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威斯康辛——麦迪逊大学拟定了一项培训临床、行政双肩挑人才的教学规划。为便于在职卫生人员的学习,灵活安排了全套课程,如利用周末的时间等。教学采用学分制,学满后便可获预防医学/行政医学学士学位,也可继续进修医学专业。课程是根据学员们在工作中所遇到的问题安排的。主要课程有:卫生制度现状、卫生管理、设计及评价、信息科学、价值准则、临床预防医学。可脱产学习一年、或带职学习数年以便获得学位。这项教学安排表明,它能有效地提高临床医师的行政能力及作用。二十五年来,美国卫生保健体系的规模及复杂性都在急剧发展。目前,卫生经费约占国民生产总值的十分之一。但对卫生保健服务的需求,仍在不断上升。随之而来的,便是对卫生人员的新的要求,要求他们在事业方面作出若干实质性的调整,要求他们不断在专科技术及知识方面有所发展。一般说来,每当医生们在专业方面取得突出成就时,他们便需承担某些领导责任或行政方面的责任;要求他们担负更高的行政管理职务。随着个人在事业上的发展,总是需要不断地进行某种正式、非正式的学习。在卫生保健领域内,通常总是医务人员最终成为主要的决策人员。他们将决定医疗保健的费用、医学生所需的培训方式等等。目前,临床医师不担负这些行政责任的很少。曾对医学院校及教学医院中专业人员的教学、科研、治疗及行政管理方面所承担的责任进行调查,结果表明,上述四方面活动中他们平均承担2·6项, 有四分之一的人员,承担着所有四个方面的活动。几乎所有的调查对象都表示有必要积极地参与决策活动,以便使上述四方面的工作得以相互结合。越来越多的卫生保健组织意识到有必要进行更有效的管理,卫生人员却没有意识到这一点。许多临床卫生工作者担任行政职务后才发现他们缺乏有关经济、法律、计划、决策分析、或领导方面的专门训练。他们认为,需有这样一批领导人,他们能将复杂的医疗及技术知识与现代卫生保健制度的行政管理知识相互结合起来。针对这方面需要,威斯康辛大学卫生科学中心设计了一项新的行政医学教学规划,并于一九七五年举办了规划的第一批训练班。
Wisconsin - Madison University has developed a teaching plan to train clinical and administrative personnel to pick talents. To facilitate the learning of on-the-job health workers, a full range of courses are flexibly arranged, such as the use of weekend hours. The teaching system adopts a credit system. Upon completion of studies, a bachelor’s degree in preventive medicine/administrative medicine can be obtained, and further studies in medical science can be continued. The courses are arranged according to the students’ problems encountered in their work. The main courses are: Health System Status, Health Management, Design and Evaluation, Information Science, Value Criteria, Clinical Preventive Medicine. You can take a one-year study or take a job for several years to get a degree. This teaching arrangement shows that it can effectively improve the administrative ability and role of clinicians. In the past 25 years, the scale and complexity of the U.S. health care system have been developing rapidly. At present, health expenditures account for about one-tenth of GNP. However, the demand for health care services is still rising. What followed was a new requirement for health workers, requiring them to make a number of substantive adjustments in their careers and requiring them to continue to develop in specialized technology and knowledge. Generally speaking, whenever doctors make outstanding achievements in their profession, they must assume certain leadership responsibilities or administrative responsibilities; they are required to assume higher administrative positions. As individuals develop in their careers, they always need to conduct some kind of formal and informal learning. In the health care field, medical personnel are always the ultimate decision maker. They will decide on the cost of health care, the training methods that medical students need, and so on. At present, clinicians do not shoulder very few of these administrative responsibilities. A survey of the responsibilities of professionals in the teaching, research, treatment, and administration of medical schools and teaching hospitals. The results show that of the four activities mentioned above, they have an average of 2.6 items, a quarter of them. The staff is responsible for all four activities. Almost all respondents stated that it is necessary to actively participate in decision-making activities in order to combine the above four aspects of the work. More and more health care organizations are aware of the need for more effective management, and health workers are not aware of this. Many clinical health workers have only found themselves in administrative posts and they lack specialized training in economics, law, planning, decision analysis, or leadership. They believe that there needs to be such a group of leaders who can combine complex medical and technological knowledge with the administrative knowledge of the modern health care system. In response to this need, the University of Wisconsin Health Sciences Center designed a new administrative medical education program and organized the first training courses in 1975.