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.
In the physician study, the team investigated 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 investigation focused 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 were examined: learning the knowledge to think like a physician, learning skills to perform skillfully, and learning professionalism to act responsibly. Outcomes of the study 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?
Over a three-year period, the research team reviewed the literature and conducted site visits to 14 medical schools and medical centers. Data was collected through 140 structured interviews, 50 focus groups, 200 observations and document review. Both qualitative and quantitative analyses were employed.
The Carnegie study of medical education culminates in the book, Educating Physicians: A Call for Reform of Medical School and Residency, by Molly Cooke, David M. Irby and Bridget C. O'Brien. This publication was released in June, 2010 by Jossey-Bass.