medical Association, likewise obtained by personal inspection, and with the records of the Association of American Medical Colleges, so far as its membership extends. The details as stated go forth with the sanction of at least two, and frequently more, independent observers. In making this study the schools of all medical sects have been included. It is clear that so long as a man is to practise medicine, the public is equally concerned in his right preparation for that profession, whatever he call himself,--allopath, homeopath, eclectic, osteopath, or whatnot. It is equally dear that he should be grounded in the fundamental sciences upon which medicine rests, whether he practises under one name or under another.... The report which follows is divided into two parts. In the first half the history of medical education in this country and its present status are set forth. The story is there told of the gradual development of the commercial medical school, distinctly an American product, of the modern movement for the transfer of medical education to university surroundings, and of the effort to procure stricter scrutiny of those seeking to enter the profession. The present status of medical education is then fully described and a forecast of possible progress in the future is attempted. The second par of the report gives in detail a description of the schools in existence in each state of the Union and in each province of Canada. It is the purpose of the Foundation to proceed at once with a similar study of medical education in Great Britain, Germany, and France, in order that those charged with the reconstruction of medical education in America may profit by the experience of other countries.... The significant facts revealed by this study are these: (1) For twenty-five years past there has been an enormous over-production of uneducated and ill trained medical practitioners. This has been in absolute disregard of the public welfare and without any serious thought of the interests of the public. Taking the United States as a whole, physicians are four or five times as numerous in proportion to population as in older countries like Germany. (2) Over-production of ill trained men is due in the main to the existence of a very large number of commercial schools, sustained in many cases by advertising methods through which a mass of unprepared youth is drawn out of industrial occupations into the study of medicine. (3) Until recently the conduct of a medical school was a profitable business, for the methods of instruction were mainly didactic. As the need for laboratories has become more keenly felt, the expenses of an efficient medical school have been greatly increased. The inadequacy of many of these schools may be judged from the fact that nearly half of all our medical schools have incomes below $10,000, and these incomes determine the quality of instruction that they can and do offer. Colleges and universities have in large measure failed in the past twenty-five years to appreciate the great advance in medical education and the increased cost of teaching it along modern lines. …

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Medical education in the United States and Canada

Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching

Medical education in the United States and Canada : a report to the Carnegie Foundation for the Advancement of Teaching by Abraham Flexner

Before beginning to consider whether social work is or is not a profession, I must confess a very genuine doubt as to my competency to undertake the discussion. My acquaintance with social work, with the literature of social work, and with social workers is distinctly limited—far too much so. Hence, if the conclusions that I have reached seem to you unsound or academic, I beg you to understand that I should not be disposed to press them. The word profession or professional may be loosely or strictly used. In its broadest significance, it is simply the opposite of the word amateur. A person is in this sense a professional if his entire time is devoted to an activity, as against one who is only transiently or provisionally so engaged. The professional nurse, baseball player, dancer, and cook thus earn a livelihood by concentrating their entire attention on their respective vocations and expect to go on doing so; whereas the amateur nurse enlists only for the duration of the war, or the amateur baseball player, during youth or college life. Social work is from this point of view a profession for those who make a full-time job of it; it is not a profession for those who incidentally contribute part of themselves to active philanthropy. However, I have not been asked to decide whether social work is a full-time or part-time occupation, whether, in a word, it is a professional or amateur occupation. I assume that every difficult occupation requires the entire time of those who take it seriously, though of course work can also be found for volunteers with something less than all their time or strength to offer. The question put to me is a more technical one. The term profession, strictly used, as opposed to business or handicraft, is a title of peculiar distinction, coveted by many activities. Thus far, it has been pretty indiscriminately used. Almost any occupation not obviously a business is apt to classify itself as a profession. Doctors, lawyers, preachers, musicians, engineers,

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Abraham Flexner

Papers

Medical education in the United States and Canada

Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching

Medical education in the United States and Canada : a report to the Carnegie Foundation for the Advancement of Teaching by Abraham Flexner

Is Social Work a Profession

Medical education : a comparative study