Today’s medical students—and tomorrow’s physicians—have a vast amount of information available to them, and teaching them to sort through the good information and use it appropriately is a challenge medical educators are working to solve.
Despite the relatively recent advent of the information age ushered in by the Internet, this problem isn’t a new one. Mark Quirk, EdD, AMA vice president for medical education outcomes, explained the problem at a workshop during the Harvard Macy Institute (HMI) 20th Anniversary Symposium in June.
“Back in the late 1800s when Index Medicus was created, John Billings complained about the plethora of medical information” Dr. Quirk said. “In fact, Billings noted that much of it was bad information. Around the same time, William Osler talked about the problems of overburdening students with knowledge and information. … There was consensus that not only were physicians and medical students overburdened with information, but that medical education, was too focused on knowledge at the expense of patient experience.”
To address this century-old problem, 11 schools in the AMA’s Accelerating Change in Medical Education initiative are seeking to reinvent traditional medical education by incorporating such elements as competency-based assessment, new technology and team-based care into daily training. Investigators from some of the participating schools hosted a workshop at the HMI event.
Participants discussed medical education as it falls under three key areas:
- Individual learning with flexible progression and seamless transition across phases of training. Participants discussed the challenges of assessing students in an individualized learning pathway. For example, medical students early in their training often don’t participate in clinical activity. Trusting students to care for patients earlier in medical school is ideal, but it’s a difficult cultural barrier to overcome, said Maryellen Gusic, MD, executive associate dean for educational affairs at the Indiana University School of Medicine.
- Effective use of technology to promote learning and assess competence. Participants agreed schools must understand which modes of technology are best for their curricula. Teaching students and faculty how to effectively use new technology to manage information inside and outside of the traditional classroom must be an important goal of medical education.
There’s another issue: “Are we teaching our students how to manage all these ‘pipelines’ of information?” said George Mejicano, MD, senior associate dean for education at Oregon Health and Science University School of Medicine. He added that not only managing information pipelines, but implementing feedback loops so faculty know how students are using technology, is important.
- Partnering with clinical systems to enhance care. Participants discussed how an integrated learning organization between clinical and health professions educational systems would be ideal but can present challenges. Managing relationships and roles are crucial.
“Busy faculty members don’t want any additional work,” said Thomas Viggiano, MD, associate dean for faculty affairs at Mayo Medical School. “We have to be respectful at integrating whatever we’re going to do in a way that’s easy to navigate with significant payoff.”
Participants agreed that reimagining medical school curricula to fall under these areas will help future physicians sort through the information overload and make more informed care choices. The consortium of schools within the AMA initiative already is delving into solutions for these issues, including:
- Systems-based learning
- Diversity, health care disparities and workforce issues
- Competency-based assessment
- Adaptive, lifelong learning
- New technologies
