Perspective: A perfect storm: the convergence of bullet points, competencies, and screen reading in medical education.

Three distinct phenomena are currently at play in medical education: (1) the pervasive use of PowerPoint in teaching, (2) the wholesale application of competency models, and (3) the shift from paper reading to screen reading regardless of course, text, or genre. Finding themselves placed at this intersection, students encounter fewer and fewer opportunities to practice some of the very cognitive and affective habits medical educators say they value in physicians, particularly critical reflection and deliberation, an eye for nuance, context, and ambiguity, and an appreciation that becoming a doctor involves more than learning content or performing skills. This article confronts these phenomena singly and then at their intersection, which may discourage, even dismantle, many of these habits. The author proposes that the rapid shift over the past decade to a technology-driven, competency-oriented environment in medical education is the medical educators' creation, one that sets up conditions for a perfect cognitive storm.