Chronic Disease Management
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CURRENT OPINION
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Chronic Disease Management Seizing the Moment in Medical Education Balakrishnan R. Nair1,2 and William Browne3 1 2 3
John Hunter Hospital, New Lambton, New South Wales, Australia Centre for Medical Professional Development, HNE Health, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia Eastern Health, Melbourne, Victoria, Australia
Abstract
Medical practice must adapt to changes in the nature of diseases and population demographics. The need to prepare doctors-in-training to manage chronic disease is assuming increasing importance as the prevalence of such diseases rise throughout the world. Medical education has traditionally lagged behind changes in clinical practice. Recent advances in medical education include the development of problem-based approaches and the teaching of evidence-based medicine. Medical training, however, continues to focus on the treatment of acute illness in a younger population. This focus potentially perpetuates problems in knowledge translation, the transfer of clinical knowledge into clinical practice. There is an urgent need to refocus medical training on conditions of greater relevance and prevalence, and to prepare medical graduates for the challenges of chronic disease management. In particular, students need to be given the skills to integrate knowledge across disciplines and to work as part of an interdisciplinary team. Adapting medical training to address chronic disease management must be the new priority in medical education.
Medical practice is changing at an ever increasing rate as scientific knowledge and technologies advance at a rapid pace. Cultural, socioeconomic and environmental changes have altered the distribution and nature of diseases in the population. In spite of this, as a profession we continue to draw on traditional approaches to treatment and education with a tendency to reductionist thinking, and to base decisions on experience and expert opinions. One of the challenges facing medical education in the modern era is the relative lack of evidence supporting different teaching strategies and the inherent difficulties in measuring the efficacy of such strategies with regard to the subsequent behaviour of graduates. In order to train medical students to meet the evolving challenge of disease management, medical schools must adapt their curricula to adequately prepare students for the challenges they will face in practice. An informed debate as to how to do this is appropriate and timely.[1] The attention of medical practitioners in the 21st century should be focused on chronic diseases, just as it was on acute diseases for the better part of the 20th century. The global population is aging and as a result the prevalence of chronic diseases and accompanying disabilities are on the rise. Yet many of these diseases are preventable or modifiable. The question is, how well are we preparing doctors-in-training to exploit the opportunity to preven
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