Intended for healthcare professionals

Education And Debate

Trend spotting: fashions in medical education

BMJ 1999; 318 doi: (Published 08 May 1999) Cite this as: BMJ 1999;318:1272
  1. Joseph K Campbell (, course director, MSc in medical education,
  2. Cindy Johnson, lecturer in medical education
  1. Academic Department of Medical and Dental Education, University of Wales College of Medicine, Cardiff CF14 4XN
  1. Correspondence to: J K Campbell
  • Accepted 12 April 1998

This article explores the nature of fashions in medical education and identifies some of the questions about medical education that such fashions raise. What constitutes a fashion in a professional or academic discipline? What do such “fashions” contribute, both positively and negatively, to the development of medical education? What steps can practitioners and academics in medical education take to change a trend into an important step forward in the development of a discipline?

We define a fashion in medical education as an approach to education that is based primarily on social influences, in contrast to approaches based on established educational principles and theories, critically evaluated experiences, or the results of valid research. An analogy is the distinction between fashion in clothes (colour and style) and the quality and functionality of clothing (material and comfort). We chose multiprofessional learning and multimedia computer aided learning as case studies, and we illustrate why each should currently be characterised as a fashion rather than informed practice. Both have received attention internationally in medical curriculum reform. 1 2

Summary points

  • Unexplored assumptions about the knowledge underpinning practice underlie some fashions in medical education

  • Definitions of a topic may be vague or differ among practitioners

  • In a fashion, educational reasoning and justification are implicit at best and at worst absent

  • Qualitative information to substantiate empirical data is often lacking

  • The feasibility of implementing interventions is ignored or overlooked


A Medline search was conducted and all available abstracts of articles addressing multimedia computer aided learning (n=258) and multiprofessional learning (n=92) written in 1985-98 were collected. Abstracts were qualitatively analysed to generate categories that could be used to classify each abstract for comparative analysis. Categories included type of publication, relevance of the publication to practice, the presence of and perceived educational rationale informing the publication, and the author's portrayal (as …

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