Education and the quality of health services

In the first section of this paper, it is argued that although education is often offered as the most important remedy for the poor quality of health services, its role may have been exaggerated and that educational attempts to improve the quality of health services may be unilateral. Education cannot solve such problems as organizational and environmental barriers to the use of knowledge and available technology which may be far more important causes of deficient quality than lack of knowledge. Educational remedies may also overemphasize the cognitive elements of care, neglect the expectations of the consumers, and lead to unnecessarily expensive care by stressing the highest attainable quality at the expense of optimal and logical quality. In spite of these limitations, education does have a useful role to play in quality assurance. The labor intensiveness of health care and the “knowledge explosion” particularly enhance the role of education as a partial guarantee of high quality. In the second section of the paper, the contributions of basic and continuing education to the quality of health services are profiled. Special attention is paid to the curriculum development process, the credentialing of health personnel, and the establishment of priorities for and educational principles in continuing education. The last two sections deal with the training of health professionals to accept, perform, and use quality assurance and the education of the public in quality related matters.