Posts Tagged ‘medical education’

Flipping the Classroom

Friday, May 4th, 2012

Movie depictions of higher education have not caught up to the way learning happens at universities nowadays. Instead of the authoritative professor in the front of the classroom lecturing to rows of students, college and medical school classes are more likely to resemble chaotic laboratories with students working in teams to solve problems.

Online tools have made this transformation possible. What used to occur in person–the efficient delivery of content via lecture–has now migrated to home viewing. The problem sets and homework that used to take place at home now go on in the classroom with the professor as facilitator.

There’s evidence that the active learning approach improves student outcomes in an undergraduate physics course. Stanford Medical School “flipped” its biochemistry course and saw a surge in student attendance. Khan Academy has popularized this model, bringing short video lessons to millions of Internet students.

So, why doesn’t every faculty member teach this way? I can think of a few barriers:

  • The effort required to revamp an existing course can be daunting.
  • If assessment measures of student learning rely on memorization of content, lecturing may be most appropriate.
  • Some students resist active learning. They feel they learn best from an expert.
  • Physical classroom space hinders group exercises.

Have you encountered other hurdles to flipping your teaching?

LGBT Health

Tuesday, November 8th, 2011

In a survey of medical school curricula, researchers found that the average medical student receives only five hours of instruction on the health of gay, lesbian, and transgendered patients. Nine schools devoted no time to the topic during the preclinical years.

Doug Hughes, Assistant Dean of Diversity and Multicultural Affairs and Professor of Psychiatry at BU, served as a panelist at the AAMC meeting in Denver. He reported that BU students receive 10 hours of LGBT health instruction, twice the national average.

A reporter from U.S. News interviewed Doug, who reported on the strides that BU and other medical schools have made in welcoming LGBT students. The visible presence of supportive faculty is particularly important, he said.

A Revised MCAT

Wednesday, May 11th, 2011

In 2008, the Association of American Medical Colleges, the organization that administers the Medical College Admission Test, appointed an advisory board to recommend changes in the test. Although not scheduled to release their final report until 2012, the board has made some preliminary findings.

Past revisions to the test strengthened its ability to predict medical school grades, but it lacks a way to gauge the personal characteristics that make for a well-rounded physician. The board, which includes a Boston University MD/PhD student, suggests adding a new section on behavioral science to help students demonstrate knowledge of the social side of medicine. A revamped verbal section would emphasize ethics and cross-cultural competency.

The qualities of professionalism may be too ineffable to capture in a standardized test. Fortunately, the recommendations also call for expanding the qualitative elements of a medical school application. Taken together, the preliminary report suggests that preparing doctors is as much an art as it is a science.

School for Educators

Tuesday, April 5th, 2011

The trend in biomedical research is building collaborative teams to tackle interdisciplinary problems. So why not in medical education? At Johns Hopkins, the schools of Education, Business, Medicine, Nursing, and Public Health have joined together to form a master’s program in education for health professionals.

The program will enroll faculty at Johns Hopkins in an 18-credit graduate certificate with the option to continue for a master’s degree. The curriculum consists of:

  • Adult Learning
  • Evidence-Based Teaching
  • Assessment and Feedback
  • Curriculum Development
  • Instructional Strategies

While occasional skill-building seminars are useful, this program recognizes that educators need a solid grounding in the fundamentals of teaching and learning. Ideally, it will also enhance participants’ ability to conduct research on their educational interventions, advancing their chances for promotion.

The Urge to Merge

Friday, January 7th, 2011

The University of Medicine and Dentistry of New Jersey is the country’s largest public institution of health sciences, but unlike other states, it is not affiliated with a research university. A new report on higher education in New Jersey is calling for the merger of the medical school with Rutgers University.

Like Boston Medical Center, the clinical arm of the Robert Wood Johnson Medical School is a large, urban hospital that provides care for the underserved. University Hospital in Newark is also carrying debt of $125 million. Any merger would have to address the hospital’s shaky finances.

It’s heartening to hear about a state government take medical education seriously. Seeing how the leaders in New Jersey follow through on the commission’s recommendations will be instructive for other academic medical centers seeking to implement systemic change.

