Innovations in Ophthalmology Education: a Particular Instantiation of General Principles
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COMMENTARY
Innovations in Ophthalmology Education: a Particular Instantiation of General Principles Phillip X. Braun 1,2 & John Encandela 3,4 & Ninani Kombo 5 Accepted: 6 November 2020 # International Association of Medical Science Educators 2020
Introduction: The Lecture in Crisis? On arrival at medical school in 2015, one of the authors (PXB) quickly became acquainted with the challenge of digesting vast quantities of information in a limited amount of time— popularly analogized as “drinking from a fire hydrant with a straw.” While a newly revised curriculum had placed increased emphasis on the flipped classroom as well as reorganization of content, lectures remained a key mode of information delivery, as is the case at most medical schools. In the learner’s (PXB) view, the effectiveness of the standard medical school lecture—whether in vivo or recorded—warrants reevaluation in at least a few respects. First, lecturers would do well to reconsider how they approach the “fire hydrant” problem. Regardless of whether lecturers historically had enough time to address content adequately—medical knowledge, and therefore medical school subject-matter, has only increased with the passing years—this is a great challenge in our current time, and even more so due to the abridgement of the pre-clinical curriculum at many medical schools in the twenty-first century [1]. With a decreasing amount of time to cover material and an increasing amount of material to cover—in addition to any longstanding pressures associated with imparting knowledge of medicine
* Phillip X. Braun [email protected] 1
Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY, USA
2
Yale School of Medicine, New Haven, CT, USA
3
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
4
Teaching and Learning Center, Yale School of Medicine, New Haven, CT, USA
5
Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT, USA
through lecture-based courses—it is unsurprising that the traditional lecture format is strained. It is not uncommon to come across 60 or more densely informational PowerPoint slides during a 50-minute lecture, and to have four such lectures delivered consecutively. This is far from ideal for digestion of content, to say nothing of thorough comprehension and retention. Second, lectures may be taught by excellent clinicians and pioneering scientists, but it is not always the case that they are taught by good educators and communicators. This could reflect institutional priorities (patient care and research before education), inertia (e.g., implicit or explicit priorities that are inherited, or perpetuating “the way it’s always been done”), or economics (by comparison with the clinic or the laboratory, educational reimbursement for the medical school lecturer may be trifling, if reimbursement is provided at all [2]). Nonetheless, it would be strange to ask someone with excellent teaching abilities to perform clinical duties with minimal clinical knowled
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