Harmen Tiddens (1923-2002): A butterfly's impact on medical education.

The history of medical education scholarship is often overlooked. Moreover, although productive educational researchers are often recognized for their scholarly contributions in peer-reviewed publications, the impact of others who are not active medical education researchers may be unknown to contemporary educators and scholars. This short paper describes the contributions of Harmen Tiddens, MD PhD to Utrecht and Maastricht Universities where he established the environment and supports for scholars to undertake profoundly influential work. Through his leadership as the founding Dean of Maastricht's new medical school, Dr. Tiddens facilitated educational principles that became exemplary for generations of health professions education scholars and curriculum developers, nationally and internationally.

Celebrating 40 years of Medical Teacher: As the "last man standing" I look back to help us look forward.

INTRODUCTION: In this reflective, descriptive, analytical, first-person piece, I offer recollections, data, and literature to help elucidate the emergence of medical education as a scholarly field, as part of celebrating Medical Teacher's 40-year anniversary. I emphasize the impressive growth of the professional literature in medical education, and recognize that much remains to be done. FINDINGS: Medical education as a domain for research and development has transitioned from being largely ignored during the first 20 of the past 60 years, through a slow growth phase, to rapid acceleration during the last 2 decades. By introducing the use and potential of "edumarkers," we can see that medical education as a focus of scholarly pursuits was absent to minimal before recent decades, and we can identify trends and questions that deserve further exploration. Concern and recommendations: Only a small subset of the large population assigned to instruct health professions learners actually conducts and responds to medical education scholarship. I raise several questions as possible guides to the future for those of us who are devoted to enhancing educational processes and outcomes for learners who are expected to help prevent and manage the health challenges faced by the world's people.

Future medical education: Preparing, priorities, possibilities.

Introduction: As educators who are guiding the preparation of future health professionals, we must do what we can to recognize and meet the needs of those our graduates will serve. Fulfilling that goal depends on our responding to relevant changes in society and to evolving understanding of learning processes. Preparing: To have educational programs that evolve appropriately when preparing learners for the future, we too must evolve. We need to prepare by recognizing shifts in population health and other societal trends that bring implications for the kinds of clinicians needed. External trends can require changes in our thinking and practices so that we reform any outdated educational traditions. Priorities: Societal changes relevant to medical education and health care are happening so rapidly that we need to select from existing trends those that are most pressing and impactful. As we set our priorities, we need to understand the process of facilitating lasting changes in people and institutions. Possibilities: In addition to responding to the changes that are arriving, we need to be initiating additional changes. Here, I suggest some reforms needed in health professions education, if our students are to become the clinicians that their future patients deserve.

Preparing educators for adaptive education (AE) programs.

CONTEXT: There has long been awareness that educational experiences should be individualized. In the health professions, this tenet remains inconsistently implemented. Adapting to the widely diverse characteristics of different learners requires educators who are prepared for planning and implementing adaptive education (AE). RATIONALE: Learning experiences, for both educators and health professions students, can be substantially enhanced by mirroring clinical care, where we respect the uniqueness of each person and increasingly approach care as a collaboration. We are continuously "diagnostic," striving to understand our patients' clinical and life circumstances, adjusting to new findings. Learners are also unique in multiple, relevant ways. They deserve educators who work with them collaboratively and "diagnostically," adapting to changing information. IMPLEMENTATION: Until recently, having educational programs that adapt to learner uniqueness was logistically and economically unrealistic. Now, thanks to deeper understandings of the learning process and new technologies, individualization is feasible. Here, we focus on the foundation step of preparing educators. Educator development: Suitably prepared educators are indispensable to success in becoming appropriately adaptive to learners' needs. For some educators, becoming more adaptive can be contrary to long-held assumptions and habits. We offer recommendations for effective educator development, without which authentic AE is unlikely.

The Time Is Now: A Plan to Redesign Family Medicine Residency Education.

A new graduate medical education program in family medicine is urgently needed now. We propose an innovative plan to develop community-based, community-owned family medicine residency programs. The plan is founded on five guiding principles in which residencies will (1) transition to independent, community-owned organizations; (2) sustain comprehensiveness and generalism; (3) emphasize collaborative learning and interprofessional education; (4) develop local educators with national guidance; and (5) share resources, responsibilities, and learning. We describe actionable steps to begin the process of transforming residencies and strengthening primary care. As community-based and locally-run organizations, residencies will gain self-determination in how time is allocated, budgets are spent, and teams function. Building on the momentum of the National Academy of Medicine's 2021 primary care implementation plan and recommendations by family medicine organization leaders, we propose a Decade of Family Medicine Residency Transformation. We encourage individuals and organizations spanning disciplines, health care systems, and communities, to join forces to reimagine and recreate the preparation of outstanding personal physicians dedicated to individual and community health and well-being.

Claude Bernard Distinguished Lecture. Becoming a truly helpful teacher: considerably more challenging, and potentially more fun, than merely doing business as usual.

Few medical faculty members are adequately prepared for their instructional responsibilities. Our educational traditions were established before we had research-based understandings of the teaching-learning process and before brain research began informing our understandings of how humans achieve lasting learning. Yet, there are several advantages you may have. If your expertise is at one of the frontiers of human biology, your teaching can be inherently fascinating to aspiring health professionals. If your work has implications for human health, you have another potential basis for engaging future clinicians. And, thanks to Claude Bernard's influence, you likely are "process oriented," a necessary mindset for being an effective teacher. There are also challenges you may face. Your medical students will mostly become clinicians. Unless you can help them see connections between your offerings and their future work, you may not capture and sustain their interest. To be effective, teachers, like clinicians, need to be interactive, make on-the-spot decisions, and be "emotional literate." If you aren't comfortable with these demands, you may have work to do toward becoming a truly helpful teacher. Program changes may be needed. Might your program need to change 1) from being adversarial and controlling to being supportive and trust based or 2) from mainly dispensing information to mainly asking and inviting questions? In conclusion, making changes toward becoming a truly helpful teacher can bring benefits to your students while increasing your sense of satisfaction and fulfillment as a teacher. If you choose to change, be gentle with yourself, as you should be when expecting your students to make important changes.

A study of the medical diagnostic process: method and preliminary findings

Meeting of the Advisory Committee on Medical Research, 9. Pan American Health Organization; 15-19 Jun. 1970