Curriculum reform: the more things change, the more they stay the same?

would identify similar themes if they asked the same questions and used the same data collection tools [3]. We were left feeling we knew nothing about curriculum reform at Tehran University of Medical Sciences. How does this differ from change at our own medical school, or that of the Chief Editor, or indeed any other institution? Surely the local context must have some relationship with the traditional curriculum and hence the nature of reform? If not, the same approaches to selection, teaching and/or assessment would look the same everywhere, which we know is not the case [4, 5]. This made us stop and think: what contextual features are currently neglected in the medical education literature but yet are influential, and hence important to consider in curriculum reform? The list is probably endless but two concepts which are currently neglected in the medical education literature (yet not in other disciplines [6]) are the space and place of learning [7]. In health care (as opposed to health care education), space and place are generally discussed in relation to the importance of the built environment and its influence on patients and families’ experiences of their care [8]. There has been little research to date exploring this aspect of context on learner (and Faculty) educational experiences, yet emerging evidence indicates buildings are important in medical education generally, and curriculum reform specifically [9]. For example, consider the impact of having a fixed (non-adjustable) facility when planning change (perhaps one in dire need of modernization), versus the educational opportunities unleashed when designing new medical school buildings. What are the implications for reform of curricular delivery when the only facilities are fixed seating, tiered lecture theatres versus flexible room space which can be organized in different ways for different sessions [10]? Moreover, what is the social and cultural impact of having a medical school which is physically isolated from the rest Lorraine Hawick [email protected]