Three "levels" of the state of the art are discussed: the "ideal," for program evaluation; the "practical," with political limitations; and the "actual," for current practices. A review by Lloyd and Abrahamson (l979) is updated and current practices are discussed. Finally, a historical review introduces a…

Includes an historical review of continuing medical education (CME) in the United States from 1909, when the Blackburn Plan began, to the post-World War II era, with the growth of instructional technology. Two earlier studies that reviewed evaluation research in CME are discussed. Lloyd's brief response disputes some of Abrahamson's points. (SK)

During the past 20 years the author has visited almost half of all the American medical schools, usually as a consultant on curriculum and instruction. Nine curricular problems are described in medical terms having to do with instructional change, curriculum evaluation, articulation between related segments, etc. (Author/LBH)

Sim One is a computer-controlled patient, a sophisticated simulator developed by the University of Southern California School of Medicine. This article summarizes fifteen cost-effectiveness studies conducted over a 2-year period. Savings with the use of Sim One were found to justify the cost within a short period. (JT)

Discusses eight principles emerging from a 1997 conference on issues facing continuing medical education (CME). The principles reflect the interspecialty and interdisciplinary consensus achieved at the conference. Urges a still more systematic and rigorously analytic approach in which CME content is determined according to assessed needs and…

Innovation in medical education is needed in curriculum, teaching methods and testing programs, as well as involvement of administrators and faculty. (IR)

A few medical schools have introduced a significant innovation--the problem-based curriculum. Students meet in small tutorials and consider biomedical problems that they cannot solve without acquiring new information and skills. This experiment at Harvard gives "respectability" to the curriculum. (MLW)

The effectiveness of continuing medical education (CME) is reviewed in terms of physician competence, physician performance, and patient health status. Although half the studies published since l960 reported some improvement following CME, methodological shortcomings prevent concluding that the improvements were caused by CME. (Author/MH)

This article notes that since World War II, medical schools have experienced substantial growth in administrative activities and expansion of faculty role, largely because of strong federal support for research and competition to obtain grants. Commonsense proposals for reform are offered, but a number of obstacles to change are also seen,…