Learner-centred medical education: Improved learning or increased stress?

CONTEXT Globally, as medical education undergoes significant reform towards more "learner-centred" approaches, specific implications arise for medical educators and learners. Although this learner-centredness is grounded in educational theory, a point of discussion would be whether the application and practice of these new curricula alleviate or exacerbate student difficulties and levels of stress. OBJECTIVES This commentary will argue that while this reform in medical education is laudable, with positive implications for learning, medical educators may not have understood or perhaps not embraced "learner-centredness" in its entirety. DISCUSSION During their training, medical students are expected to be "patient-centred". They are asked to apply a biopsychosocial model, which takes cognisance of all aspects of a patient's well-being. While many medical schools profess that their curricula reflect these principles, in reality, many may not always practice what they preach. Medical training all too often remains grounded in the biomedical model, with the cognitive domain overshadowing the psychosocial development and needs of learners. CONCLUSIONS Entrusted by parents and society with the education and training of future healthcare professionals, medical education needs to move to a "learner-centred philosophy", in which the "whole" student is acknowledged. As undergraduate and post-graduate students increasingly apply their skills in an international arena, this learner-centredness should equally encapsulate the gender, cultural and religious diversity of both patients and students. Appropriate support structures, role models and faculty development are required to develop skills, attitudes and professional behaviour that will allow our graduates to become caring and sensitive healthcare providers.