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Keio J Med. 2005 Mar;54(1):22-8.

Trends in North American medical education.

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Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA.


Medical education in the United States of America (USA), and worldwide, is increasingly concentrating on the process and outcome of the educational experience. The first efforts to substantially improve medical education in the USA resulted in the Flexner Report in the early 1900s. The release of this report led to significant advancements in the quality of curriculum content. However, in the past few decades there has been increasing realization that delivery of content will not, by itself, assure the development of excellent physicians. As a result, there has been an increasing emphasis on the process, and, most recently, the outcome, of medical education. Process movements have examined the context and methods for teaching and learning. The problem-based learning movement is perhaps the most widely-known example of process trends. The latest trends in USA medical education focus on the outcomes of the learning process. At the forefront of this movement is the American Council on Graduate Medical Education (ACGME), which accredits all USA post-graduate training programs. Recently, the ACGME has defined a set of six core clinical competencies that all graduates must demonstrate. A second emerging trend is inter-professional education. Increasingly, healthcare is provided by inter-professional healthcare team, and students must be competent to function effectively in this setting. Many academic health centers are developing joint curricula to address this need. Medical education has evolved from a primary focus on content to an emphasis on process of teaching and learning, and will increasingly concentrate on educational outcomes.

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