health professions education, education that does not prepare clinicians to practice in today’s work environments, a lack of faculty or knowledge by faculty about what needs to be taught, and ineffective approaches to education can adversely affect the development of needed competencies.

Barriers to Education

Gap Between Health Professions Education and the Current Practice Environment

There are broad concerns about health professions education that go far beyond the lack of emphasis on biopsychosocial models of illness and recovery. Experts in education and health care delivery have concluded that clinical education has not kept pace with the shift in patient demographics and desires, changing expectations for the workforce within health systems, evolving practice requirements and staffing arrangements, the continuous flood of new information, the focus on quality improvement, and new technologies. Accordingly, they have called for the restructuring of health professions education to make it more relevant to twenty-first century health care (IOM, 2001, 2003). The IOM has recommended an intensive focus on five core competencies as the cornerstones of health professions education and improved workforce performance (IOM, 2003:4):

  • Patient-centered care—Identify, respect, and care about patient differences, values, preferences, and expressed needs; relieve pain and suffering; coordinate continuous care; listen to, clearly inform, communicate with, and educate patients; share decision making and management; and continuously advocate disease prevention, wellness, and promotion of healthy lifestyles, including a focus on population health.

  • Work in interdisciplinary teams—Cooperate, collaborate, communicate, and integrate care in teams to ensure that care is continuous and reliable.

  • Employ evidence-based practice—Integrate best research with clinical expertise and patient values for optimum care, and participate in learning and research activities to the extent feasible.

  • Apply quality improvement—Identify errors and hazards in care; understand and implement basic safety design principles, such as standardization and simplification; continually understand and measure quality of care in terms of structure, process, and outcomes in relation to patient and community needs; and design and test interventions to change processes and systems of care, with the objective of improving quality.



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