Background  There is increasing interest in the role of context in medical education, with the conjecture that learning in a clinical context may be helpful for later recall of knowledge. Although this may be true in a general sense, at a closer look it appears that the notion of context is not well substantiated in the medical education literature and that the concept is not clearly defined. Effects of context on learning appear to depend on type of learning task, the relationship or interaction between the context and the learning material, and motivational features of the context. Context is often implicitly regarded as a uniform concept but conceptual analysis shows that a distinction can be made in several dimensions. Results  In this paper, we identify 3 different dimensions of context: a physical dimension, representing the environmental characteristics; a semantic dimension, reflecting how well the context contributes to the learning task, and a commitment dimension, representing the amount of commitment (in terms of motivation and responsibility) that is generated by the context. On these dimensions, context can be ordered from reduced (providing few cues, little meaning, little commitment) to enriched (many cues, much meaning, high commitment). Conclusion  This model can serve a dual purpose: first, to disentangle several aspects of educational contexts (e.g. as high in meaning but low in commitment), and second, to provide a theoretical framework to generate research on the influence of different contexts in education on students' learning.

Curricular integration represents collaborations between disciplines to establish a coherent curriculum and has become the dominant recommendation for medical education in the second half of the twentieth century. Vertical integration specifically is the integration between the clinical and basic science parts throughout the program. Vertically integrated curricula present basic sciences imbedded in a clinical context from the start of medical school.The authors briefly discuss vertical integration in relationship with context theory, motivation theory, professional identity formation, transition to practice and the continuum of education and practice. They conclude that vertical integration, rather than horizontal integration, extends far beyond curriculum structure. They consider vertical integration a philosophy of education, with impact on students’ maturation and engagement with the profession, and which applies not only to undergraduate education but to the lifelong learning of professionals. The definition of vertical integration as “an educational approach that fosters a gradual increase of learner participation in the professional community through a stepwise increase of knowledge-based engagement in practice with graduated responsibilities in patient care” is more comprehensive than its older conceptualization.

The aim of the present study was to investigate whether basic scientists and physicians agree on the required depth of biomedical knowledge of medical students at graduation. A selection of basic science and clinical teachers rated the relevance of biomedical topics for students at graduation, illustrated by 80 example items. The items were derived from ten organ systems and designed at four levels: clinical, organ, cellular and molecular. Respondents were asked to identify for each item to what extent recently graduated medical students should have knowledge about it. In addition, they were asked to indicate whether the content of the item should be included in the medical curriculum. Analysis showed that basic scientists and physicians do not diverge at the clinical level. At the organ, cellular and molecular levels however, basic scientists judge that medical students should have more active knowledge. As expected, basic scientists also indicate that more deep level content should be included. Explanations for this phenomenon will be discussed.