Medical Education Fellowships
Developing Educational Leaders: The
Teaching Scholars Program at the University
of California, San Francisco, School of
Medicine
Jessica H. Muller, PhD, and David M. Irby, PhD
Abstract
A Teaching Scholars Program (TSP) was
established in 1998 in the University of
California, San Francisco (UCSF), School
of Medicine with the mission of building
knowledgeable and skilled educational
leaders, teachers, and scholars.
Conducted through the Office of
Medical Education (OME), the TSP is a
10-month program that accepts 12
scholars per year. Financial support for
the program, including salary support for
co-directors and staff, is provided by the
OME. Scholars’ departments are required
to provide release time for one afternoon
per week for 10 months.
The TSP provides participants with an
intensive weekly seminar series,
I n 1998, a Teaching Scholars Program
(TSP) was established at the University of
California, San Francisco (UCSF), School
of Medicine with the mission of creating
knowledgeable and skilled educational
leaders, teachers, and scholars. This 10-
month program provides scholars with
an intensive weekly seminar series,
collaborative learning experiences,
mentored projects, and a network of
educational colleagues.
Background: Improving UCSF’s
Educational Mission
A 1996 site visit by the Liaison Committee
on Medical Education survey team resulted
in a report that criticized the UCSF medical
Dr. Muller is professor, Department of Family and
Community Medicine, University of California, San
Francisco, San Francisco, California.
Dr. Irby is vice dean for education and professor of
medicine, University of California, San Francisco, San
Francisco, California.
Correspondence should be addressed to Dr. Muller,
Box 0900, Department of Family and Community
Medicine, University of California San Francisco, San
Francisco, CA 94143-0900; telephone: (415)
476-6051; e-mail: (mullerj@fcm.ucsf.edu).
Academic Medicine, Vol. 81, No. 11 / November 2006
collaborative learning experiences,
mentored projects, and a network of
educational colleagues. The weekly
seminars use an interactive format to
address topics within seven targeted
areas: (1) learning theory; (2) teaching
methods; (3) curriculum development/
evaluation; (4) assessment of learning;
(5) leadership and organizational
change; (6) career development; and
(7) educational research.
Since its inception, 76 scholars have
graduated from or are currently enrolled
in the TSP. The majority are clinicians at
assistant professor rank, although four
basic scientists, two medical students,
and three OME staff members have also
school curriculum and its lack of
educational leadership and curricular
oversight. In response to these criticisms,
the dean of the School of Medicine sought
to make the educational mission equal in
quality to the research and patient care
missions of the school. In 1997, he
recruited a new vice dean for education to
pursue this goal. Planning for curriculum
reform commenced in 1998 and resulted in
a transformation that began in 2000.
Integral to the curriculum redesign effort
was the creation of an Office of Medical
Education (OME) by the vice dean for
education. The OME was formed to
support UCSF’s educational enterprise
across the continuum of medical
education, develop the school’s electronic
curriculum and educational technology,
strengthen the school’s educational
research efforts, and expand its faculty
development program. The OME
launched the TSP and a school-wide
faculty development workshop series in
1998. Other OME educational initiatives
have included the development of
educational research and evaluation
resources, an Office of Educational
Technology, a Clinical Skills Center,
participated in the program. The TSP is
highly valued by participants, and
preliminary evaluation data suggest that
the program has resulted in an increase
in educational research, scholarly
activities, and the number of skilled and
knowledgeable faculty with major
leadership roles in medical education at
