DOI QR코드

DOI QR Code

의료인문학 교육과정 개편에 대한 Kern의 교육과정개발 모델에 근거한 비판적 성찰

A Critical Review of Medical Humanities Education Curriculum Development Based on Kern's Curriculum Development Model

  • 이이레 (연세대학교 의과대학 의학교육학교실) ;
  • 안신기 (연세대학교 의과대학 의학교육학교실)
  • Lee, I Re (Department of Medical Education, Yonsei University College of Medicine) ;
  • An, Shinki (Department of Medical Education, Yonsei University College of Medicine)
  • 투고 : 2020.06.02
  • 심사 : 2020.06.30
  • 발행 : 2020.10.31

초록

Medical humanities education (MHE) is as essential as basic medical sciences and clinical medicine education. Despite the importance of MHE, MHE curriculum development (CD) has proven to be challenging. This critical review examines the MHE CD at one medical school. The critical review methodology was developed based on Kern's six step CD model to systematically examine the CD of "Doctoring and Medical Humanities (DMH)" at the Yonsei University College of Medicine. Five review questions were developed related to (1) necessity, (2) direction and purpose, (3) design, (4) operation, and (5) evaluation of CD based on Kern's model. The review showed that the process of DMH CD mapped to components of Kern's model. The DMH curriculum content selected was closely related to medical practice and aimed to combine the acquisition of understanding and skills by designing a student-participatory curriculum based on clinical cases. Assessment methods that emphasized students' reflections were actively introduced in the evaluation section. Since the regular committee for DMH continued the work of the special ad hoc committees for DMH CD, the CD was effectively completed. However, the planning and evaluation functions and responsibilities of the DMH committee need to be strengthened. Despite the apparent limitations, the fact that students showed a high satisfaction rate and preferred small group discussions based on clinical cases has significant implications in the instructional design of MHE, where changes in self-awareness and attitude are more important than the acquisition of information. It is necessary to systematically review and study students' reflection results produced by the changed assessment methods and to develop assessment indicators for MHE that reflect the achievements of the MHE competencies of students.

키워드

참고문헌

  1. Pellegrino ED. The humanities in medical education: entering the post-evangelical era. Theor Med. 1984;5(3):253-66. https://doi.org/10.1007/BF00489474
  2. Kosik RO, Huang L, Cai Q, Xu GT, Zhao X, Guo L, et al. The current state of medical education in Chinese medical schools: humanities and medical ethics. Chin Educ Soc. 2014;47(3):74-87. https://doi.org/10.2753/CED1061-1932470308
  3. Reis S, Urkin J, Nave R, Ber R, Ziv A, Karnieli-Miller O, et al. Medical education in Israel 2016: five medical schools in a period of transition. Isr J Health Policy Res. 2016;5:45. https://doi.org/10.1186/s13584-016-0104-5
  4. Singh S, Barua P, Dhaliwal U, Singh N. Harnessing the medical humanities for experiential learning. Indian J Med Ethics. 2017;2(3):147-52.
  5. Korean Institute of Medical Education and Evaluation. Accreditation standards of Korean Institute of Medical Education and Evaluation [Internet]. Seoul: Korean Institute of Medical Education and Evaluation; 2019 [cited 2020 Jun 24]. Available from: http://www.kimee.or.kr/board/data/?uid=1171&mod=document&pageid=1.
  6. Wear D, Zarconi J. A humanities-based capstone course in medical education: an affirming and difficult look back. J Learn Arts. 2006;2(1):8.
  7. Shapiro J, Coulehan J, Wear D, Montello M. Medical humanities and their discontents: definitions, critiques, and implications. Acad Med. 2009;84(2):192-8. https://doi.org/10.1097/ACM.0b013e3181938bca
  8. An S, Bu S. Reflection on the experience of medical professionalism education at Yonsei University College of Medicine. Korean Med Educ Rev. 2012;14(1):25-36. https://doi.org/10.17496/KMER.2012.14.1.025
  9. An S. A diachronic study of the curriculum development of the undergraduate medical education: based on the case of Yonsei university medical college [dissertation]. Seoul: Yonsei University; 2018.
  10. Chen BY, Kern DE, Kearns RM, Thomas PA, Hughes MT, Tackett S. From modules to MOOCs: application of the six-step approach to online curriculum development for medical education. Acad Med. 2019;94(5):678-85. https://doi.org/10.1097/ACM.0000000000002580
  11. Clark ML, Hutchison CR, Lockyer JM. Musculoskeletal education: a curriculum evaluation at one university. BMC Med Educ. 2010;10:93. https://doi.org/10.1186/1472-6920-10-93
  12. Orale RL, Uy ME. When the spiral is broken: problem analysis in the implementation of spiral progression approach in teaching mathematics. J Acad Res. 2018;3(3):14-24.
  13. Peterkin A. Curating the medical humanities curriculum: twelve tips. Med Humanit. 2016;42(3):147-8. https://doi.org/10.1136/medhum-2015-010795
  14. Shapiro J, Duke A, Boker J, Ahearn CS. Just a spoonful of humanities makes the medicine go down: introducing literature into a family medicine clerkship. Med Educ. 2005;39(6):605-12. https://doi.org/10.1111/j.1365-2929.2005.02178.x
  15. Sandars J. The use of reflection in medical education: AMEE guide No. 44. Med Teach. 2009;31(8):685-95. https://doi.org/10.1080/01421590903050374
  16. Sobral DT. An appraisal of medical students' reflection-in-learning. Med Educ. 2000;34(3):182-7. https://doi.org/10.1046/j.1365-2923.2000.00473.x
  17. Niemi PM. Medical students' professional identity: self-reflection during the preclinical years. Med Educ. 1997;31(6):408-15. https://doi.org/10.1046/j.1365-2923.1997.00697.x
  18. Trumbo SP. Reflection fatigue among medical students. Acad Med. 2017;92(4):433-4. https://doi.org/10.1097/ACM.0000000000001609
  19. Anseel F, Lievens F, Schollaert E. Reflection as a strategy to enhance task performance after feedback. Organ Behav Hum Decis Process. 2009;110(1):23-35. https://doi.org/10.1016/j.obhdp.2009.05.003
  20. De la Croix A, Veen M. The reflective zombie: problematizing the conceptual framework of reflection in medical education. Perspect Med Educ. 2018;7(6):394-400. https://doi.org/10.1007/s40037-018-0479-9
  21. Wald HS, Borkan JM, Taylor JS, Anthony D, Reis SP. Fostering and evaluating reflective capacity in medical education: developing the REFLECT rubric for assessing reflective writing. Acad Med. 2012; 87(1):41-50. https://doi.org/10.1097/ACM.0b013e31823b55fa
  22. Isaacson JH, Salas R, Koch C, McKenzie M. Reflective writing in the competency-based curriculum at the cleveland clinic lerner college of medicine. Perm J. 2008;12(2):82-8.
  23. Ousager J, Johannessen H. Humanities in undergraduate medical education: a literature review. Acad Med. 2010;85(6):988-98. https://doi.org/10.1097/ACM.0b013e3181dd226b
  24. Gonzalo JD, Caverzagie KJ, Hawkins RE, Lawson L, Wolpaw DR, Chang A. Concerns and responses for integrating health systems science into medical education. Acad Med. 2018;93(6):843-9. https://doi.org/10.1097/ACM.0000000000001960