Standardizing and Personalizing Science in Medical Education

Abstract

In the century since the initial publication of the Flexner Report, medical education has emphasized a broad knowledge of science and a fundamental understanding of the scientific method, which medical educators believe are essential to the practice of medicine. The enormous growth of scientific knowledge that underlies clinical practice has challenged medical schools to accommodate this new information within the curricula. Although innovative educational modalities and new curricula have partly addressed this growth, the authors argue for a systematic restructuring of the content and structure of science education from the premedical setting through clinical practice. The overarching goal of science education is to provide students with a broad, solid foundation applicable to medicine, a deep understanding of the scientific method, and the attitudes and skills needed to apply new knowledge to patient care throughout their careers. The authors believe that to accomplish this successfully, the following changes must occur across the three major stages of medical education: (1) a reshaping of the scientific preparation that all students complete before medical school, (2) an increase in individualized science education during medical school, and (3) an emphasis on knowledge acquisition skills throughout graduate medical education and beyond to assure lifelong scientific learning. As students progress through the educational continuum, the balance of standardized and personalized scientific knowledge will shift toward personalization. Greater personalization demands that physicians possess well-refined skills in information acquisition, interpretation, and application for optimal lifelong learning and effective clinical practice.

Nanomedicine concepts in the general medical curriculum: initiating a discussion

“…129 However, both premedical courses and the MCAT have been criticized on the basis that they do not adequately take into account advances in scientific knowledge at the cellular and molecular levels that will be required for the practice of medicine in the 21st century. 47,51 Similar critiques may be made of the United States Medical Licensing Examination (USMLE), which also has been claimed to encourage the "binge and purge" mentality of students who do not recognize the importance of the basic sciences in medical practice, and hence tend to memorize basic science information for short-term retention only. 51,[130][131][132][133] At time of writing, several significant changes have occurred to the format of both the MCAT and the USMLE.…”

“…47,51 Similar critiques may be made of the United States Medical Licensing Examination (USMLE), which also has been claimed to encourage the "binge and purge" mentality of students who do not recognize the importance of the basic sciences in medical practice, and hence tend to memorize basic science information for short-term retention only. 51,[130][131][132][133] At time of writing, several significant changes have occurred to the format of both the MCAT and the USMLE. In an effort to "focus on skills and concepts that tomorrow's doctors will need", it may be noted that the updated version of the MCAT (April 2015) now tests .…”

“…45 Numerous examples may be found in the medical education literature of commentaries issuing similar warnings. [46][47][48][49][50][51] While the commentaries offer a variety of sometimes competing perspectives (eg, in terms of the extent and depth of basic science content in the medical curriculum or the relative importance of the basic sciences compared to the development of clinical diagnostic skills in the professional education of doctors), there is general consensus that unprecedented advances in scientific knowledge and in contemporary medical practice necessitate corresponding adaptations in the general medical curriculum.…”

“…[46][47][48][49][50][51][52][53][54][55][56][57] This is likely to be one of the primary objections against incorporating key nanomedicine concepts into what long has been argued is an already "overstuffed curriculum". 118 Nevertheless, if there is broad agreement within the medical education community that existing basic science content in the general medical curriculum does not adequately address "the expanding scientific knowledge base of medicine", 45 it then becomes necessary to consider the ways in which "medical school curricula must continue to adapt in order to best prepare physicians for practice in the twenty-first century".…”

From Particularities to Context: Refining Our Thinking on Illness Narratives

“…At the heart of using illness narratives and teaching cultural competency is a desire to ensure excellent care for all patients-recognizing that patients face differential experiences and barriers to careand to contribute to reducing health disparities related to race and ethnicity [9]. Nevertheless, given the demand on medical education to accommodate and standardize new scientific knowledge [10], individual and structural contexts of narratives can be reduced to lists of cultural attributes. Here, we show that the problem that The Spirit and similar illness narratives pose for medical training resides not in the narrative itself but rather in how such books are taught and interpreted [11,12].…”