UCSF. Challenges facing the TSP include
scholar release time, mentoring time,
and follow-up contact to encourage TSP
graduates’ postgraduation productivity,
continuing educational development,
and support.
Acad Med. 2006; 81:959–964.
Fellowships in Medical Education
Research, and a Medical Education
Fellowship for students between their
third and fourth years.
In addition to the TSP, other faculty
development activities have emerged at
UCSF. The OME sponsors a general
faculty development workshop series
throughout the year. Most of these half-
day instructional improvement
workshops are offered on Tuesday
afternoons to allow the scholars to
attend. Through the OME we also run
faculty development sessions focusing on
how to lead discussions effectively for
small-group leaders who teach in the first
two years of the curriculum. The
Department of Family and Community
Medicine and the Department of Internal
Medicine have had year-long faculty
development fellowship programs as well.
We also send a cohort of faculty to the
Harvard/Macy educational leaders
courses annually.
The scholarship of teaching and learning
is supported by an educational researcher
in the OME who works one-on-one with
faculty members on their research and
959
Medical Education Fellowships
grant writing. There is also a weekly
medical education journal club and
works-in-progress series that prior, and
occasionally current, scholars participate
in, along with other faculty with an
interest in educational research.
Complementing all of these educational
programs is the Haile T. Debas Academy
of Medical Educators (AME), which was
established at UCSF in 2001. The AME
also provides faculty development
opportunities, many of which are co-
sponsored with the OME.
For a select few faculty members who wish
to become independent investigators in
medical education research, we offer a two-
year, 20% funded and mentored Fellowship
in Medical Education Research. This is jointly
sponsored by the OME and the AME.
The TSP Administration
The TSP is conducted through the OME in
the Office of the Vice Dean for Education.
The co-directors share the development
and teaching of the curriculum, while other
faculty, staff, and consultants conduct
specific sessions on such topics as literature
searches, educational technology,
educational research, and evaluation.
Financial support for the program,
including salary support for the co-
directors and staff, is provided by the OME.
The approximate cost of the program is
$50,000 a year. The TSP does not offer
stipends to its scholars; however, the
scholars’ departments are required to
release them from service responsibilities
every Tuesday afternoon for 10 months as a
prerequisite for admission to the program.
The Teaching Scholars
The TSP targets UCSF School of Medicine
faculty of any rank who are interested in
enhancing their teaching and leadership
skills as well as their educational
scholarship. Applications are solicited from
faculty at all UCSF primary teaching
hospitals and programs, including the San
Francisco Veteran’s Administration
Medical Center, San Francisco General
Hospital, UCSF Medical Center, UCSF
Children’s Hospital, and the UCSF Fresno
Medical Education Program. Applicants
must submit an application form,
curriculum vitae (CV), and goal statement,
as well as a letter of support from their
department chair or residency program
director, who must guarantee release time
for scholars on Tuesday afternoons for the
960
duration of the program. The selection
process is competitive. The program
directors make the selection based upon
applicants’ potential to become educational
leaders (or current demonstration of
educational leadership), ability to devote
adequate time to the TSP in relation to
their other responsibilities, and nature of
their proposed goals and projects. In cases
where multiple applications come from one
department, the directors request
additional information from the
department chair to help make the
decision.
From 1998 through 2006, 76 scholars
