Intended for healthcare professionals

Education And Debate

Learner centred approaches in medical education

BMJ 1999; 318 doi: (Published 08 May 1999) Cite this as: BMJ 1999;318:1280
  1. John A Spencer (, senior lecturer in primary health care,
  2. Reg K Jordan, professor of medical education
  1. Medical Education, Faculty of Medicine, University of Newcastle, Newcastle upon Tyne NE2 4HH
  1. Correspondence to: Dr Spencer
  • Accepted 16 April 1999

Medical education is a lifelong process embracing premedical experience, undergraduate education, general clinical training, specialist or vocational training, subspecialty training, and continuing medical education. Although medical education was once seen as the province of medical schools and teaching hospitals, large and increasing numbers of practitioners now provide teaching and promotion of learning outside the traditional environment.

Over the past decade both the university sector and the NHS have seen considerable change and increased accountability for their activities, and all the signs suggest that the next 10 years will be no different. Simultaneously, medical schools are having to acknowledge the implementation of new curricula, the consequences of new health service priorities, an increase in the number of medical students, and the implications of the report from the National Committee of Enquiry into Higher Education, chaired by Sir Ron Dearing.1

The most recent recommendations of the General Medical Council's education committee were intended to promote an approach to undergraduate medical education and to give a perspective on its aims, which differ substantially from those of traditional curricula.2 Although the 13 principal recommendations are now well known, at the core is the promotion of the merits of learner centred and problem oriented approaches to learning, which aim to produce doctors better equipped with the adult learning skills necessary for them to adapt to, and meet, the changing needs of the community they serve.

The pedagogic shift from the traditional teacher centred approach, in which the emphasis is on teachers and what they teach, to a student centred approach, in which the emphasis is on students and what they learn, requires a fundamental change in the role of the educator from that of a didactic teacher to that of a facilitator of learning.3

Our aim was to explore some of the …

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