The clinical clerkship is the crucial experience in medical student education. To be learned effectively, bioethics, decision analysis, demographics, medical sociology, and many other important topics must be attached to a patient-centered problem; separate lectures and seminars are insufficient. This was part of the message of my article, and Fretscher supports it with his personal experience. He also suggests that non—patient-centered pedagogic efforts sometimes may be counterproductive and, in his experience, generate negative sentiments.
The challenge to medical educators is to incorporate these vital issues into the student-patient clinical encounter.