The medical teacher's job: "Working together to zero in on patient safety, and zero out preventable errors" (Clinton 1999).

The role of a medical teacher proposed 25 years ago is still recommended. Some teachers are born to greatness, but more careful and more thoughtful attention, rather than less, should be given to preparation for that role for those not born to greatness. In addition the penury of blueprint of the expected relevant professional profile makes it difficult to construct certifying exams of an acceptable level of validity in order to protect the population from incompetent doctors.

The ambiguous and bewitching power of knowledge, skills and attitudes leads to confusing statements of learning objectives.

The words "knowledge", "skills" and "attitudes" are given different meanings by health personnel when discussing educational issues. Ambiguity is known as a handicap to efficient communication. In the design of a curriculum the quality of the definition of learning objectives plays a fundamental role. If learning objectives lack clarity, learners and teachers will face operational difficulties. As Robert Mager said, "If you are not certain of where you are going you may very well end up somewhere else and not even know it". Knowledge is not only memory of facts but what you do with it. The complexity of human behaviour should not be underestimated. This is why educational objectives need active non-ambiguous verbs in order to achieve better communication between teachers and learners and to assess that complexity. This is why I suggest using the expression intellectual skill (or competence) as meaning "a rational decision or act". Sensomotor skill (or competence) would replace "skills" as presently used and cover only "acts which require a neuromuscular coordination". Interpersonal communication skill (or competence) would replace "attitude(s)" and be limited to "verbal and non-verbal relation between persons". As the level of validity of assessment of learners' competencies is linked to the clarity of learning objectives, it is hoped that the above suggestions will raise the overall level of validity of the evaluation system. This is why it is important that everybody understands, in the same manner, the meaning of a learning objective. It will help learners to focus their learning efforts on the right target. It will help teachers to ensure the relevance to health needs of their teaching and the validity of assessment instruments. In both cases it will be beneficial to the health of the population.

Curriculum change and strategies, past and present: why is it taking so long?

For the last 30 years or more the old war songs of medical education (community orientation, active learning, etc.) have been repeatedly ventilated in meeting after meeting, article after article. But of the present 1642 medical schools on the planet, only about 100 members of The Network and a few other have put these principles into practice, more or less. Obstacles and constraints are known. Is it the system, or the leadership, or the university culture, or the accreditation rules, or all of the above that are responsible for this lack of progress? Still, some overcame the obstacles, some removed the constraints. It would be useful to be better informed about HOW it was done. I suggest that Education for Health: Change in Learning & Practice (EfH) should present more articles explaining HOW successful schools managed to DO IT or WHY they were NOT able to DO IT.

Comparison of the opinion of students and teachers concerning medical education programmes in Switzerland.

Three medical schools in Switzerland (Geneva, Lausanne and Bern) have recently started to implement a problem-based learning community-oriented reform. It seemed worthwhile to attempt to identify the opinion of those who would be concerned (teachers and students) before any changes were made. Data were collected through interviews and questionnaires on the seven following themes: (i) community-oriented education; (ii) professional profile; (iii) learner-centred education; (iv) teachers' educational competence; (v) coveritis; (vi) problem-based learning; and (vii) programme evaluation. The opinions of teachers and students were also compared with the position taken by specialists in medical education. The aim of this article was to present the key finding of this complex research. Interested readers are invited to refer to the full report.

[Educational strategies and tools in a public health program at the University of Geneva]. / Stratégies et outils pédagogiques dans le cadre d'un Diplôme de Santé publique: une expérience à l'Université de Genève.

In the Swiss context, the newly developed MPH programme at the University of Geneva is experimental in educational matters. Indeed the programme is fully learner-centered and community-oriented. Throughout the curriculum students plan, implement and evaluate intervention programmes or/and research projects related to health problems of the communities they are in charge of. In this article, we describe the educational strategies and tools used in this MPH curriculum (professional profile, mind-mapping procedures, field-work either on research projects or on intervention programmes, group work and evaluation procedures). These strategies and tools might assist some educational experimentation in MPH programmes in search of public health relevance and pedagogic efficacy.

[An innovative program for public health training at the University of Geneva. Program during employment centered on the student and oriented to the population's health needs]. / Un programme innovateur de formation en santé publique à l'université de Genève. Programme en cours d'emploi centré sur l'étudiant et orienté vers les besoins de santé de la population.

Switzerland's first Master degree course in public health was launched in the autumn of 1990 at the Geneva University School of Medicine. It is a 3 year, part-time course, which is learner-centred and community-oriented. The aim of the course is to prepare students to use a multi-disciplinary approach to plan, implement and evaluate activities intended to solve public health problems. Throughout the course, studies plan, implement and evaluate projects concerning health problems they have encountered in their work as health professionals. The curriculum includes individual and group work, discussions and seminars with teachers and students, and brainstorming sessions with specially trained facilitators. The students can thus identify and fulfil individual educational objectives while working on community-related health projects. Priority health needs of individuals and communities are thus the pivotal points of the novel approach to public health training.

The construction of a 'topic tree': a way of familiarizing a teaching staff to problem-oriented learning in a master's programme in public health.

At the planning stage of a community-oriented and problem-based learning master's programme in public health it is indispensable to build a network of teachers, experts in specific fields, willing to guide the students in acquiring new competencies and ready to facilitate the experimental learning process. We discuss in this paper the construction and the utilisation of the 'topic tree'. In addition we show how the teaching staff get acquainted with that educational methodology by experimenting with it themselves (prior to the students). About 10 experts, each one a specialist in a given field, have conceptualized their approach in building a topic tree (concept tree); such a tree makes it possible to schematize the topics to be understood in order to solve a given problem and the relationship existing between actions to be undertaken. The experiment, meant to initiate the teaching staff in experimental learning procedures, was appreciated by all the experts, who considered it a creative and stimulating method. It also permitted the construction of a bibliography including key documents concerning each identified priority health problem. We discuss the utility and the relevance of our approach in the perspective of initiating teachers in experiential learning based on problem-solving.