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Rethinking the "sage on stage" model in medical education

Rethinking the "sage on stage" model in medical education

As reported here last week, two Stanford professors recently recommended making dramatic changes to the medical education format, including re-imagining the traditional lecture. An opinion piece published on TechCrunch further examines the proposal to adopt a flipped classroom model:

Students forget most of what they hear in lecture and then only recall 40% of the tested material two years later. Lectures do little for students actually enrolled in the school, let alone the millions of online users who will study part-time, without a supportive community or frequent feedback from a professor.

So, last week, two Stanford professors made a courageous proposal to ditch lectures in the medical school. “For most of the 20th century, lectures provided an efficient way to transfer knowledge, But in an era with a perfect video-delivery platform — one that serves up billions of YouTube views and millions of TED Talks on such things as technology, entertainment, and design — why would anyone waste precious class time on a lecture?,” write Associate Medical School dean, Charles Prober and business professor, Chip Heath, in The New England Journal of Medicine. Instead, they call for an embrace of the “flipped” classroom, where students review Khan Academy’s YouTube lectures at home and solve problems alongside professors in the classroom. Students seem to love the idea: when Stanford piloted the flipped classroom in a Biochemistry course, attendance ballooned from roughly 30% to 80%.

Skeptical readers may argue that Khan Academy can’t compete with lectures from the world’s great thinkers. In response, Prober and Heath point to a recent one-week study that compared the outcomes of two classes, a control class that received a lecture from a Nobel Prize-winning physicist and an experimental section where students worked with graduate assistants to solve physics problems. Test scores for the experimental group (non-lecture) was nearly double that of the control section (41% to 74%).

Previously: Stanford dean discusses changing expectations for medical students, Think medical education takes too long? So does Victor Fuchs and A quick primer on getting into medical school
Photo by Stanford EdTech

2 Responses to “ Rethinking the "sage on stage" model in medical education ”

  1. Marlies Schijven Says:

    This is just the way to do it.

    In surgery, people are thinking ‘the new curriculum’ must be full of elearning and simulators. It must not.
    Simulators stand on their own, catching dust, and elearning is not engaging students.

    This week, I will present a lecture on the flipped classroom for surgical residents at the EAES in Brussels. Starting with the desired outcome, and following back on one’s footsteps using simulation and serious gaming. Pathway focused, instead of outcome focused. I’m a believer! Who else is?
    Marlies Schijven, surgeon

  2. Thomas V. Smallman Says:

    I am an orthopaedic surgeon who has been directing a basic science course for Canada’s orthopaedic residents for 25 years. We started out didactic for content, with a lab, using microscopes to examine link clinical cases to what happening at the cellular level. It was painful to sit through and many fled. But the course content was “gold” and the course took hold as a concept, despite this. We worked over the years to make the course more user friendly, making giant strides with the advent of digitization. Having course content on a CD doubled our attendance, but my observation always was that many sat and fiddled, or looked at the internet during the didactic lectures. We made further changes, trying to make each session of the week-long course interactive and case-based. We now have a highly regarded course that receives high evaluation ratings by the participants. But it still suffers from a lack of engagement by the participants.
    I am excited by the concept of the flipped classroom, because it promises to solve the problem of a lack of intellectual engagement. I now am reaching out to see who else in medical and surgical education is doing this.


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