Study of Medical Education

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The Carnegie Foundation for the Advancement of Teaching has played a historic role in the study of medical education dating back to the Flexner Report of 1910. Today the Foundation continues its leadership role in the scholarship of teaching by conducting the Preparation of the Professions Program in six fields: clergy, engineers, lawyers, nurses, physicians and teachers. These studies investigate which curricular structures, instructional practices, assessment approaches and environmental/institutional characteristics optimally support the development of professionals-in-training.

Research Objectives

In the physician study, the team is investigating both the common challenges of preparing physicians for complex practice and some of the distinctive curricula, pedagogies and assessment practices that have been developed to meet these challenges. The central focus of the investigation is on the professional development of physicians-in-training at three key points in their clinical education: 1) the early exposure to “doctoring”; 2) the third year clerkships; and 3) the residency. At each level, three forms of learning will be examined: learning the knowledge to think like a physician, learning skills to perform skillfully, and learning professionalism to act responsibly. Outcomes of the study will include examples of innovative curricular structures, promising pedagogies and thoughtful approaches to assessment, all of which support the professional development of learners; a critique of inadequate educational practices; and a series of recommendations for strengthening clinical education.

Selected Research questions:

Curriculum: How does the formal and informal curriculum support the professional development of knowledge, skills and professionalism?

Pedagogy: What teaching/learning methods facilitate learning of knowledge, skills and values in clinical education?

Learning: How do students/residents learn to think, perform and act like a physician? What are the common struggles and transitions that student/residents encounter in becoming physicians?

Assessment: How are the knowledge, skills and professionalism of students and residents assessed?

Context: How are current university and practice environments affecting teaching and learning for students and residents? What should medical education be doing entirely differently?

Research Methods

Over a three-year period, the research team will review the literature and conduct site visits to 14 medical schools and medical centers. Data are being collected through 140 structured interviews, 50 focus groups, 200 observations and document review. Both qualitative and quantitative analyses will be employed. Findings from the study will be published in journal articles and a book by Jossey-Bass.

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