4.3.5.1 Knowledge

Until the early seventies of the last century the Flexner report shaped undergraduate medical education [Phillips 2008]. Basic and clinical sciences were separated. Basic sciences such as anatomy, physiology, histology and biochemistry, were dealt with in the first years and clinical sciences such as pathology, pharmacology and surgery, in later years. The distinctive medical specialties and their related knowledge and skills such as history taking and physical examinations, were addressed just before students entered their clerkships. Lectures were the dominant teaching method and examinations focused on knowledge reproduction. Sometimes the curriculum contained lectures about psychology with patient-physician communication as one of the topics. However, the teaching of communication skills was not embedded in curricula [Wakeford 1983] and most medical students graduated without ever interviewing a patient under direct supervision [Baumal 2008].