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Education or training: medicine's learning agenda

BMJ 1997; 314 doi: (Published 29 March 1997) Cite this as: BMJ 1997;314:983
  1. ZoË-Jane Playdon,
  2. DanË Goodsman
  1. education adviser to the South Thames Department of Postgraduate Medicine and Dentistry
  2. education adviser to the United Medical and Dental Schools of Guy's and St Thomas's, London

    Although the process of professionalisation for doctors is called medical education its rhetoric is that of training. To professionals from mainstream education this presents a paradox as we recognise a critical distinction between training and education.

    We identify training as a learning process which deals with known outcomes. It is exemplified in the production line and production management, and its central concern is that the same product should be produced identically each time. So it deals in repetitive skills and uniform performances which are expressed as standards or criteria which must be followed exactly. Medicine deals with some areas where uniformity of this kind is desirable–for example, taking blood. But, clearly, these protocols are not the whole of medicine.

    For that we must turn to education. Education is a learning process which deals with unknown outcomes, with circumstances which require a complex synthesis of knowledge, …

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