graduated from or are currently enrolled
in the program. Table 1 lists demographic
characteristics of current and graduated
TSP scholars. Five individuals who were
admitted did not complete the program
because of illness, family obligations, or
departure from the university. The number
of individuals participating in the program
each year has increased over time, from six
in the first year to 12 in the last three years.
The majority are at the assistant professor
rank when they take part in the program.
While most participants are clinicians, we
have had four from the basic sciences, two
medical students participating in the
Medical Education Fellowship between
their third and fourth years, and three staff
members from the OME. Regardless of
their backgrounds, all participants are
expected to meet the same level of
performance, and we have found that the
nonclinicians’ perspectives and knowledge
contribute greatly to group discussions.
The TSP Curriculum
The overall goal of the TSP is to produce
educational leaders for UCSF. The TSP
provides scholars with the knowledge and
skills needed to become educational
leaders by offering them learning
experiences in seven targeted areas: (1)
learning theory; (2) teaching methods;
(3) curriculum development and
evaluation; (4) assessment of learning; (5)
leadership and organizational change; (6)
career development; and (7) educational
research. The specific learning objectives
are outlined in List 1.
To complete the program successfully,
scholars are expected to attend a weekly
three-hour seminar, complete session-
specific reading assignments and
exercises before the seminar, assume
responsibility for leading some of the
Academic Medicine, Vol. 81, No. 11 / November 2006
discussions, and complete a scholarly
project. They are also encouraged to
attend the school-wide faculty
development workshop series sponsored
by the OME, as well as to participate in a
TSP mentoring program.
The weekly seminars use an interactive
discussion-based format to address topics
within the seven target areas over the
course of the year. List 2 highlights the
curricular components of the TSP. We
begin the year with a discussion of
different learning theories and how they
relate to clinical practice. This theme is
picked up later in the year when we
discuss technology and learning, and the
literature on physician and teacher
expertise in medicine. Interspersed
throughout the year are sessions on
teaching skills. These include large and
small group teaching methods, one-on-
one clinical teaching skills, and team
learning. We begin our examination of
curriculum development and evaluation by
discussing different curriculum models.
Using the book, Curriculum Development
for Medical Education: A Six-Step
Approach by Kern et al.,1 we engage the
scholars in the process of curricular
design, implementation, and evaluation
by asking them to bring to the group
their own curricular projects as “cases” to
work on in small groups. To address
issues of assessment, we have sessions on
reliability and validity, and performance
and attitude assessments, as well as
course, teacher, peer, and self-assessment.
The focus of the leadership and
organizational change module focuses on
identifying different leadership styles,
applying leadership skills, understanding
how to bring about organizational
change, and developing teams and
coalitions. We define leadership as the
ability to achieve remarkable results
through others, and we expect every
member of the group to exercise
leadership in some arena. Career
development encompasses sessions on
career planning and academic
advancement, mentoring, CV review, and
preparation of the Educator’s Portfolio.
Finally, we provide a series of seminars
during the year on various aspects of
educational research, including quantitative
and qualitative research methods, defining
research questions, searching the literature,
and survey development.
A typical TSP session begins with a brief
introduction to the topic of focus by one
 Medical Education Fellowships

