Towards an integrated and student-driven learning culture in medical schools

Prof Ian Symonds, Dean of School of Medicine at International Medical University (IMU), Malaysia shares with us how medical education has evolved in tandem with the wider shifts in the industry

Over the past decade, the healthcare landscape has constantly evolved and changed, with the advent of new technologies, digitalisation, and so on. It follows that medical education will need to evolve in tandem, so medical students graduate well-equipped to hit the ground running in their new roles.

“Medical education has become much more than just cramming information into the curriculum,” said Prof Ian Symonds, Dean of School of Medicine at International Medical University (IMU), Malaysia.

“It’s also about learning the skills for lifelong learning, reflection, interpersonal skills, teamwork, understanding of how health care systems work and how socioeconomic factors impact of the health of communities,” he said – all of which are ‘soft skills’ critical for today’s healthcare professionals.

Not enough to be book smart

The need to impart such soft skills meant that medical education had to move away from its tendency to rely on books and one-way instructional teaching.

“There was a fundamental shift in the last quarter of the 20th century away from simple didactic learning to much more integrated and student driven learning, using small groups focusing on clinical problems to provide the context,” said Prof Symonds.

Another example was the simulation-based education model, which replicates real-life clinical scenarios and allows students to pick up skills in dealing with critical but uncommon events.

Medical schools have also increasingly adopted technological tools in the teaching environment. “Our students will work in an increasingly technologically complex health care environment so it’s only appropriate they should learn in one,” Prof Symonds explained.

The role of digital

Such tools include online systems that allow students to access recorded lectures and curriculum. Digital classrooms have proved to be invaluable during the pandemic, and also enabled more distributed learning models, where students can learn in a way that best suits them.

However, greater connectivity is not without its pitfalls. “Over the last 20 years, widespread access to information through digital media means students have unlimited access to factual information in ‘real time’. The challenge is deciding what is important and accurate,” noted Dr Symonds.

The fact is that the amount of medical information can be overwhelming for students – and that doesn’t get easier for them when they enter their role as full-fledged clinicians, and where the stakes are higher. Overwhelmed clinicians may fall behind in getting the latest information on new disease or treatment guidelines and research, ultimately affecting their levels of clinical effectiveness and patient outcomes.

This is where medical schools come in to guide students on their discerning ability. “For me, clinical effectiveness is all about how a doctor brings together evidence-based knowledge with clinical experience to work with their patients to get the best outcomes for their patients and families. It’s a process that evolves over time as a result of new knowledge from research and monitoring of clinical outcomes through audit,” said Prof Symonds. “The role of a medical school is to provide students with the skills in knowing where to find the best knowledge and how to apply this in clinical decision making.”

Towards this goal, since 2009, IMU’s library had subscribed to UpToDate, an evidence-based resource of medical content constantly updated by a 7,000-strong team of physician authors, editors and reviewers. Prof Symonds noted that the solution has been widely used by both faculty and students: “It is mainly used by faculty members for case-based teaching and by-the-bedside teaching, but is heavily used by students when they are in the clinical Phase of the programme.”

IMU students are required to compile a portfolio – a series of case summaries, research project reports etc as evidence of learning – to be submitted in Semester 10, when they complete their undergraduate studies. UpToDate has been a much relied-on resource for this purpose; Prof Symonds recalled that there are citations from UptoDate in every Semester 10 Portfolios, indicating that they have referred to it for their cases. In addition, usage data has shown consistent upload of 300,000+ views per year over the last four years.

Digital tools and solutions have shown the value they can contribute to medical education. While the digital age may bring about an overwhelming amount of medical information, appropriate digital tools can be leveraged on to filter the information to present just the most recent, trusted data for students’ research and knowledge – thus fully reaping the benefits the digital age and the sort of unlimited, real-time information exchange it allows.

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