Music and Healing

Monday, December 20th, 2010

We tend to think of teaching medicine as scientific training. But healing involves a holistic view of the patient. With that in mind, medical schools are integrating the arts into their curricula.

Studio 360, an NPR show, recently featured ways that medical students are learning about patient care through music, visual art, and narrative.

At BU, Robert Saper offers an optional course to students called the Healer’s Art. His program in Integrative Medicine extends the approach to faculty development by inviting employees to participate in free weekly yoga classes.

Curricular Change

Thursday, December 16th, 2010

The University of Texas Medical Branch at Galveston enrolls a much larger percentage of underrepresented minority students (25% compared to 15% nationally). Despite the success at recruiting a diverse student body, the medical school was not as accomplished in helping those students achieve. Only 2.9% of non-URM students failed the USMLE step 1 exam, but 16.6% of URM students failed.

In a study published in Medical Education, professors at Galveston report how they were able to boost those numbers so that 1.9% of non-URM students failed the exam and only 3.9% of URM students.

They implemented a wide-ranging rethinking of the curriculum, replacing a traditional memorization model with integrated learning. They incorporated problem-based learning and greater interaction with faculty. At the same time, the school invested in faculty development resources to equip teachers with skills in assessment and pedagogy.

The transformation did not happen overnight. The findings emerged from a comparison of students who matriculated between 1995-1997 and those who started between 2003-2005. But their experience shows how an institutional effort to improve learner outcomes can make a difference.

A Global Flexner Report

Tuesday, December 14th, 2010

In the centennial year of Flexner’s report on medical education, leaders in academic medicine have issued new calls for reform. The Carnegie Foundation issued a report this summer and this month a conference on Health Professionals for a New Century convened in Boston.

The conference organizers summarized their findings in an article in the Lancet. They found that worldwide 2420 medical schools train 1 million new physicians each year. The distribution of medical schools, however, do not match population. The U.S. has over 150 medical schools while 36 countries have no medical schools at all. Providing universal, high-quality health care, the authors argue, should be the goal of medical education.

This new phase of interdependent medical training involves a new kind of learning.

  1. First we had informational learning, which is the assimilation of facts and skills.
  2. Then comes formational learning, which prepares trainees to become professionals.
  3. The next step should be transformational learning, where trainees develop leadership attributes to serve as change agents.

The report does not offer many concrete suggestions for how to implement transformational learning or what changes it would mean for existing curricula. It seems that they mean to provide an overarching vision that will help shape global health citizens.

MedEd Portal

Wednesday, November 24th, 2010

On the MedEd Portal homepage, the first featured publication is a submission from our Department of Medicine colleagues, Dan Alford, Angela Jackson, and Jane Liebschutz (with Ben Siegel from Pediatrics).

Their publication, Prescription Drug Abuse: An Introduction, started as a two-hour lecture for internal medicine residents. After receiving evaluations, they enhanced the presentation with PowerPoint slides and references. For submission to peer review, they included learning objectives and lessons learned.

The Faculty Development Seminar series will include a presentation on how to publish educational scholarship using MedEd Portal. It is scheduled for Monday, December 13 at noon in Evans 118. The on-line database is also a helpful source for ready-made and tested teaching materials.

Your First Patient

Wednesday, November 10th, 2010

We know from Mary Roach’s oddly cheerful book, Stiff, that human cadavers play an unseen but important role in everything from bullet testing to automobile safety. Of course, cadavers are also central to medical education. Learning anatomy by dissecting an anonymous body is a rite of passage for future doctors.

It’s also an expensive ritual. As medical imaging technology improves, some medical schools are seeking to replace live dissection with computer simulation. One school in Indiana is going in the opposite direction. They are integrating dissection into the entire curriculum by making the cadaver a doctor’s first patient.

As reported in the Chronicle of Higher Education, students at Indiana University Northwest meet relatives of the deceased to gain a fuller picture of how the person lived, not just how she died. The students learn a more holistic approach to medicine, applying the lessons of their histology class to the tissues they examined.

For their part, the family members gain insight into their family’s health history. The husband of one donor plans to attend the graduation of the students who dissected his wife. This approach models not only good pedagogy, but also good clinical practice.