Postgraduate medical education: see one, do one, teach one…and what else?

Abstract

Postgraduate medical education (PGME) faces many challenges and must evolve. Three principles can guide this evolution. First, PGME apprenticeship, a form of situated learning, is guided by the four dimensions of the Cognitive Apprenticeship Model: content, method, sequence, and sociology. Second, situated learning involves experiential learning and inquiry processes; it is most effective for learners practicing self-directed learning. The promotion of self-directed learning requires consideration of its three dimensions: process, person, and context. Finally, the need for competency-based PGME can be accomplished through holistic models, such as situated learning. The implementation of this evolution should be informed by the characteristics of the new paradigm, inner and outer settings of the organisations, and individuals involved. Implementation encompasses communication to engage stakeholders, training process redesign in accordance with the new paradigm, faculty development to empower and engage involved individuals, and research to enhance the understanding of PGME.