Intended for healthcare professionals



BMJ 2005; 331 doi: (Published 22 September 2005) Cite this as: BMJ 2005;331:703
  1. Chris Johnson, consultant anaesthetist (
  1. Anaesthetic Department, Southmead Hospital, Bristol

    Senior clinicians are often castigated for being out of date. Rapid developments in technology and frequent alterations in evidence based guidelines make it difficult to ensure constant modernity. But does neuronal loss incapacitate the senior clinician? Are young people inherently more receptive to new ideas? Or are other mechanisms at work? Dame Janet Smith suggests that revalidation should require doctors to pass regular summative knowledge tests. No doubt educationalists will seek to develop fair, validated, and defendable examinations, and we will face some form of multiple selection questionnaire, probably linked to a visit to a simulator to resuscitate a plastic doll. An industry will establish itself around such tests, and—given time, afew courses, and plenty of practice—I might hope to surmount the hurdle.

    But my fear is that, as a senior adult learner, I will be expected to conform to methods of teaching, learning, and testing that alienate me. I suspect that younger doctors will find it easier to pass the tests …

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