Sunday, August 21, 2011

Khan Academy

Recently I began to follow the work of Salman Khan.  He has become a celebrity in many circles, and I would not be surprised if he makes the cover of Time within the next year.  He is changing education by changing the method of it's delivery.

At his 2011 TED talk, Khan said something extremely profound and the audience didn't react.  After Kahn began his next sentence, and after the profound statement had time to creep into the minds of the audience members, the crowd suddenly errupted into applause.

At about 6:30 into the you-tube video, Kahn says, 

"I assign the lectures for homework, and what used to be homework, I now have students doing in the classroom."

Watch the video here:

This will change the method of delivery for medical education and in reality, many medical schools are already inadvertently using the Khan method at their schools!

For example, when I was going through my basic science years at NYU, I rarely went to lecture.  Instead, I sat in my bedroom and listened to the recorded lectures and read along with the PowerPoints that had been video-captured.  I would rewind when I didn't understand a lecturer's point, I would press stop when I wanted to eat lunch or was getting board, and I would press fast forward and listen to the lecture in 2.5 times speed when I came upon content that I already knew.  The big part missing from my method of study that Khan's method embraces, was the "doing in the classroom" "what used to be homework ."

Why can't medical education take advantage of this sensible method of delivery?  Students can watch lectures and read required texts and articles at home.  Then, they can be parsed into knowledge groups in which those groups meet with a professor to discuss relevant patient cases and medical content.  Those with a high understanding of the content might meet with a professor for a shorter period of time than those with a lower level of understanding.  Or those with higher understanding could go over more advanced topics pertaining to the lectures that they watched.

Better yet, after doing the work at home, students could sign up for which class they wanted to take.  Those who feel they've mastered the content at home, would have a small group with a professor who would discuss more advanced topics or related topics like medical ethics or public health; those who prefer learning in person to the Khan method, could have their own more traditional method grouping; the possibilities for groupings are endless.

How do you think the Khan Academy could change medical education?    

Monday, August 1, 2011

New Hofstra Medical School Doing It Right

If we are to apply inductive reasoning to medical education, we must think of creative ways to expose novice level medical students early on in their education to the undifferentiated patient.  We should not expect students to try to understand the basic science behind a myocardial infarction without those students first witnessing chest pain, without them witnessing what a heart attack actually looks like.

The brand new Hofstra/North Shore - Long Island Jewish  School of Medicine has taken advantage of its unique advantage of creating a medical school curriculum from scratch.  The school's first class will have the opportunity to learn via inductive reasoning by seeing patients with chest pain before they learn all the factual parts of what makes up a myocardial infarction.  They will know chest pain and from that knowledge point, as they continue onwards with their more traditional studies, they will then have the advantage of context.  The students will know what cardiac cell necrosis looks like, and what troponin bumps look like, and what statins are designed to prevent, and what the past event is that pathological q-waves represent.

Here is an excerpt from an article found on PRNewswire-USNewswire from July 27, 2011:

"Within the first weeks of their arrival, students will be trained and certified as emergency medical technicians and begin working in ambulances. By learning to be EMTs and practicing emergency care from the beginning of their studies, students will be exposed as members of an emergency-response team to patients in crisis situations. The school's ground-breaking academic course content offers students the unique opportunity to learn medicine through a new and innovative curriculum that integrates basic science with hands-on clinical experience throughout the four years of medical school."

If you know of other schools practicing novel approaches to expose medical students early to patients, especially to patients who are in their first stages of presentation, please leave a comment.

Thank you to Hofstra for getting it right.

-Teach, MD