No description available.

No description available.

No description available.

No description available.

No description available.

No description available.

No description available.

No description available.

In 1900 the United States had more medical schools than the rest of the world combined. Many of them were commercial institutions devoted to making profits rather than to educating men to perform competently within the medical profession. The profit incentive precipitated low educational standards and made American medical practice decidedly inferior to medical practice almost anywhere else in the civilized world. By 1900 medical education had become pernicious, threatening the health of the nation and the future of the American medical profession. This thesis discusses the efforts to reform medical education practices.

Undergraduate medical curricula are required to change and evolve in order to reflect the evolving and changing needs of contemporary medical practice. Making substantial changes to the form and delivery of medical education is challenging. While there is a growing body of research that focuses on curriculum change, relatively little attention is given to the notion of curriculum reform as a process rather than an outcome. In addition, the buildings and learning spaces where curriculum reform and undergraduate medical education are enacted contribute to people's experiences of these spaces. However, this aspect of context is currently neglected in the medical education literature. This thesis investigates the influences, vision, intentions and unintended consequences associated with an undergraduate medical curriculum reform and how the learning place and space of the medical school (where a curriculum is translated) is understood and experienced by key stakeholders (e.g., building designers, teaching faculty and students). Ontologically and epistemologically grounded within the social constructivist paradigm, the overall thesis aim was achieved through four overlapping empirical studies. Using a qualitative exploratory case study approach, data were gathered from document analysis, interviews and focus groups, and enriched by different theoretical concepts. Findings demonstrated that both (re)designing a medical curriculum and the learning space and place where reform is enacted and where teaching and learning occur is extremely complex, multifactorial and shaped and impacted by a myriad of influences and external and internal drivers for change; influenced by numerous voices and differing opinions and perspectives, different values systems, local traditions, history, geographical location and overall context. Finally, as a contribution to scholarship, the collective findings in this thesis advances our understanding of the complexities and unintended consequences associated with curriculum reform and the space and place of learning.