Stanford professors propose re-imagining medical education with “lecture-less” classes

To make better use of the fixed amount of educational time available to train doctors, dramatic changes are needed in medical education including re-imagining the traditional lecture format, according to a perspective piece to be published tomorrow in the New England Journal of Medicine by two Stanford professors.

In a piece, titled “Lecture Halls without Lectures-A Proposal for Medical Education,” Charles Prober, MD, senior associate dean for medical education at the School of Medicine, teamed with Chip Heath, PhD, a professor of organizational behavior at the Stanford Graduate School of Business, to look toward optimizing medical education.

Teaching practices haven’t innovated in step with the rapidly expanding body of medical knowledge, they say, noting that the last major reform occurred in 1910. From the perspective piece:

It’s time to change the way we educate doctors. Since the hours available in a day have not increased to accommodate the expanded medical canon, we have only one realistic alternative: make better use of our students’ time.

The authors draw from a new educational model that reverses the traditional teaching method of classroom time being reserved for lectures and problem-solving exercises being completed outside of school as “homework.” Known as the “flipped-classroom” model, the approach was popularized by institutions including the nonprofit Khan Academy.

We propose embracing a flipped-classroom model, in which students absorb an instructor’s lecture in a digital format as homework, freeing up class time for a focus on applications, including emotion-provoking simulation exercises. Students would welcome more opportunities for case-based, problem-based, and team-based exercises-strategies that activate prior knowledge. Teachers would be able to actually teach, rather than merely make speeches.

This year, the core biochemistry class at Stanford’s medical school was redesigned to follow this model. The lecture-based format was replaced with short, online videos that students watched on their own time. During class time, instructor facilitated interactive discussions of clinical vignettes that highlighted the biochemical bases of various diseases.

Early experimentation with this model has been extremely positive with substantial increases in student reviews of the course and gains class attendance from 30 to 80 percent, despite attendance being optional, according to a release.

Previously: Stanford dean discusses changing expectations for medical students, Think medical education takes too long? So does Victor Fuchs and A quick primer on getting into medical school
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