Commentary

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. Aserious look at how educational innovations are dis-seminated may give the thoughtful observer cause toquestion the pervasiveness of the “scientific method. ” Sometimes it seems that education moves from one fad to the next. In my now longish career, I have seen many educational methods come and go: patient-management problems, modified essay questions, behav-ioural objectives, learning styles and more. This decade’s “flavours of the month ” — reflective practice, e-learning and high-fidelity simulations — appear to be no more evidence-based than all those that have come (and gone) be-fore. Sadly, although good evidence in support of a particu-lar educational innovation may exist, it is rarely instrumen-tal in decisions to adopt that innovation. Nowhere is this pattern more evident than with the locally grown phenomenon, problem-based learning. In this rad-ically different approach to medical education, learning is driven by challenging, open-ended problems; students work in small groups; learning is facilitated by a tutor; courses do not exist; and lectures are minimal. Problem-based learnin