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Could TED Talks Help Medical Schools Break a 100 Year Rut?

Lainie Hardman - Toshiba Learning Center Editor | April 20, 2015




At the turn of the century in 1900, the Council on Medical Education (created by the AMA) was focused on medical school reform.  They asked the Carnegie Foundation for the Advancement of Teaching to survey and evaluate the quality of education and training provided by all medical schools in America and create a report.  Abraham Flexner was chosen to conduct the survey. 

The resulting Flexner Report had a major impact on medical schools.  Flexner recommended changing the current 2-year model to a 4-year model for medical school.  Flexner also recommended students do 2 years of basic science training in a lecture hall format then move on to 2-3 years of clinical rotations in a hospital.  This model largely remains in place – over 100 years later - in today’s medical schools. 

A Call for Change

It is hard to believe that the structure of medical education remains so firmly rooted in the past when technology, the healthcare system, and medicine have all experienced such radical change. 

A popular criticism of the current medical education is the fact that students are not exposed to patient cases early enough or with consistency.  In their article for The New England Journal of Medicine, authors Charles G. Prober, M.D. and Chip Heath, Ph.D  advocate using the “power of the clinical scenario” to make concepts “stickier” so that students will find them easier to remember.   In the article they assert that, “Patient’s stories are what make the acquisition of medical knowledge compelling."
Patient’s stories are what make the acquisition of medical knowledge compelling.
 - Charles Prober, MD and Chip Heath, Ph.D
Lecture Halls without Lectures — A Proposal for Medical Education

Drs. Prober and Heath are both professors at Stanford University and discuss the validity of the lecture hall when video platforms provide content like TED Talks to billions of viewers around the world.  When it comes to transferring knowledge in the 21st century they pose the question, “Why would anyone waste precious class time on a lecture?”

Critics argue that this is not the best method to produce quality physicians and the teaching method is outdated for today’s multitasking medical student.  On the other hand this new group of students tend to respond very well to new innovations in teaching and communication similar to what non-profit TED facilitates.     
TED’s mission is spreading ideas and TED Talks are widely regarded as inspiring audience members to apply what they heard in a meaningful way.  Could changing the large lecture teaching model in medical school to the short informal TED Talk model be part of the answer to modernize medical schools?

TED - An Idea Worth Spreading

TED (Technology, Entertainment, and Design) was unofficially founded in 1984 as a one-off event.  Now the non-profit organization has a reach that spans the globe.  TED Talks are short videos of presentations meant to share an idea.  Ted Talks share core characteristics as a rule, the talk will be no more than 18 minutes long, PowerPoint slides won’t have more than a few facts or ideas, and the speaker will be passionate about the subject and use real world examples.  TED speakers usually pose one clear concept or idea and use their time to make that idea stick.

TED Talks are widely regarded as engaging and audience members walk away from them ready to action.  TED curator Chris Anderson imposed the 18 minute rule so that the talks were “long enough to be serious but short enough to hold people’s attention”.  He also contends the length is perfect for viral sharing. 
Compare these characteristics with a typical medical school lecture that is an hour in length and would most likely not contain real world examples or clinical scenarios.  Imagine how much more effective that lecture might be if key concepts were delivered in 18 minute videos that could be viewed by students at their own pace. 

TEDMED also adds to the value of the TED brand for enhancing medical education.  Created by TED’s founder, TEDMED seeks to accelerate innovation in health and medicine with an annual event and video presentations that can be easily viewed and shared.
 
TED Talks are long enough to be serious but short enough to hold people’s attention - Chris Anderson - TED curator
Not so Modern Medicine

In a blog post for US News and World Report, a first year medical student gave a glimpse into a day in his life.  The day started with three back to back one-hour lectures starting at 8:30am.  The afternoon brings two additional lectures.  One lecture includes some patient case discussion and another includes learning how to get patient histories.  In a blog post for medaholic, a student with a similar schedule makes an interesting note during her first lecture,  “It’s halfway through the lecture and at this crucial point, depending on how good or bad the lectures has been going, I will either increase my concentration and focus for the remaining slides left or… begin checking my email.” 

These may be modern students but their schedules are very similar to their colleagues from 100 years ago.  They both endure long days almost exclusively filled with lectures with little patient case review or hands on skill building.  Their evenings are spent studying and memorizing the factual scientific information delivered in the lectures of the day.

Imagine a new scenario blending a TED Talk lecture format and the “Flipped Classroom” approach.  In this scenario these students would review videos at their own pace in the TED format, 18 minutes long and focusing on one clear concept.  Lecture time would be focused on questions, problem solving, and patient cases. 

Reshaping a New Century in Medical Education

Nearly 100 years after the publication of the Flexner Report, it may be time for a new one.
Innovations in technology and radical changes to how we view, share, and teach information provides many opportunities to reshape medical school education.  Other universities employ social media in the hopes of creating peer networks that share knowledge and research.

Medical school education could gain a real benefit by using the TED Talk model to reshape its curriculum.  The list of people who have delivered TED Talks include former world leaders, Nobel Laureates, corporate visionaries, and celebrities.  This is a part of the appeal.  Using this model lectures delivered in the form of TED Talks could be given by leading doctors and scientist in the industry.  Levels of teaching available to high profile schools could be shared globally.  Patient cases could be delivered by the patient in this model adding to the stickiness factor.

In this era of mass communication and global sharing, medical schools have an opportunity to modernize curriculums and globally share faculty expertise.  TED Talks may be the answer to discovering a new way to improve healthcare through education.
 
References:
Flexner, Abraham, 1910, “Medical Education in the United States and Canada, The Carnegie Foundation for the Advancement of Teaching, http://archive.carnegiefoundation.org/pdfs/elibrary/Carnegie_Flexner_Report.pdf

Duffy, Thomas P., M.D., September 2011, “The Flexner Report – 100 Years Later”, Yale Journal of Biology and Medicine, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178858/

Prober, Charles G. M.D., and Chip Heath, Ph.D,, May 3, 2012,  “Lecture Halls without Lectures – a Proposal for Medical Education”