Contents



Preface

As with many, if not all aspects of twenty-first-century society, contemporary medical education (ME) is evolving at a tremendous rate with the traditional models of education—learning and teaching—being challenged in the process. In the past, the roles and responsibilities of teachers and students were well defined, as the content and curriculum, at least in the context of ME, was based upon mastering the core topics of basic science, followed by the introduction of clinical curricula focusing on various medical and surgical specialties and subspecialties. While this basic paradigm still exists as a foundation for learning "facts" about diseases and their treatments, it is becoming clear that the topic of ME is much broader and more complex. The search continues for better tools and techniques aimed at teaching and objectively testing core knowledge, its application to patient care, and the early integration of basic and clinical sciences as the ME system continues to evolve. Furthermore, the key principles that described the "art of medicine" as historically lectured, tested, and applied are still emphasized, but the education of a contemporary physician is much more complex and will continue to get more so.

Traditionally, the physician is often viewed as the leader of the healthcare team. In a manner that was often viewed as absolute and without question, he (as most were males) directed the care of patients by generating hypotheses and ordering various diagnostic tests and procedures, and coordinating care with consultants and colleagues. As the role of the physician evolved, especially in the context of leadership, the focus moved toward healthcare team integration with the role often viewed as more of a politician who negotiates an agenda for care in which 'best practices' are often the subject of intense debate. The concept of effective teamwork, regardless of how defined, is a crucial component of being a successful physician. Consequently, physicians are now expected to learn how to lead, manage, and navigate a full spectrum of healthcare challenges, in addition to overseeing the overall care of an individual patient. Examples of multidisciplinary teams include Cancer Tumor Boards, Heart Teams, Trauma Teams, as well as various Critical Care and Emergency Specialty (e.g., Emergency Medicine, Stroke, High-risk Obstetrics, etc.) teams and, more and more, subsets of such teams for disease or therapy-specific situation. The physician is expected to develop, champion, and run such teams, recognizing and leveraging the unique value that each team member brings to the table. There is also a rapidly growing profession of non-physician providers such as physician assistants, doctors of nursing, and advanced nurse practitioners who are becoming critical members of the overall healthcare team. In addition to disease or organ-specific specialization, such individuals are often serving as de facto team leaders, champions, and coordinators or, as commonly described, navigators. As such, the current ME initiatives must provide the foundation that allows trainees to understand and appreciate the need for mutual respect, professionalism, and division of roles, expertise, and responsibilities that everyone brings to the bedside

regardless of educational background or titles.

It is clear, as emphasized in this text, that the traditional approaches toward teaching (and learning) medicine have changed significantly over the past two decades, and even more so as we continue on in this digital information age.
