Medical Education and Curriculum Reform: Putting Reform Proposals in Context

Abstract

*Centre for Clinical Governance Research in Health School of Public Health and Community Medicine University of New South Wales Sydney, NSW, 2052, Australia †Centre for Clinical Management Improvement, Wolfson Research Institute University of Durham Stockton Campus University Boulevard, Thornaby Stockton on Tees TS17 6BH, U.K. ‡Centre for Clinical Governance Research in Health School of Public Health and Community Medicine Faculty of Medicine University of New South Wales Sydney, NSW, 2052, Australia **Bankstown-Lidcombe Hospital School of Public Health and Community Medicine Faculty of Medicine University of New South Wales Sydney, NSW, 2052, Australia Abstract: The purpose of this paper is to elaborate criteria by which the principles of curriculum re- form can be judged. To this end, the paper presents an overview of standard critiques of medical education and examines the ways medical curriculum reforms have responded to these critiques. The paper then sets out our assessment of these curriculum reforms along three parameters: pedagogy, educational context, and knowledge status. Following on from this evaluation of recent curriculum reforms, the paper puts forward four criteria with which to gauge the adequacy medical curriculum reform. These criteria enable us to question the extent to which new curricula incorporate methods and approaches for ensuring that its substance: overcomes the traditional opposition between clinical and resource dimensions of care; emphasizes that the clinical work needs to be systematized in so far as that it feasible; promotes multi-disciplinary team work, and balances clinical autonomy with accountability to non-clinical stakeholders.