The innovations to science, technology, engineering and mathematics (STEM) education you recommend (Nature 523, 272–274 and 282–284; 2015) have already had a major impact on the teaching of medicine in Europe over the past 15 years, especially in the United Kingdom and the Netherlands. These have been inspired by initiatives such as Best Evidence Medical Education (BEME; www.bemecollaboration.org) and ASPIRE (www.aspire-to-excellence.org), both run by the Association for Medical Education in Europe.

There have been 32 systematic reviews examining the literature to determine which teaching methods work and why, and how they could be made more effective — including three highly cited BEME reviews (S. A. Azer Acad. Med. 90, 1147–1161; 2015). The ASPIRE initiative has ensured that teaching is now recognized internationally alongside excellence in research (see R. M. Harden and D. Wilkinson Med. Teach. 33, 95–96; 2011).

There has also been a drastic change in performance assessment of medical students. This no longer relies on regurgitating facts. Examples include the objective structured clinical examination, workplace-based assessments and entrustable professional activities, which emphasize the importance of feedback in monitoring and supporting undergraduate learning.