About 200 academic physicians discussed the role of technology in medical education during the Harvard Macy Institute (HMI) 20th Anniversary Symposium last week in Boston, sharing ideas for transformational learning in the face of a changing health care system.
HMI, a continuing professional development program for medical educators, brought alumni of the program together to discuss how schools across the country are promoting sustainable, institution-specific changes. Much of the conversation focused on how technology, such as massive open online courses (MOOC), are changing how students get information and the need for institutions to appropriately incorporate technology into curricula. A MOOC is a class or course made available online, for free, to anyone with an Internet connection.
“With technology and education, it’s mostly old wine into new bottles, and then we’re surprised that the wine doesn’t taste any better,” said Eric Mazur, PhD, dean of applied physics and Balkanski professor of physics and applied physics at Harvard University, during a panel discussion on future directions in education.
Structuring new curricula to better meet the needs of future doctors isn’t easy, most attendees agreed. Programs are increasingly moving toward teaching students how to ask appropriate questions, acknowledge when they need assistance and question their sources of knowledge in the Internet age.
“The process of getting your students to be highly reflective … is not only a critical process for them cognitively, but for us as instructors, [it is] one of the greatest ways to understand where they are and where they are headed,” said Robert Lue, PhD, faculty director of HarvardX, Harvard University’s MOOC program. “We are increasingly less interested in the three-hour exam and 14-page problem set. We’re increasingly interested in [students’] own ideas.”
A major challenge in making such changes, however, is assessment. Implementing competency-based programs and less rigid curricula makes it difficult to compare how students perform.
The 11 medical schools participating in the AMA’s Accelerating Change in Medical Education initiative are puzzling through the same challenge. Faculty at the schools are working together to identify milestones to assess competency in different areas.
The consortium of schools in the initiative is looking at how students can use technology effectively—such as patient simulations, electronic health records (EHR) and supercomputers—and how students can become master adaptive learners, incorporating the ability to learn, asses and adapt throughout their careers.
Another presentation at the HMI Symposium looked at deliberately developmental organizations , companies that purposefully create a culture in which people see their mistakes as opportunities for personal growth by weaving it into their daily work. The idea is that anyone—from entry-level to senior-level workers—can ask questions without the fear of being thought of as stupid or incompetent, and can outwardly recognize and transcend their personal limitations in a flexible work environment.
Educators can apply similar principles to teaching future physicians by instilling in students that they will make mistakes and should be open to accepting constructive criticism about how to prevent future mistakes, a component of teaching how to be a master adaptive learner.
For Tara Lang, MD, assistant professor of pediatrics at Mayo Medical School and part of the school’s grant work under the AMA’s Accelerating Change in Medical Education initiative, the concept of deliberately developmental organizations is even broader.
“One of the most important aspects of the AMA is that they are providing an opportunity for everybody to share ideas and question the status quo without any fear of repercussions,” Dr. Lang said. “It’s an open forum to exchange ideas and really transform the way we do medical education—that is the very definition of a developmental organization. You can do that within your own microcosm, but until we as a national organization question the status quo, the culture isn’t going to change.”
