Team Training of Medical Students in the 21st Century: Would Flexner Approve?
Team Training of Medical Students in the 21st Century: Would Flexner Approve?
As the 100-year anniversary of the Flexner Report approaches us, the physician workforce in the 21st century faces a radically different health care environment. To function effectively in this environment, future physicians, including medical students, will need educational programs that incorporate the theory and practice of teams and teamwork. Medical school graduates will be expected to understand how teams function and be capable themselves of functioning in a team. They will need to be competent in the knowledge, skills, and attitudes of teams and teamwork.
Numerous reports during the past 10 years from national oversight and safety institutes and agencies have supported the need for team training in the health care environment, especially as a means to decrease errors and increase patient safety. Hospital training programs have begun implementing interdisciplinary team training around high-risk scenarios for their trainees and staff.
However, for most medical schools, competence in team training has not been an instructional objective of educating medical students. Most instruction has been individual learning (i.e., lectures) or group learning (i.e., team-based or problem-based learning) even though there is strong evidence for team learning to be effective. With the ongoing changes in health care, it is argued that Flexner would concur that team training is necessary for medical students.
The physician workforce of the 21st century faces a radically different health care environment than did physicians caring for patients or doing research in the previous century. Today, physicians are expected to become part of interdisciplinary health care teams, and researchers (including physician scientists and translational scientists) are expected to become part of multidisciplinary research teams. Therefore, the required educational programs for all physicians, including medical students as future physicians, will need to incorporate the theory and practice of teams and teamwork.
For years, team training has been a hallmark of educational programs in at least half of all U.S. business schools. Leading corporations have long realized that employees skilled in forming, working on, and leading teams make for a more successful, effective, and productive company. To reduce accident rates, both the aviation and nuclear reactor industries have, for 30 years, mandated team training in simulated scenarios involving complex and potentially high-risk endeavors. Implementation of such programs resulted in a dramatic decrease in errors and a markedly improved safety record for both industries. The military services, as well as domestic emergency responders such as emergency medical technicians and fire and rescue squads, use team training to achieve key goals and to create a safe working environment.
Here, we discuss the culture change occurring in health care and why this change may necessitate team training for all future physicians. We define what constitutes a team and teamwork and explore the implications of learning in teams. A brief description of existing team training programs in undergraduate medical education and graduate medical education (GME) is provided. Looking to the future, we discuss the rationale for team training in medical school and why Flexner would concur that team training is integral to medical education.
Abstract and Introduction
Abstract
As the 100-year anniversary of the Flexner Report approaches us, the physician workforce in the 21st century faces a radically different health care environment. To function effectively in this environment, future physicians, including medical students, will need educational programs that incorporate the theory and practice of teams and teamwork. Medical school graduates will be expected to understand how teams function and be capable themselves of functioning in a team. They will need to be competent in the knowledge, skills, and attitudes of teams and teamwork.
Numerous reports during the past 10 years from national oversight and safety institutes and agencies have supported the need for team training in the health care environment, especially as a means to decrease errors and increase patient safety. Hospital training programs have begun implementing interdisciplinary team training around high-risk scenarios for their trainees and staff.
However, for most medical schools, competence in team training has not been an instructional objective of educating medical students. Most instruction has been individual learning (i.e., lectures) or group learning (i.e., team-based or problem-based learning) even though there is strong evidence for team learning to be effective. With the ongoing changes in health care, it is argued that Flexner would concur that team training is necessary for medical students.
Introduction
The physician workforce of the 21st century faces a radically different health care environment than did physicians caring for patients or doing research in the previous century. Today, physicians are expected to become part of interdisciplinary health care teams, and researchers (including physician scientists and translational scientists) are expected to become part of multidisciplinary research teams. Therefore, the required educational programs for all physicians, including medical students as future physicians, will need to incorporate the theory and practice of teams and teamwork.
For years, team training has been a hallmark of educational programs in at least half of all U.S. business schools. Leading corporations have long realized that employees skilled in forming, working on, and leading teams make for a more successful, effective, and productive company. To reduce accident rates, both the aviation and nuclear reactor industries have, for 30 years, mandated team training in simulated scenarios involving complex and potentially high-risk endeavors. Implementation of such programs resulted in a dramatic decrease in errors and a markedly improved safety record for both industries. The military services, as well as domestic emergency responders such as emergency medical technicians and fire and rescue squads, use team training to achieve key goals and to create a safe working environment.
Here, we discuss the culture change occurring in health care and why this change may necessitate team training for all future physicians. We define what constitutes a team and teamwork and explore the implications of learning in teams. A brief description of existing team training programs in undergraduate medical education and graduate medical education (GME) is provided. Looking to the future, we discuss the rationale for team training in medical school and why Flexner would concur that team training is integral to medical education.
