A century of curricular and instruccional changes in medical education (part 1)

Abstract

Medical education has transformed teaching and learning practices in the last century in order to respond to the social, cientifical and technological challenges of each moment. Some of the innovations are still being implemented and have even been adapted to other contexts (i.e. problem-based learning), while others have been discarded. In order to present a broad perspective of the educational innovations in medicine, the authors undertook a critical review of the literature and identified the new approaches that impact curriculum, teaching and learning, and assessment of this practice. This article covers the findings regarding the first two dimensions. In regards to curriculum, the different models for defining and organizing the medical education curriculum that were proposed as an alternative to the Flexner structure are discussed (i.e. modular structure, flexible curriculum, competency based education). Then, teaching strategies that have tried to promote active learning and foster student-centered approaches for developing clinical skills in students will be described (such as, Problem-based Learning, One Minute Preceptor and SNAPPS). Curriculum and teaching innovations have influenced one another and have also had an impact on assessment practices. In another article, innovations in this area will be analyzed as well as the role that technology has played in the implementation of innovations in medical education.