The Fallacy of Teaching and the Illusion of Learning: Improving Articulation of Basic Science in the Medical School Curr
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INNOVATION
The Fallacy of Teaching and the Illusion of Learning: Improving Articulation of Basic Science in the Medical School Curriculum Maria H. van Zuilen 1 & Jonathan S. England 1 & Daniel A. Sussman 1 & Amar R. Deshpande 1 & Alex J. Mechaber 1 S. Barry Issenberg 1 & Mathias G. Lichtenheld 1
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Accepted: 2 September 2020 # International Association of Medical Science Educators 2020
Abstract Despite calls from educators to re-engineer how faculty deliver medical student curricula with integrated basic science concepts, this content is still frequently disarticulated from other curricular components. We renewed our curriculum using evidence-based pedagogical and cognitive learning strategies to interleave basic science across the 4-year curriculum. Keywords Medical students . Curricular reform . Basic science curriculum . Curricular articulation
Innovation There is a common fallacy that the vast amounts of basic science content faculty teach medical students in the preclerkship curriculum are adequately learned. Likewise, there is little evidence that students spending large amounts of time memorizing information leads to long-term retention and application. An all-too-familiar scenario is an attending who is presented with a blank stare and silence when asking the clerkship medical student to draw on earlier learning to explain how a pathophysiologic mechanism manifests in clinically relevant ways, or how a proposed intervention works. Educators have called for a re-examination of the role of basic science in medical education [1] as medical students struggle to retain increasingly vast amounts of frequently disarticulated basic science concepts in the pre-clerkship curriculum. There has also been exponential growth in biomedical information and increasing demands to integrate broader topics into the curriculum, such as health systems science. Information overload is a key source of student stress [2]. The University of Miami Miller School of Medicine is transforming its curriculum with evidence-based, cognitive learning strategies that promote active, deep, and lifelong learning. Emphasis is placed on learning strategies such as
* Maria H. van Zuilen [email protected] 1
University of Miami Miller School of Medicine, Miami, FL, USA
interleaving and spaced practice, generation and elaboration, and calibration and reflection [3]. We optimize vertical and horizontal integration of basic science and other curricular content in an educational spiral [4] across its three phases: pre-clerkship, integrated core clerkships, and personalized areas of study. During our 2-year planning and piloting phase, we reviewed, consulted with, and/or visited nearly 20 institutions who had recently undertaken broad curricular reform, but the extent of basic and clinical science integration varied and generally was less robust than in our planned curriculum. An advisory committee of integrated faculty meets bi-weekly and oversees working teams for each phase of the curriculum. Core faculty leading the development and deliver
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