Can you teach an old dog new tricks?

The assumption that all physicians with identified educational deficiencies can be remediated is overly optimistic. This pilot study reports on an intensive three year program in which five physicians with deficiencies in knowledge and/or clinical abilities were enhanced with one-to-one tutoring, lectures, simulated patients, problem based learning, bring your own problems, video playback and case based learning. An academic family doctor with extensive experience in adult education initially reviewed each assessment. Next, the five physicians met as a small group for three hours twice a month for three years, using cases from their practices as stimuli to discuss clinical and basic science issues. After approximately 144 hours of educational intervention, the physicians were individually reassessed One physician improved significantly and one remained the same. The other three who had graduated 301 years, deteriorated. Despite the high quality of the intervention, and the skills of the facilitator, four of the five physicians failed to improve. One common denominator in our findings is age. This has prompted us to include formal cognitive screening as part of the assessment. However, some older physicians who have been assessed have scored above average. Therefore, age alone is not the answer. As responsible medical educators we must study other factors that determine who can benefit from costly educational programs in the future.