As early as 1863 the education committee of the General Medical Council (GMC) recognised the tendency of medical education to overload medical students with factual knowledge. Since then, there has been a considerable body of evidence that when students spend their time learning facts only, they often fail to apply the knowledge that they have gained (Ramsden, 1992). In 1993 the education committee of the GMC made detailed recommendations regarding a change to more problem-orientated learning and the encouragement of students to learn independently (GMC, 1993). This is currently leading to changes within all medical schools curricula so that students will be helped to integrate their formal learning with the experience of seeing patients and their families and thus be able to apply their factual knowledge.
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