learning. Scholars then write their own

Table 1 definitions of learning, which they
Demographic Characteristics of Teaching Scholars in the University of California, exchange with others in the group. Later
San Francisco, School of Medicine Teaching Scholars Program from 1998 –2006 in the session, we use team learning to
Demographic characteristics No. % of all scholars stimulate deeper understanding of
Number of scholars 1998–2006 76 learning theory and instructional
.........................................................................................................................................................................................................
1998–1999 class 6 8 practices through the use of an individual
.........................................................................................................................................................................................................
1999–2000 class 6 8 and group readiness assessment test and
.........................................................................................................................................................................................................
2000–2001 class 9 12
discussion. Appendix 1 is a sample lesson
......................................................................................................................................................................................................... plan for the session on “Theories of
2001–2002 class 8 11
......................................................................................................................................................................................................... Learning.”
2002–2003 class 11 14
.........................................................................................................................................................................................................
2003–2004 class 12 16
......................................................................................................................................................................................................... A major goal of the TSP is the
2004–2005 class 12 16
......................................................................................................................................................................................................... completion, presentation, and possible
2005–2006 class 12 16
publication of a scholarly project.
Rank at time of TSP participation Following Boyer’s expanded definition
.........................................................................................................................................................................................................
Professor 3 4 of scholarship, these projects can reflect
.........................................................................................................................................................................................................
Associate 12 16 the scholarship of discovery,
.........................................................................................................................................................................................................
Assistant 49 64 integration, application, and/or
.........................................................................................................................................................................................................
Clinical Instructors 2 3 teaching.2,3 While the majority of
.........................................................................................................................................................................................................
Fellows 4 5 scholarly projects completed by the
.........................................................................................................................................................................................................
Chief Resident 1 1
.........................................................................................................................................................................................................
scholars have focused on curriculum
Medical Students 2 3
.........................................................................................................................................................................................................
development or evaluation, they have
OME Staff 3 4 also included educational research, the
Women 45 59 creation of instructional materials, and
Department type the development of assessment
.........................................................................................................................................................................................................
Clinical 67 88 methods. We encourage scholars to
.........................................................................................................................................................................................................
Basic science 4 5 meet the three key criteria of
.........................................................................................................................................................................................................
Other (medical students & OME staff) 5 7 scholarship: the product should be
Departmental affiliation made public, peer reviewed, and
.........................................................................................................................................................................................................
Medicine 31 41 accessible for others to build upon.2
.........................................................................................................................................................................................................
Pediatrics 8 11
Scholars are required to present their
......................................................................................................................................................................................................... projects to the other scholars at the end
Family and Community Medicine 5 7
......................................................................................................................................................................................................... of the year, and are strongly
UCSF Fresno Medical Education Program 5 7
......................................................................................................................................................................................................... encouraged to present to the wider
Psychiatry 4 5
......................................................................................................................................................................................................... community at an Education Day
Anesthesia 3 4
......................................................................................................................................................................................................... symposium sponsored by the UCSF
Otolaryngology 3 4
......................................................................................................................................................................................................... AME, and/or at regional (eg, Western
Biochemistry 2 3 Group on Educational Affairs) and
.........................................................................................................................................................................................................
Dean’s Office, School of Medicine 2 3 national (eg, Association of Professors
.........................................................................................................................................................................................................
Medical students 2 3 of Gynecology and Obstetrics, Society
.........................................................................................................................................................................................................
Other (external to UCSF) 2 3 of General Internal Medicine, Society
.........................................................................................................................................................................................................
Cellular and Molecular Pharmacology 1 1 of Teachers of Family Medicine,
.........................................................................................................................................................................................................
Dermatology 1 1 Association of Surgical Educators)
.........................................................................................................................................................................................................
General Surgery 1 1
.........................................................................................................................................................................................................
meetings. A few examples of scholarly
Laboratory Medicine 1 1
.........................................................................................................................................................................................................
projects that have been presented
Neurology 1 1
.........................................................................................................................................................................................................
locally and nationally include:
Neurological Surgery 1 1 “Teaching Residents to Teach:
.........................................................................................................................................................................................................
Orthopaedic Surgery 1 1 Developing a Curriculum to Improve
.........................................................................................................................................................................................................
Pathology 1 1 Resident Teaching Skills”; “Between the
.........................................................................................................................................................................................................
Physiology 1 1 Blackboard and the Bedside: An
Examination of the Hidden Curriculum
in End-of-Life Care”; and “An
of the instructors. Scholars may then be as in-class writing assignments, break-out Interactive Browser-based Program that
asked to reflect on and/or write about a groups, or team learning activities. For Teaches the Infant Neurological Exam.”
personal experience or connection with example, in one of the sessions on
the topic. Individual scholars then take learning theories, the scholars begin by As much as possible, the co-directors of
turns leading the seminar discussion, identifying a powerful and purposive the program mentor the scholars and
based on the particular articles they had learning experience and describe what assist them with their projects. Recently
been assigned to read prior to the made it effective. In the ensuing we have expanded the mentoring
seminar. Interspersed throughout the discussion, scholars make connections program by connecting TSP alumni with
discussion are interactive activities, such from these experiences to theories of current scholars. Scholars are matched

