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Reviews professionalization of medical education and elaborates on a conceptual framework for understanding reforms. Uses a concept map to demonstrate factors influencing professionalization. (Contains 74 references.) (Author/YDS)

Defines the conceptualization of evidence-based learning as a framework to support curriculum innovation. Proposes implementing an intrinsically motivating touching/learning format as a means of managing change in instructional design and educational outcome. (Author/CCM)

Economic constraints, profound changes in the healthcare system and insufficient educational expertise have gripped medical education. The objective of this study was to review professionalization of medical education and to contribute to an elaboration of a conceptual framework for understanding reforms. We developed a concept map based on information retrieved by searching the Medline/Knowledge Finder and the Cochrane Library databases. The descriptors used for the searches were 'certification, credentialing, education, faculty medical, quality assurance health care, research, staff development, teaching'. The endpoints for the study were: frequency, quality of studies and propositional content with regard to professionalization for developing a concept map. Thirty-one relevant studies were found in Medline.The Cochrane Library search returned no relevant studies. The evidence of the few studies was weak. The literature-derived concept map shows that faculty development is a prerequisite for certification leading to professionalization. Other related variables were resource allocation, intrinsic motivation to learn, educational research, study time, financial policy, organizational and staff development, and new specialized roles such as clinician-educator. It is concluded that professionalization of medical education is needed. This deficit underscores the need for conceptually sound research approaches. The concept of intrinsic motivation explains how to comply with scientifically based standards, thus fostering professionality. Approaches facilitating compliance, such as evidence-based learning, potentially professionalize the practice of medical education. Novel approaches such as quality management and best evidence medical education could professionalize medical education. [ABSTRACT FROM AUTHOR]

Abstract Medicine has evolved toward rationalization since the Enlightenment, favouring quantitative measures. Now, a paradigm shift toward control through formalization can be observed in health care whose structures and processes are subjected to increasing standardization. However, educational reforms and curricula do not yet adequately respond to this shift. The aim of this article is to describe innovative approaches in medical education for adapting to these changes. The study design is a descriptive case report relying on a literature review and on a reform project’s evaluation. Concept mapping is used to graphically represent relationships among concepts, i.e. defined terms from educational literature. Definitions of ‘concept map’, ‘guideline’ and ‘algorithm’ are presented. A prototypical algorithm for organizational decision making in the project’s instructional design is shown. Evaluation results of intrinsic learning motivation are demonstrated: intrinsic learning motivation depends upon students’ perception of their competence exhibiting path coefficients varying from 0.42 to 0.51. Perception of competence varies with the type of learning environment. An innovative educational format, called ‘evidence-based learning (EBL)’ is deduced from these findings and described here. Effects of formalization consist of structuring decision making about implementation of different learning environments or about minimizing variance in teaching or learning. Unintended effects of formalization such as implementation problems and bureaucracy are discussed. Formalized tools for designing medical education are available. Specific instructional designs influence students’ learning motivation. Concept maps are suitable for controlling educational quality, thus enabling the paradigm shift in medical education. [ABSTRACT FROM AUTHOR]

In spite of the empirically evident merits of innovative teaching/learning formats such as PBL, resistance is observed to implementing promising curricular innovations, or to changing the traditional medical curricula. Moreover, reforms have failed because of resistance to change. To solve these problems it is accepted worldwide that faculty have to find and apply innovative approaches and to manage change in medical education. The aim of this study is to conceptualize change in pedagogy. The hypotheses developed in this article are visualized by concept mapping. A path analysis (correlation study) is demonstrated investigating the relationship between instructional design and motivation to learn. This article is designed as a case study. Well-defined teaching/learning goals, learning by doing, feedback and social integration of the students are features of instructional design. They correlate positively (0.14-0.32) with students' experience of self-efficacy, which leads to intrinsic motivation to learn (0.48). Implementing an intrinsically motivating teaching/learning format is proposed as a means to managing change in instructional design and, consequently, educational outcome. Evidence-based learning (EBL) was conceptualized in order to develop a format that provides these design conditions. EBL is characterized by seven instructional steps synthesizing: problem-based learning (PBL) with critical appraisal of concepts to be learned, and with quality management of learning projects. The definition of EBL given here provides the basis for further investigation directed towards continuous improvement in medical education. [ABSTRACT FROM AUTHOR]

Suggests quality-management approach (QM) as remedy to the lamented quality of medical education. Evaluation results of the QM-driven educational projects; Isomorphism of structured concepts in industrial QM and education; Case study on the implementation of quality management in medical education.