It also involves a widening of accountability to patients, the community, managers and policymakers, and a form of evaluation which is internal, participatory and collaborative rather than external and scientific in character.

Junior doctors need to acquire many skills in their training for the efficient and successful day-to-day clinical management of patients. These include effective communication skills, which are essential for a doctor to be able to ask the relevant questions in a sympathetic manner to the patient to acquire the precise facts. Correct examination techniques are also needed to allow doctors to effectively spot clinical signs and formulate their thinking to provide a differential diagnosis, and good presentation skills are needed to enable the students to deliver their findings in a systematic and logical manner.

This study raises concerns about the aims and functions of courses offering qualifications in medical education. It identifies a number of obstacles to the development of educational researchers who are skilled in the philosophical underpinnings of research activity or equipped to undertake educational research that is of a quality sufficient to withstand the scrutiny of the authors' scientific and clinical counterparts. We argue that if research into medical education is to thrive, it requires the full commitment of all those who are engaged in teaching the topic and supporting researchers.

This paper examines the question of evaluation which has been largely neglected in the credit-based systems of continuing medical education adopted by the Medical Royal Colleges. These systems are seen to encourage a training model of continuing education and a scientific model of evaluation as measurement. By contrast, humanistic evaluation is interpretative and differs not only in its criteria and methods, but also in its underpinning curricular ideologies and values. This model has closer links with concepts of education and professional practice associated with continuing professional development. Decisions about who should conduct the evaluation, what is to be evaluated, how it should be carried out, and about the goals and purposes of evaluation are outlined, noting that they presuppose an ideological view of the relationship of professional knowledge, values and practice. In a concluding discussion of evaluation and the control of professional knowledge, it is argued that the narrow, professional control of evaluation, buttressed by the quality assurance and monitoring mechanisms of the Colleges, is inappropriate, given the increasingly diverse accountabilities which affect medical professionals.