Operational definitions for service, training, education, and learning

The terms "service," "training," "education," and "learning" are ambiguous and lead to confusion in medical education. An alternate method of defining the terms is explored from the point of view of the role changes which students experience as they become medical practitioners. New definitions are developed. Repetitive activities or role changes not based on the acquisition of new knowledge and skills or supervision are called "noneducational." Role refinements and changes based on the acquisition of new knowledge and skills only are called "educational." Role refinements and changes based on the acquisition of new knowledge and skills and guided by supervision are called "training." These operational definitions permit new approaches to program evaluation and a new basis for discourse between students and their teachers.