This practice was seen as requiring knowledge integration, decision-making, working together with others, and communicating with patients (Barrows, 1983, Barrows and Tamblyn, 1980). Yet, medical students lacked clinical reasoning, problem-solving, and critical thinking skills. There was concern that medical schools put a too heavy emphasis on memorisation of -potentially irrelevant or soon-to-be-outdated - facts instead of skills necessary to practice medicine (Barrows, 1983, Savery, 2006).