Perspective: a tale of two curricula: a case for evidence-based education?

In discussing the major curricular reform at one medical school and the subsequent challenges in identifying which changes contributed to outcome, the author argues for the practice of evidence-based education, which could allow a systematic examination of medical training by applying principles similar to evidence-based medicine in clinical practice. Although the medical school accreditation process provides general oversight of medical education at the national level, the faculty at each medical school has local responsibility over content and design. Therefore, curricular evolution has proceeded separately at different schools, and published cross-institutional studies are few because most schools' experiments with reform do not incorporate data generation for outcomes analysis. The author believes it is time to ask the hard questions, to design the studies, and to seek objective answers on which to base informed decisions concerning the future construct of medical training in the United States and elsewhere.