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July 1994

General Pediatrics in a Time of ChangeLessons We Must Unlearn

Arch Pediatr Adolesc Med. 1994;148(7):675-676. doi:10.1001/archpedi.1994.02170070013002

IN THE March issue of the Archives,1 I challenged you to begin to invent the future of pediatrics out of the turmoil of discontinuous change, the kind of rapid and revolutionary change coming with health care system reform. I invited you to recognize the signals of discontinuous change and move past the stage of shock to survival. I suggested that the process would require "unlearning," the discarding of old assumptions and patterns.

Nowhere is the necessity for unlearning more apparent than in the habits we have developed for educating medical students and residents. The educational process in which we have become expert both as teachers and students no longer closely matches the needs of the adult learner preparing for tomorrow's medical practice.

To stimulate discussion, I list six lessons I believe medical faculty need to unlearn. You may find the list makes you angry or defensive. Unlearning means radical