Academic Medicine, Vol. 81, No. 11 / November 2006 961

Medical Education Fellowships

of the TSP they found most valuable,

List 1 scholars have written:
UCSF Teaching Scholars Program Learning Objectives
Finding a group of scholars and
Learning Objectives: At the end of the year-long program, scholars will be able to legitimizing what I do—I feel like I am
1. Analyze how learning theory relates to the design of curriculum and educational activities. more comfortable stating I am a medical
• Understand and assess different learning theories. educator because the program was
• Apply theories of learning to instructional practices. stimulating and invigorating to me—
• Assess the research evidence related to different learning theories. making me realize I really enjoy medical
• Analyze the successful use of technology to enhance learning. education and maybe I can make a career
2. Demonstrate the ability to use various teaching methods appropriately. at least in part as a medical educator.
• Analyze the relationship between learning styles and teaching styles.
New ways of thinking about teaching and
• Determine elements of instructional design.
• Master various teaching strategies. learning— often grounded in “common
▪ Large group sense” but now I know this stuff is
▪ Small group validated—it makes me more
▪ Simulations comfortable about what we do, and
▪ One-on-one inspires me to do more.
• Develop expertise in giving feedback.
Opportunity to meet university
3. Determine the steps in curriculum development and evaluation. leadership and gain a better
• Identify different curricular models. understanding of the structure of the
• Describe the process of curriculum development. university.
• Design a program evaluation.
• Determine how to identify the costs of a curriculum. The quality of the reading materials have
• Analyze approaches for obtaining informed consent for curricular research. really opened vistas re: educational theory
• Examine the relationship between accreditation and curriculum. and how to approach learning. Although
4. Master various assessments of learning. at times the literature was challenging, I
• Interpret reliability and validity of measures of tests and assessment instruments. think this was a very important part of the
• Analyze the strengths and weaknesses of various assessment strategies. curriculum.
• Design assessments of
▪ Knowledge. A place to breathe and take time to learn
▪ Attitudes. for myself.
▪ Skillful performance.
• Design a survey. The school benefits from the TSP by
• Select appropriate course and instructor evaluations.
having an expanding cadre of highly
5. Analyze leadership in organizations and develop leadership skills. skilled and knowledgeable educational
• Discuss leadership styles, behaviors and functions.
leaders who now have major leadership
• Identify leadership opportunities in medical education locally and nationally.
• Assess educational leadership opportunities within and outside the university. roles in medical education. Examples of
• Discuss organizational change. such roles include director of the Clinical
6. Reflect on and plan their academic careers. Skills Center, director of the Simulation
• Establish career goals and benchmarks. Center, director of the Office of
• Describe the academic promotion process. Educational Technology, chair of the
• Revise CV and develop an Educator’s Portfolio. curriculum committee and several
• Develop mentoring skills.
subcommittees, course directors,
7. Develop skills in educational research sufficient to propose, conduct, analyze, and present a residency program directors, continuing
study. medical education directors, and
• Write a proposal with a well-defined research question.
• Select appropriate research designs and measures for given research questions. education committee members. In most
• Devise an analytical plan that addresses power, analytical challenges, missing data, and instances, scholars were appointed to
procedures. these leadership positions after
• Identify characteristics of accepted and rejected studies. completion of the TSP program.
• Write an abstract for medical education research.
• Critique an educational research article.
In addition, a number of scholars, in
collaboration with the AME, have
become strong advocates for educational
according to interests and experience. According to their evaluation improvement and have been actively
Mentoring may be limited to the comments, they value most highly their involved in the curricular innovations in
scholar’s scholarly project or it may enhanced knowledge and teaching the school.
include broader career mentoring. skills, increased understanding of
The School of Medicine has also been
curriculum and academic program
able to recruit highly talented educators
The Benefits of the TSP development, strengthened academic to UCSF because of the TSP. This has
Scholars have been very satisfied with the leadership skills and career included recruitment of clerkship
TSP, as is evident in their overall ratings development, and collegiality of a directors and fellows who wanted to
of the program, which have ranged from network of peers interested in medical make medical education research their
4.2 to 4.9 (on a 5-point scale where 5 ⫽ education and educational research. area of career development. In both
excellent) over the past seven years. For example, when asked which aspects instances, the TSP has been a strong

