The current emphasis on providing quality undergraduate and postgraduate medical education has focused attention on the educational responsibilities of all doctors. There is a greater awareness of the need to train doctors as educators and courses have been set up to satisfy this need. Some courses, such as those on how to conduct appraisal, are speci®c to one task facing a medical educator. Other courses take a broader view and relate educational theory to practice. In this paper we describe an outcome-based approach in which competence in teaching is de®ned in terms of 12 learning outcomes. The framework provides a holistic approach to the roles of the teacher and supports the professionalism of teaching. Such a framework provides the basis for the development of a curriculum for teaching excellence. It helps to de®ne important competences for different categories of teachers, communicate the areas to be addressed in a course, identify gaps in course provision, evaluate courses, assist in staff planning and allow individuals to assess their personal learning needs. The framework is presented to encourage wider debate.

The first in a new series of short educational programmes covering a range of important topics in medical education. Each programme defines the topic, provides some background information, presents some practical tips, gives some theoretical underpinning where relevant, provides some further reading and suggests an activity which can be carried out independently or with colleagues. The series has been designed in collaboration with NHS Education for Scotland as an aid to all engaged as trainers or teachers in the healthcare professions.

Recent changes in medical education have resulted in an increased focus on patient safety. It is vital that new doctors can recognize and manage acutely-ill patients, as well as work safely and effectively as a member of a multi-professional team. A ward simulation exercise has been developed to provide a safe, but authentic setting to support junior doctors with further practice and feedback. In developing such an exercise realism is important in recreating the complex climate in which the junior doctor has to function as part of the healthcare team in the hospital ward. This paper shares the design methodology of a ward simulation exercise and the views on its authenticity from both the junior doctors and the observers.

As part of a larger study on learning outcomes for the first year of postgraduate medical training (already reported), semi-structured interviews with middle grade trainees were used to explore their perceptions of trainee development during this first training year. Data generated focused not only on learning outcomes, but also on important process issues. Dissatisfaction was expressed with formal and informal teaching and learning opportunities. Factors that enhance the learning environment were identified. These included being supported, a feeling of being a valued member of the team, being stretched but not over stretched, having a broad range of experiences, knowing the system, having a clear remit and being well organized. Factors inhibiting the learning environment included fractured working patterns, insufficient time with patients and seniors, as well as the converse of many of the enhancing factors. The process issues gathered in this paper will be of interest to those involved in the delivery of training for junior doctors.