Med Ed: The Road Ahead

Medical education is changing. OK, yes, it's always changing. But I think we're approaching a major paradigm shift. As more programs adopt flipped classroom models and embrace the use of FOAM, where does that leave our current pre-clinical educators? 

The traditional med ed model relies on professors to be the experts, imparting their knowledge to students through lectures and textbooks (often written by these same professors). I mean no disrespect to these educators, who are undoubtedly brilliant in their respective fields. Many have even mastered the art of the 50 minute lecture, providing engaging talks and visuals. But as medical practice is changing, so must education. 

First of all, the sheer volume of information has increased drastically. It is impossible for today's students to fully comprehend and retain all of the material placed in front of them. More importantly, with easy access to apps and online references that are constantly updated, one could argue we shouldn't be teaching students to retain obscure bits of knowledge, but rather, how to seek out, synthesize, and apply the best information. 

Secondly, continued medical advancements coupled with rapid sharing of information makes life-long learning essential. Students need to learn to actively seek out and participate in their own education. These skills are integral to a successful medical career. Standard lectures and textbooks may contain all of the relevant information (and more), but often don't engage students as well as some of the newer methods. Problem based learning (PBL), team based learning (TBL), and the flipped classroom are promising modalities for medical education, but need to be more widely implemented. 

And then there is FOAM. Free open access meducation. Clinicians (especially those less tech savvy) are slowly embracing it. Students can't get enough of it. They are on blogs, social media, apps and quiz sites - some that they even have to pay for. We, as educators, need to be able to direct learners to the best content. And here is where the biggest shift occurs. Professors need to step away from writing lectures and become curators of information. For example, a flipped classroom course might require students to watch videos or complete modules on their own, and then participate in a team based learning or hands on session during class time. The key is that the pre-class materials need not be created by the professor - why reinvent the wheel when there is so much good stuff out there? 

Of course, this is all new and controversial, and actively evolving. It is challenging to ask educators who have learned and taught one way for their entire career, to adopt a completely new model, especially one that relies less on their scientific knowledge and more on their teaching abilities. It may take a great deal more effort to create a flipped classroom session than to write a lecture in your area of expertise. Finding and selecting appropriate FOAM resources can be time consuming, as well. And then there is the issue is pride and prestige. How do educators set themselves apart when they are using materials created by another professor, often at another institution? And what if their strength lies in their knowledge of their area of expertise rather than in employing innovative education? 

There are no easy answers and this movement will encounter may challenges. Those of us who want to be catalysts for change will have to work on breaking down barriers for current educators and facilitating a dialogue with students. We need to ask ourselves, what is in the best interest of our students? Students who are learning and practicing in our evolving, interconnected, technological world. 

By Sarah Medeiros

For an excellent graphic explanation of where med ed is going, please check out this presentation on Revolutionizing Education in Medicine, by the great Michelle Lin. 

Revolutionizing Education in Medicine: AACEM 2017 from Michelle Lin, MD