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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]