Publicly funded institutions, such as NIH, NLM, and state-supported universities, have explicit public service missions that extend beyond the walls of a single institution. During the past few years, national organizations, such as NLM and AAMC, have funded studies and projects to measure how well universities are adapting to technological change and educational reform. The IAIMS models are evidence of universities fostering cooperative rather than duplicative effort. Opportunities and problems facing universities extending systems and services to the private practice setting, to community-based health care HMO's, and to state and local health care agencies are discussed in terms of political, economic, and geographic realities. Instilling lifelong learning concepts begins before the health professional enters practice and is dependent on the emphasis universities place on "excellence in teaching." Without cooperation among core facilities, such as libraries, computer centers, and excellent instructors, continuing education will remain a parochial issue instead of a national thrust toward the continuum of the learning process. If continuing education is to become a high priority for universities and take its place on the education spectrum, flexible policies must be established to accommodate individual practitioners' expectations and interests.
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