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We describe the accreditation of medical education programs that lead to the Doctor of Medicine degree in the United States and Canada. We identify select accreditation standards that relate directly to the preparation of medical school graduates, as required for the supervised practice of medicine in residency training and for developing the skills of self-directed, independent learning. With standards that promote flexibility and encourage innovation, the Liaison Committee on Medical Education utilizes a continuous improvement model for the accreditation of undergraduate medical education with standards that promote flexibility and encourage innovation. The standards focus on curricula to meet learning objectives that address the current context of medical care. In undergraduate and graduate medical education, the relevance of the hospital as the predominant learning environment is challenged; in continuing medical education, traditional lectures are called into question for failing to change physician behavior and improve health care outcomes. To improve medical education from undergraduate through continuing medical education, all the relevant accrediting agencies must collaborate for success.

Objectives This paper reviews why and how theories of agency can be used as analytical lenses to help health professions education ( HPE) scholars address our community's wicked problems. Wicked problems are those that resist clear problem statements, defy traditional analysis approaches, and refuse definitive resolution (e.g. student remediation, assessments of professionalism, etc.). We illustrate how theories of agency can provide new insights into such challenges by examining the application of these theories to one particular wicked problem in HPE: interprofessional education ( IPE). Methods After searching the HPE literature and finding that theories of agency had received little attention, we borrowed techniques from narrative literature reviews to search databases indexing a broad scope of disciplines (i.e. ERIC, Web of Science, Scopus, MEDLINE and PubMed) for publications (1994-2014) that: (i) examined agency, or (ii) incorporated an agency-informed analytical perspective. The lead author identified the theories of agency used in these articles, and reviewed the texts on agency cited therein and the original sources of each theory. We identified 10 theories of agency that we considered to be applicable to HPE's wicked problems. To select a subset of theories for presentation in this paper, we discussed each theory in relation to some of HPE's wicked problems. Through debate and reflection, we unanimously agreed on the applicability of a subset of theories for illuminating HPE's wicked problems. This subset is described in this paper. Results We present four theories of agency: Butler's post-structural formulation; Giddens' sociological formulation; cultural historical activity theory's formulation, and Bandura's social cognitive psychology formulation. We introduce each theory and apply each to the challenges of engaging in IPE. Conclusions Theories of agency can inform HPE scholarship in novel and generative ways. Each theory offers new insights into the roots of wicked problems and means for contending with them. [ABSTRACT FROM AUTHOR]

We describe the accreditation of medical education programs that lead to the Doctor of Medicine degree in the United States and Canada. We identify select accreditation standards that relate directly to the preparation of medical school graduates, as required for the supervised practice of medicine in residency training and for developing the skills of self-directed, independent learning. With standards that promote flexibility and encourage innovation, the Liaison Committee on Medical Education utilizes a continuous improvement model for the accreditation of undergraduate medical education with standards that promote flexibility and encourage innovation. The standards focus on curricula to meet learning objectives that address the current context of medical care. In undergraduate and graduate medical education, the relevance of the hospital as the predominant learning environment is challenged; in continuing medical education, traditional lectures are called into question for failing to change physician behavior and improve health care outcomes. To improve medical education from undergraduate through continuing medical education, all the relevant accrediting agencies must collaborate for success. [ABSTRACT FROM AUTHOR]

Background: Animal models suggest that compounds containing a nitrosyl group (N-nitroso compounds (NNO)) can act as potent transplacental carcinogens. Many common drug formulations have the potential to undergo nitrosation in vivo. The association between maternal use of nitrosatable drugs during pregnancy and development of brain tumours in the offspring was examined in a SEER-based case-control study.Methods: Maternal exposure to nitrosatable drugs during pregnancy was compared among 361 childhood brain tumour cases and 1083 matched controls recruited through random-digit dialing.Results: There was no increase in risk observed for childhood brain tumours overall (OR = 1.15; 95% CI: 0.69-1.94) or for astrocytomas individually (OR = 1.16; 95% CI: 0.50-2.69). A slight elevation in risk was noted for medulloblastomas (OR = 1.47; 95% CI: 0.28-7.62) and 'other' tumours (OR = 1.27; 95% CI: 0.56-2.86), however, both estimates were based on small numbers.Conclusions: Our findings suggest that no increased risk of childhood brain tumours was associated with maternal exposure to nitrosatable drugs. The study results should be viewed with caution given the imprecision of the point estimates as well as the lack of data on specific timing and dosage of exposure and degree of nitrosatability of drugs taken. [ABSTRACT FROM AUTHOR]

Online learning is a strategic policy that is expected to contribute to the sustainability of educational performance. However, this policy has not been able to optimally solve existing problems. Shortcomings of students in attaining skills from core competency courses and the lecturers' limited ability to provide online learning are problems faced by the Bandung Polytechnic Diploma III Dental Health Study Program. This study employed a literature review approach. We compiled a comprehensive collection of relevant studies by identifying collaboration theories; this was strengthened by including research related to distance learning collaboration in the health sector associated with Poltekkes Bandung's SWOT. The results of this study suggested that the problems faced by the Dental Health program can be overcome through strengthening collaborative governance. Poltekkes Bandung can issue a policy to collaborate with the Faculty of Dentistry; they can thereby tackle the problem of students achieving core competencies and improve the capacity of lecturers to provide teaching by collaborating with educational institutions that have consistently held online distance learning. [ABSTRACT FROM AUTHOR]

The article focuses on a series of strategies adopted by Chancellor Carol Aschenbrener to prepare the University of Nebraska Medical Center (UNMC) in Omaha, in facing market challenges. The strategies include total quality management, cultural diversity, and values for excellence. The successful implementation of the strategies depends largely on the effectiveness of UNMC in addressing people-related issues. The human resources was repositioned as a strategic function engaged in driving organizational change through the appointment of a new chief human resources officer position. It was created to report directly to the chancellor. In 1995, a team engaged in a repositioning process, resulting in a human resource strategy that supported the continued success of UNMC.

Background: The medical education system based on principles advocated by Flexner and Osler has produced generations of scientifically grounded and clinically skilled physicians whose collective experiences and contributions have served medicine and patients well. Yet sweeping changes launched around the turn of the millennium have constituted a revolution in medical education. In this article, a critique is presented of the new undergraduate medical education (UME) curricula in relationship to graduate medical education (GME) and clinical practice. Discussion: Medical education has changed and will continue to change in response to scientific advances and societal needs. However, enthusiasm for reform needs to be tempered by a more measured approach to avoid unintended consequences. Movement from novice to master in medicine cannot be rushed. An argument is made for a shoring up of biomedical science in revised curricula with the beneficiaries being nascent practitioners, developing physician-scientists --and the public. Conclusion: Unless there is further modification, the new integrated curricula are at risk of produce graduates deficient in the characteristics that have set physicians apart from other healthcare professionals, namely high-level clinical expertise based on a deep grounding in biomedical science and understanding of the pathologic basis of disease. The challenges for education of the best possible physicians are great but the benefits to medicine and society are enormous. [ABSTRACT FROM AUTHOR]