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Undergraduate medical education 

Undergraduate medical education
Undergraduate medical education

H. Thomas Aretz

and Elizabeth G. Armstrong

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date: 17 November 2018

Undergraduate medical education has undergone enormous changes on a global scale over the last 40 years. While originally being under the purview of the university, it has increasingly become an integral part of the activities and mission of academic medical centres and so has become more practically and clinically focused. It has more recently been challenged to become an integral part or the healthcare system, responsive and responsible to society. This will require a dramatic shift in the culture of academic medicine. Rapid advances and changes in healthcare delivery have also necessitated many innovations in undergraduate education: • Changes in demographics and epidemiology of diseases has led to increased training in the ambulatory setting, as well as longitudinal clerkships and postings. • The explosion of knowledge and new technologies has led to integrated curricula focusing on core concepts, while ethics and professionalism became more emphasized to combat technocratic medical practice. • The delivery of healthcare has become increasingly dispersed, leading to increased community-based training. • The complexity of care requiring teams and systems has led to an emphasis on group learning and interprofessional education. • The emphasis on quality and patient safety have required increased knowledge, skills, and experience in all fields, and have led to the competency-based learning outcomes model. • Better understanding of the learning process and the application of pedagogical technologies have led to a thorough re-evaluation of how we learn. Problem-based learning, developmental approaches, experiential learning methods and online learning and simulation, were the results of these advances. Despite these innovations, it is clear that much more change is to come. We suggest that academic planning follow three distinct phases: 1. When determining the mission, vision and strategies of a new programme or institution, align the desired outcomes with values germane to the societal mission. Translating these into measurable competencies and operating principles will assure clear long-term goals and a value-informed operating framework and culture. 2. During detailed planning, make sure to align resources to the academic plan at all stages and take steps to assure that what is desirable is also do-able. 3. Make sure that implementation and operation are solidly grounded in a quality assurance system that is responsive to change and that is constantly improving.

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