The adaptive medical curriculum: A model for continuous improvement.

This paper describes the medical curriculum designed to foster adaptive expertise. Engaging in the formal and informal curriculum, students learn to achieve desired outcomes in novel situations, perform comfortably with uncertainty, and are often recognized for creative problem-solving. Students learn by asking and answering their own and others' questions. They readily operate at the metacognitive level, anticipating events, self-monitoring, and checking decisions and emotions. A key function of the reflective process is to identify gaps or shortcomings in the thinking process. The adaptive learner shifts into reflective thinking when confronted with complex contextual and situational demands. We are only beginning to understand how to create educational pathways to foster adaptive learning. An essential focus is the adaptive teacher who frames learning and assessment around predictive analytics, reflective spaced practice, and authentic learning material. To be effective, the teacher must engage the learner outside the formal classroom in the parallel curriculum. A major premise is that learning occurs individually and together with peers, teachers, and team members in multiple contexts. During the learning process, the learner readily operates at the metacognitive level, anticipating behavior, self-monitoring and assessing, and checking theirs and others decisions and emotions. The adaptive medical curriculum provides the pathway for such learning.