Education and debate

Continuing medical education: Learning and change: implications for continuing medical education

^a Research Center for Continuing Professional and Higher Education, University of Oklahoma, Norman, OK 73037-0003, USA, ^b Department of Continuing Education, Harvard Medical School, PO Box 825, Boston, MA 02115, USA

Correspondence to: Professor Fox rfox@ou.edu

	Introduction

Medical education, particularly continuing medical education (CME), has been greatly influenced by studies of adult learning. The observation that it is not teaching but learning that leads doctors to change their practice has resulted in a shift in perspective: rather than education being regarded as instruction, it is regarded as facilitation of learning. This paradigm shift has been based on research into how and why doctors change their practice and into the role of learning in that process.

The direction of continuing medical education in North America and elsewhere has changed in response to the new perspective that has emerged from contemporary studies of learning and change. The nature of this new perspective is evident from a comparison of the common elements of CME in the 1980s with the approach that is now being used. Traditionally a CME programme was an educational event that applied . . . [Full text of this article]

	Understanding change in clinical performance

Summary points

	Understanding the context of change and learning

Features of an innovation that modify its adoption

	Understanding the role of needs and motivation

	Understanding ways of learning

Self directed learning
Organisational learning

	Implications for the future of CME

Role of CME providers

	Notes

	References

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