Obstacles to Excellence

How do we know whether our educational programs are achieving their goals? Medicine itself has experienced a movement toward outcomes assessment, grounded in the view that we cannot really know whether medicine works if we do not undertake an assessment of outcomes, and this trend has affected medical education, as well.We can say how many hours students spend in the classroom, the curriculum they are expected to study, and how many faculty members are involved in teaching them, but we really need to know what the students are learning and what they are able to do as a result. This has spawned interest in such evaluative techniques as objective structured clinical examinations, where students are asked to demonstrate their ability to take histories and perform physical examinations, rather than merely answer multiple-choice questions.