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The Market Pushes Education From Ward to Office, From Acute to Chronic Illness and Prevention
Will Case Method Teaching-Learning Change?
Arch Intern Med. 2000;160:273-280.
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INTRODUCTION
LOOKING BACK, clinical education, largely centralized in the hospital ward since the 1900s, has focused on the diagnosis and treatment of acute disease. Over these years, with various other pedagogical rationales, recurring efforts have been made to move more education from the ward to the clinic. These outpatient programs have been largely unsustained, sometimes resisted. But in the last decade, a market economy, decentralized technologies, and group organization of practice have moved more care outside the hospital, pressuring more education into ambulatory practices. This market move of education into an ambulatory mode brings educational challenges: (1) a reorientation of teaching and learning from acute to chronic illness and prevention; (2) a redirected use of the case method from diagnosis alone to patient-centered assessment and management; and (3) a commitment to the goals of care, ie, early diagnosis, prevention, and rehabilitation. Ambulatory teaching-learning practices also require changing roles of students, instructors, . . . [Full Text of this Article]
OFFICE-BASED EDUCATION IN THE PAST
THE RATIONALES OF OFFICE-BASED EDUCATION
ATTITUDES ABOUT OFFICE-BASED LEARNING
THE CHALLENGE OF OFFICE-BASED EDUCATION: CHRONIC ILLNESS CARE AND PREVENTION
CASE METHOD USE ON THE WARD: DIAGNOSIS AND TREATMENT OF ACUTE ILLNESS
CASE METHOD USE IN THE OFFICE: ASSESSMENT AND MANAGEMENT OF CHRONIC ILLNESS
ASSESSMENT TASKS OF THE CASE METHOD IN CHRONIC ILLNESS AND PREVENTION
MANAGEMENT SKILLS OF THE CASE METHOD IN CHRONIC ILLNESS AND PREVENTION
CHANGING ROLES, RELATIONSHIPS, ROUNDS, AND RECORDS
STUDENT ROLE: FROM JUNIOR ON THE WARD TEAM TO STUDENT ASSISTANT IN THE CLINIC
OFFICE RELATIONSHIPS
PATIENT ROLE IN THE CLINIC: COTEACHING
OFFICE ROUNDS
OFFICE RECORDS
CONCLUSIONS
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