Teaching medical students without lectures

20170207140000, Zayani Bhatt
Just lecturing medical students is no longer enough – interactive, hands-on learning is required.
Medicine is continually evolving, both in its ability to cure more illnesses every day and in the nature of doctor-patient relationships. This means that students have to learn more than ever and immerse themselves into patient-centered care, in which doctors consider life circumstances and personal preferences along with symptoms and vital signs.

Medical schools are responding by taking measures to change the way in which medicine is actually taught to students, to arm them with both people skills and knowledge.

"The next generation is going to transform the practice of medicine. They need the tools and skills to do it," says Sherine Gabriel, dean of the Mayo Medical School.

Different teaching methods developed by universities

The University of Vermont’s medical school has been leading this innovation, with its pledge to eliminate all lectures by 2019, focusing instead on interactive forms of learning. Already more than half of its curriculum is interactive. For example, a “flipped classroom”, in which students learn material through videos, presentations and reading, before the class. In class, their learning is reinforced through group-based problem solving in which they confront a real-life case.

“Much of what is taught by a professor merely talking is forgotten within weeks and sometimes is obsolete within years,” says Dr. William B. Jeffries, senior associate dean for medical education at Vermont.

Students at the David Geffen School of Medicine at the University of California, Los Angeles, are given the opportunity to develop their own creative projects, which are then used to teach future medical students. They choose their own topics, plan and research their own projects and then implement them in an interactive format.

The experience of creating these serves as an opportunity for hands-on learning for the students. At Penn State College of Medicine, students create comics to depict their interactions with patients, to learn to empathise better.

Quicker exposure to clinical care

Traditionally, the first two years of medical school are spent in the classroom but at Vanderbilt University School of Medicine, students are given the opportunity to be a part of a care team; conducting interviews with patients in clinics and helping them understand new drug prescriptions.

"People learn much better if they learn a body of knowledge in the context in which it’s going to be used," says Bonnie Miller, senior associate dean for health sciences education at the university.

Second year students learn about the transition from hospital to home by helping to discharge patients and in some cases following up with house calls. Through such programs, trainees see how putting the focus on the patient prevents costly readmissions and leads to better health outcomes. All of this training enables students to learn communication and teamwork skills especially with professionals in other areas of medicine.

At Thomas Jefferson University, medical students are made to work with students of nursing, pharmacy and physical therapy, for example. At Northwestern University, students are made to explain how to make a peanut butter and jelly sandwich to an alien to improve their communication skills, at the most basic level.

The University of North Texas Health Science Centre believes that developing a sense of social mission in its students is important and therefore sends them out with social workers, to disadvantaged neighborhoods to administer screenings and vaccines.

Bridging the gap between the old and the new

The key to all of these changes is making students lifelong learners and professors at Harvard Medical School are doing just that. Workshops held at the university are designed to help faculty members better understand the six steps of self-directed learning, as they prepare a new generation of physicians.

There is still a long way to go though. Marie Kenney, a second year student at Vermont, was unaware of the curriculum changes when she applied. “Because my learning style is more solo than group-based, I find that lectures are a lot more valuable to me,” she said.

Soraiya Thura, a third-year medical student at the university, said that as professors struggled to learn the new formats, they sometimes stumbled, and the experience fell flat. Despite these teething problems, the concept of providing medical students with a more rounded education, through different teaching methods, is necessary in molding the better doctors of tomorrow. MIMS

Read more:
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Teaching medical students of the future: High-tech is the way to go
To improve patient safety, doctors are learning to give instructions on making sandwiches

Sources:
https://www.bostonglobe.com/metro/2017/01/31/who-needs-lectures-vermont-medical-school-chooses-other-ways-teach/NnVNKxLGF9dqYtXDoctBhO/story.html
https://hms.harvard.edu/news/teaching-how-learn
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139328/
http://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/2015/03/18/5-ways-medical-schools-aim-to-teach-the-doctors-of-tomorrow