60 Chapter 2 that in those ten years the overall structure of the framework remained the same. Moreover, our data show that even a decade after the innovation to a learning-centred curriculum, multiple educators still hold a teaching-centred belief orientation. Thus, we expect that the proposed framework continues to be applicable. Finally, we intentionally focused on the preclinical teaching context. Therefore, some caution is required when extending conclusions from our findings to other contexts. Indeed, a postgraduate setting, as opposed to our preclinical context, might uncover more learning-centred belief orientations, consistent with the findings of Samuelowicz and Bain.13,14 Implications for teaching and future research The sharp divide between teaching-centred and learning-centred belief orientations in the framework implies that a change from a teaching- to a learning-centred orientation is a major transition. Current literature emphasises that this transition is a prerequisite for a lasting change in teaching behaviour, which in turn influences student learning. In learning-centred curricula, one way that faculty development programmes could support educators in making this transition is by helping them to become aware of their beliefs. The new framework can make these beliefs more explicit and can encourage medical educators to revisit their beliefs about teaching, learning, and knowledge. The framework’s dimensions can be used as an instrument for reflection and discussion about a medical educator’s educational beliefs. The adaptations and extensions that this framework provides are those areas that are relevant to the context of learningcentred medical education. Reflecting on how to determine which knowledge is relevant to be acquired, how to create a positive learning climate, how to help the students in their professional development, and how to foster intrinsic student motivation, are of major importance for the quality of our education of future health professionals. Further research is needed to investigate the extent to which the beliefs of medical educators can change and develop towards learning-centredness. For such a study, the presented framework can provide a useful instrument.
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