Academic medicine : journal of the Association of American Medical Colleges
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Price competition and other aspects of the changing health care environment are threatening many academic health centers (AHCs) and causing them to reassess their education and research missions. In order to design effective AHCs for the next century, medical leaders must define the unique competencies needed by tomorrow's physicians and describe the educational enterprises required to produce physicians with these competencies. Two of the most important of these competencies are the ability to manage the uncertainty associated with creating clinical paradigms and the ability to manage the uncertainty associated with managing care delivery. ⋯ Currently, AHCs are more competent in managing--and educating students to manage--the uncertainty involved in creating clinical paradigms. But there is an increasing demand for physicians who manage the second type of uncertainty associated with care delivery. The authors conclude that in order to remain viable, AHCs, and particularly their medical schools, must broaden their educational goals so that students can learn to manage both forms of uncertainty.
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To assess the educational value of an objective structured clinical examination (OSCE) administered in three consecutive years (1992-93 to 1994-95) to first-year residents in a family practice residency. ⋯ The OSCE is a useful tool for teaching basic clinical skills and for forming initial impressions of interns' clinical styles and abilities, but it should be used with caution for summative assessments.