962 Academic Medicine, Vol. 81, No. 11 / November 2006

 Medical Education Fellowships

List 2
Curricular Components of the University of California, San Francisco, School of
Medicine Teaching Scholars Program, 1998 –2006
Learning Teaching Curriculum Assessment Leadership Career Research
• Learning theories • Instructional design • Curricular models • Reliability and validity; • Defining • Career • Educational
Comparisons of educational planning research; defining a
methods scholarship problem; searching
the literature; IRB
• Learning styles • Large group • Steps in • Measurement • Leadership • CV review; • Research design and
teaching (lecture, curriculum resources; paper and styles Educator’s methods (qualitative
team learning) development pencil assessments; Portfolio and quantitative);
other cognitive survey development
assessments
• Clinical teacher • Small group • Curriculum • Performance • Leadership skills • Academic • Data basics: set up
expertise in teaching (PBL); mapping and assessments (OSCE, promotions database, basic
medicine simulations supporting OSTE, simulations); process statistics, power
(standardized technology other assessments analysis
patients & centers)
• Technology and • Strategies for • Accreditation; • Attitude surveys • Educational • Mentoring • Writing an abstract
learning changing attitudes curriculum leadership in the
and behaviors; oversight university
simulations (organizational
chart and roles)
• Feedback • Faculty • Course evaluations; • Educational • Critiquing an article
development; self and peer leadership
cost of the assessment outside the
curriculum university
(professional
organizations)
• Team learning • Program evaluation • Organizational • Research
change presentation; poster;
oral presentation

inducement for prospective applicants at
UCSF. At the same time, the school
benefits from the program through
increased visibility for UCSF nationally.
Through scholarly presentations and
publications, UCSF has become known
for its innovation and leadership in
medical education. This was not true
prior to the program’s inception in 1998.
A study is currently underway to
determine the impact of the TSP on
different types of scholarly activities. A
survey was conducted with alumni of the
program to assess their perceived self-
efficacy in education-related scholarly
activities. CV analysis was used to
compare productivity before and after
the program in the areas of education-
related publications, awards, and
leadership. Although we have only
preliminary results at this point, the data
strongly suggest that the TSP produced
significant increases in research and
leadership activities.
The Challenges Facing the TSP
Release time has always been a struggle
for the scholars. Some receive true release
time, but most merely have their clinical
responsibilities shifted from Tuesday
afternoons so they can attend the
seminar. Unfortunately, this adds to the
time pressures scholars already feel, and
curtails the amount of time they can
spend on their scholarly projects. Better
time protection for participation in the
program would lessen scholar frustration
and strengthen their active engagement
in the program.
Mentoring has been the rate-limiting
factor in the size of the program.
Although the co-directors devote time to
mentoring scholars and their projects,
their time constraints do not allow them
to mentor the full cohort of scholars. We
are hoping that engaging TSP graduates
in the mentoring program will help to
alleviate this quandary.
Another challenge we face is how to bring
TSP graduates together. Creating a
follow-up program to bring graduates
together would encourage
postgraduation productivity and
continuing educational development as
well as support. A newly initiated, weekly
medical education journal club/works-in-
progress seminar appears to be
addressing some of this need.
A Successful Transformation
The TSP offers a longitudinal educational
program for faculty members who share
a passion for teaching. The success of the
program is attributable, in part, to the
excellent quality of the scholars, a strong
academic and mentoring program, plus
department and school support. The
school and the departments are well
served by the ongoing leadership these
faculty members play in the educational
enterprise. The scholars bring honor to
the school and to their departments
through their distinguished teaching,
publications, and service both locally and
nationally. The TSP produces a cadre of
exceptional teachers whose creativity,
innovations, and scholarship have
transformed the culture of education at
UCSF.
References
1. Kern DE, Thomas PA, Howard DM,
Bass EB. Curriculum Development for
Medical Education. A Six-Step Approach.
Baltimore Md: Johns Hopkins University
Press; 1998.
2. Boyer EL. Scholarship Reconsidered: Priorities
of the Professoriate. Princeton, NJ: The
Carnegie Foundation for the Advancement of
Teaching; 1990.
3. Glassick GE. Boyer’s expanded definitions of
scholarship, the standards for assessing
scholarship, and the elusiveness of the
scholarship of teaching. Acad Med. 2000;
75:877–880.

