As I am thinking about and developing a web course on EBM I have come to the conclusion we need to change the way we educate medical students. Medical schools need to be schooled on education innovation. Yes we change curriculums to be problem based or whatever the latest buzz word is but they are still mired in the one true impediment to lifelong learning—- the hour-long lecture. Perhaps it’s because medicine has such tradition that we are stuck in the teaching methodology of the last century. It’s time to flip it on its head.

WE (emphasis added by me) can’t fit it all in the curriculum. It’s just not possible

This quote is from a dean of a Canadian medical school. It reflects the problem with the current paradigm.  His focus (“WE”) is on what educators want to cover and not what the students need or want. We have this sense at medical schools that WE must lecture about everything. But that’s not possible.

Flipping is doing traditional classwork  at home and doing homework in class. What this means is that students would do online background course work (ie short videos developed by faculty) at home and class time would be spent on discussion and interactive exercises that support knowledge retention. Why do we (meaning medical educators….or any educators for that matter) force students to learn at our pace during the traditional 1 hour lecture (which is actually 50 min at my medical school)? How can we make sure students (all students!) understand the information? What if a few don’t understand a concept? Do we stop the whole class? Usually not, we just trudge along giving our lecture usually leaving some time at the end for questions which few have because their brains are numb from being lectured at.

With online learning each student can proceed at his or her own pace, taking more time on a harder topic if needed. She can also skip a topic if she has already mastered that information. Students can take time to link to other material to get an even deeper understanding if needed.

This generation of students (the millenials) are different from us older educators (I’m a gen x’er). They use technology (and to them email isnt technology!) much more than we do to communicate and learn. They prefer social, group based education. They like to learn by solving problems and don’t like as much lecture. It’s time we adapt our teaching to their learning.

This isnt easy as I am learning. Schools will have to invest in infrastructure and protect time for faculty to develop and maintain these interactive materials. The biggest obstacle though is us….we have to change our ways…..leave our comfort zone of the hour lecture.  As I am finding it has been incredibly intellectually satisfying  to develop material for a “new” teaching platform. I am hoping my course will be the sentinel event that stimulates my medical school to seriously  revamp the curriculum in a meaningful way, not just a name change but a paradigm change.