How should we be teaching our undergraduates?

Medical education has changed significantly over the past two decades in ma ny European countries. Rheumatologists have kept up to date with this chang e by becoming involved in curricular reform, and with the development of na tional,(1) and European(2) rheumatology curricula for undergraduate and pos tgraduate education Most of the examples of change cited in this article ar e based on the UK medical schools, but it is likely that these changes are reflected in other European countries. In addition, medical schools are in the midst of the implementation of substantial reforms of their own curricu la after the General Medical Council recommendations.(3) The quality of rhe umatology teaching is in the process of being evaluated as part of the Qual ity Assurance Agency visits, and there is likely to be an increasing demand for teachers in higher education (including medicine) to be trained follow ing the Dearing report.(4) Provided that we can continue to keep abreast of these changes the standard of undergraduate teaching in rheumatology will improve considerably. One of the current themes of medical education is that it has become recogn ised as a lifelong process.(5) Our undergraduates need to acquire learning skills that will take them from their undergraduate experience, through the ir general clinical training, specialist registrar training, and continuing medical education as consultant rheumatologists. Another theme is the shif t from a teacher centred approach, where the emphasis is on the teachers an d what they do, to a learner centred approach, where the emphasis is on wha t the students learn. To achieve this shift, a learning facilitator replace s the traditional didactic teacher, and traditional didactic teaching metho ds are replaced by interactive teaching in smaller groups. The principles behind these methods are based on a body of educational rese arch that has identified characteristics related to effective university te aching and learning. The aim of this article is to refer to the background educational theory, and to outline newer teaching methods developed on this basis. We hope also to provide a practical guide for our rheumatology teac hers (and learners) in this new millennium.