The design, implementation and evaluation of an innovative course on e
ducation for a group of hospital doctors, general practitioners and de
ntists is described. It took place over five 2-day modules spread over
21 months. There were 33 participants and several tutors and external
resources. The course was designed around group work and used a learn
er-centred agenda. Evaluation was by use of the nominal group techniqu
e during the course and by open questionnaires after 18 months. The co
urse was successful in stimulating a number of activities and in devel
oping the skills and confidence of the participants. Problem areas cen
tred around the tension between the learner-centred agenda and the par
ticipants' need for structure. Courses such as this require good admin
istration, a cohesive and supportive tutors' group, a clear statement
of aims, even within a learner-centred framework, and the establishmen
t of clear ground rules to allow the participants to feel safe. Withou
t safety it is arguable that less challenging learning will occur.