Medical Knowledge ?

1910 Flexner report

20 69

1910 155 1930 76

The Flexner report

Abraham Flexner

(1866~1959

http://content.nejm.org/content/vol355/issue13/images/large/08f1.jpeg

Abraham Flexner

1908 The American College

155

1.

2.

3.

4.

5.

1910 Flexner report

The Flexner Report

California Medical College

Baylor University College of Medicine

Birmingham Medical College

Washington University Medical School St. Louis

Tennessee

Vanderbilt

Knoxville & Chattanooga Utterly wretched

1918American College Surgeons

1953Joint Commission on Accreditation of Hospital

JCAH

1987Joint Commission on Accreditation of Healthcare

Organizations; JCAHO

1992National Committee on Foreign Medical Education and

AccreditationNCFMEA

19989

NCFMEA

1950

1998 16

(Non-comparable)

11 18

NCFMEA

1945/

1949

1954

1958

1960

1975

1983

1987

1994

2000

2009 :

19989

NCFMEA

1998108 NCFMEA

1. ?

2.

3.

4.

5.

6.

7.

NCFMEA

2002

1999

TMAC

1999

2002 NCFMEA

2009 NCFMEA

Taiwan Medical Accreditation Council TMAC

SARS

2003

Medical Knowledge ?

1.

2.

3.

4.

5.

6.

Recommendation for Medical Education

in Taiwan

et al 2009

92

(Postgraduate Year 1; PGY1)

95

12

3 6

100

(AAMC, 1996)

WFME, 2003)

IIME, 2003)

To Err Is Human (IOM, 2000)

Crossing the Quality Chasm (IOM, 2001)

Health Professions Education (IOM, 2003)

World Federation for Medical Education (WFME)

20033

Phase I:

Phase II:

Phase III: /

Global Minimum Essential Requirement

GMER

2005

2005

2004

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92

(Postgraduate Year 1; PGY1)

95

12

3 6

100

ACGME

2006

Accreditation Council for Graduate Medical Education

(ACGME)

1918 (ACS

1953 JCAH

1981

(ACGME)

Accreditation Council for Graduate Medical Education

(ACGME)

6 MIS + 3P

1 Medical knowledge

2 Interpersonal & communication skills

3 System-based practice

4 Patient care

5 Professionalism

6 Practice-based learning & improvement

Accreditation Council for Graduate Medical Education

(ACGME)

PGY UGY

1. 2. 3. 4. 5. 6. 7. 8. 9.

1. 2. 3. 4. 5. 6. 7.

PGY UGY 1. (MK) 2. (MK) 3. CVPFoleyNGSB tube(MK) 4. (MKPC) 5. (MKPC)

1. MKPC 2. (PCCS) 3. (MKPC) 4. (PCCS) 5. PCCSSBP

1. PLI 2. PBLISBP 3. P 4. PCS SBP

1. (MK) 2. (MK) 3. (MK) 4. (MK) 5. (MK) 1. PCCS 2. (MKPC) 3. (MKPC) 4. PCCSSBP 5. MKPC

1. PBLI 2. P 3. P

EDUCATE UP

UP

EDUCATE

Lawrence M. Opas

LAC + USC Medical Center

ACGME

2006

I1 I2 PGY1

1Medical knowledge

2Interpersonal and communication skills

3System based practice

4Patient care:

5Practice based learning and improvement

6Professionalism

2008

2008

Adult education

Childhood Education

Compulsory

Teacher initiated

Teacher motivated

Teacher directed

Teacher assessed

Non reflective

Non critical

Adult education Motivation

Learner centered

Relevant

Clear goals

Feedback

Experiential reflection

Development

2008

2008

2008

2008

We want to turn out

Good Doctors

ACGME Outcome Project

Thanks your attention