Applying adult learning principles to medical education in the United States.

An extensive literature on adult learning principles has been developed over the last 40 years. Simultaneously, undergraduate medical educational programs have undergone varying degrees of curricular reform. The present paper discusses the educational and societal factors that have functioned as a catalyst for innovations in medical education, and reviews the major initiatives which have been undertaken. Data are analyzed to assess the extent to which some of these changes have been incorporated into medical curricula. A comprehensive review of adult learning principles is than presented, in order to provide a framework for the incorporation of principles of adult learning into the next wave of medical education reform. The review of adult learning principles reveals that undergraduate medical educational reform has underutilized the robust literature on adult learning. The present paper concludes with suggestions for medical education reform that incorporates the principles of adult learning and discusses the major impediment to curricular reform.