Strides in Development of Medical Education

Document Type : Original Article


1 PhD in Medical Education, Assistant Professor, Department of Medical Education, School of Medical Education Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Ph.D. Student, Department of Medical Education, School of Medical Education Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran


  Background & Objective: In addition to teaching predesigned courses physicians are usually expected to participate directly in designing curriculum during their professional life Today traditional education systems are not sufficient for developing the expected competencies in physicians One of the applications of new advancements by cognitive sciences in curriculum design is the development of strategies for improving the quality of the undergraduate medical education curriculum Educational strategies are “fundamentaloriented decisions in teaching which are aimed to achieve educational goals”   Methods: This was a narrative review that introduced and explained the most important educational strategies in undergraduate medical curriculum through surveying valid electronic and library resources   Results: Now the most important educational strategies in undergraduate medical curriculum are: a series of studentcentered problembased learning integrated or interprofessional teaching communitybased electivedriven and systematic strategies (SPICES) and also a set of strategies that are productfocused relevant interprofessional short courses multisite locations and symbiotic (PRISMS) and a group of realistic integrated feedback learning and evaluation strategies (RIFLE) as well   Conclusion: Each strategy is represented as a spectrum In each spectrum the educational planner must define the position of every component of the curriculum In order to apply these strategies the curriculum must be intervened according to the selected strategy so that the results of the evaluations and evidence of interventions ensure the planners that the quality of the curriculum is improved


  1. Cantillon P, Wood D. ABC of Learning and Teaching in Medicine. 2nd ed. British: Blackwell; 2011.
  2. Dent JA, Harden RM. A practical guide for medical teachers. 3nd ed. Edinburgh: Elsevier; 2009.
  3. Rider EA, Nawotniak RH. A practical guide to teaching and assessing the ACGME core competencies. 2nd ed. Marblehead: Hcpro Incorporated; 2010.
  4. Harden RM, Davis MH, Crosby JR. The new Dundee medical curriculum: a whole that is greater than the sum of the parts. Med Educ 1997; 31(4):264-71.
  5. Harden RM. Ten questions to ask when planning a course or curriculum. Med Educ 1986; 20(4):356-65.
  6. International Federation of Medical Students' Associations (IFMSA) & European Medical Students' Association (EMSA). Quality Assurance in Medical Schools: Moving from Quality Assurance to Quality Improvement. Communiqué from EMSA/IFMSA Quality Assurance Workshop, Copenhagen (Denmark). [cited 2005 Jul 6]. Available from: 9846/scome_manual_august_2009.pdf.
  7. Yazdani S, Hosseini F, Homayouni Zand R. Reform in General Medical Degree curriculum. Educational Development Center, Shahid Beheshti University of Medical Science. Tehran: Mehrayaneh; 2007. [In Persian]
  8. Kern DE, Thomas PA, Hughes MT. Curriculum development for medical education: a six step approach. 2nd ed. Baltimore MD: Johns Hopkins University Press; 2009.
  9. Harden RM, Sowden S, Dunn WR. Some educational strategies in curriculum development: the SPICES model. Med Educ 1984;18(4):284-97.
  10. Harden RM. Evolution or revolution and the future of medical education: Replacing the oak tree. Med Teach 2001; 22(5):435-42.
  11. Harden RM. The integration ladder: A tool for curriculum planning and evaluation. Med Educ 2000; 34(7):551-7.
  12. Harden RM. AMEE Guide No. 21: Curriculum mapping: A tool for transparent and authentic teaching and learning. Med Teach 2000; 23(2):123-37.
  13. Bligh J, PrideauxD, Parsell G. PRISMS: new educational strategies for medical education. Med Educ 2001; 35(6):520–1.
  14. Lowry S. Strategies for implementing curriculum change. BMJ 1992; 305(6867):1482-05.
  15. Barrow M, McKimm J, Samarasekera DD. Strategies for planning and designing medical curricula and clinical teaching. South East Asian J Med Educ 2010; 4(1):1-8.
  16. Harden RM, Davis MH. The continuum of problem-based learning. Med Teach 1998; 20(4):317-22.
  17. Harden R, Crosby J, Davis MH, Howie PW, Struthers AD. Task based learning: the answer to integration and problem-based learning in the clinical years. Med Educ 2000; 34(5):391- 7.
  18. Harden RM. Looking back to the future: a message for a new generation of medical educators. Med Educ 2011; 45(8):777–84.
  19. Norcini JJ, Banda SS. Increasing the quality and capacity of education: the challenge for the 21st century. Med Educ 2011; 45(1):81–6.
  20. Wong BM, Levinson W, Shojania KG. Quality improvement in medical education: current state and future directions. Med Educ 2012; 46(1):107–19.
  21. Azizi F. Necessity for change in training of general practioner. Pajouhesh Dar Pezeshki 2003; 27: 1-2. [In Persian].
  22. Azizi F. Medical Education: Mission, Vission, and Challenges. Tehran: Ministry of Helath and Medical Education; 2003. [In Persian].
  23. Kojuri J, Amini M, Bazrafkan L, Dehghani MR, Saber M, Alavi Z. A critical review of new medical education in Iran, challenges and oppurtunities. Med Educ Dev Center Shiraz 2008; 1:9-16. [In Persian]
  24. Azizi F. The reform of medical education in Iran. Med Educ 1997;31(3):159-62.
  25. Haeri A. Reform in medical education. Gastroenterol Hepatol Bed Bench 2010; 3(2):49. [In Persian]