Faculty Development and Diversity

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?

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 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.

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.