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Medical Education Fellowships

Appendix 1
Lesson Plan for a University of California, San Francisco, School of Medicine
Teaching Scholars Program (TSP) Session: “Theories of Learning”
Session Title: Theories of Learning
TSP Goal: Analyze how learning theory relates to design of curriculum and educational activities
TSP Strand: Learning
Introduction
Over the past several decades, three families of learning theories have emerged into the mainstream of education. These include behavioral, cognitive
and social theories of learning. Each theory is additive and contributes to our understanding of the complex processes of learning—especially in
clinical environments. By understanding these three theories, we can expand the scope of our teaching activities to encompass a broader array of
powerful methods of learning.
A second objective of the session is to learn how to use team learning by experiencing it. The great virtue of team learning is that it actively engages
everyone in the learning process even in large classes.
Learner Objectives
At the end of the session scholars will be able to:
1. Describe how behavioral, cognitive and social learning theories define learning.
2. Outline the key recommendations for facilitating learning based upon each theory.
3. List the key components of team learning
Learning Activities
Participants will be asked to identify a powerful and purposeful learning experience and describe what made it effective. Connections will be made
from these experiences to the theories of learning. Scholars will write their own definition of learning, wad it up, throw it around the room, read and
interpret someone else’s definition.
Team learning will be used to stimulate deeper understanding of learning theory and instructional practices. Scholars will be given a readiness
assessment test, work in small groups to reach consensus on the answers, and later apply the concepts to a case.
In Class Assignment:
Write a note to yourself identifying key insights you gained today and how you might apply them to your teaching and your project.
Bibliography
Required reading prior to this session
1. Irby D. Conceptual Lenses on Learning
2. Mann KV. Thinking about learning: implications for principle-based professional education. Journal of Continuing Education in the Health
Professions. 22:69–76,2005.
3. How People Learn. (Handout)
4. Michaelsen L. Three Keys to Using Learning Groups Effectively. (Handout).
Recommended Readings
1. Bordage, G. Elaborated knowledge: a key to successful diagnostic thinking. Academic Medicine. 69(11):883–885, 1994.
2. Bowen J, Carline J. Learning in the social context of ambulatory care clinics. Academic Medicine. 72:187–190, 1997.
3. Brown A. The advancement of learning. Educational Researcher. 23(8):4–12, 1994.
4. Bransford JD, Brown AL, Cocking RR. (Eds) How People Learn: Brain, Mind, Experience, and the School. Washington, DC: National Academy of
Science, 1999.
5. Bruer, J. Schools for Thought: A Science of Learning in the Classroom. (Cambridge, MA: MIT Press, 1993).
6. Bruffee, K. Collaborative Learning: Higher Education, Interdependence, and the Authority of Knowledge. (Baltimore: The Johns Hopkins
University Press, 1993).
7. Cunningham A, Blatt S, Fuller P, Weinberger H. The art of precepting: Socrates or Aunt Minnie? Arch Pediatr Adoles Med. 153:114–116, 1999.
8. Custers E, Boshuizen H. Psychology of learning. In International Handbook of Research in Medical Education. Norman G, Ven der Vleuten C,
Newble D (Eds). Boston: Kluwer Academic Publishers, Part 1, pp. 163–183.
9. Gijselaers W. Connecting problem-based practices with educational theory. In New Directions for Teaching and Learning. San Francisco: Jossey-
Bass Publishers, no. 68, Winter 1996.
10. Gruppen L. Implications of cognitive research for ambulatory care education. Academic Medicine. 72:117–120, 1997.
11. Michaelsen L, Knight A, Fink L (Eds). Team-Based Learning: A Transformative Use of Small Groups in College Teaching. Sterling, VA: Stylus
Publishing, 2004.
12. Regehr G, Norman G. Issues in cognitive psychology: implication for professional education. Academic Medicine. 71:988–1001, 1996.
13. Smith S, Irby D. The roles of experience and reflection in ambulatory care education. Academic Medicine. 72:32–35, 1997.

964 Academic Medicine, Vol. 81, No. 11 / November 2006