Journal Club: The Inevitable Reimagining of Medical Education

Reference: Emanuel EJ. The Inevitable Reimagining of Medical EducationJAMA. Published online February 27, 2020. doi:10.1001/jama.2020.1227

The End of Preclinical Classroom Instruction

  • Move to online training
  • Introduction of standardised tests
  • Competency-based assessments
  • Reduction of in-person lectures
  • Online approach offers flexibility
  • Offer a series of short—about 6 to 15 minutes—video sessions, each covering 1 or 2 major points with an associated set of readings
  • Provide additional cases or examples and key associated readings
  • Why can’t they—why shouldn’t they—learn from the world’s 2 or 3 best instructors in any particular field? 
  • Students can learn from the best teachers in the world—certainly an important goal of education.
  • Medicine will remain irreducibly personal

The Against

” One objection to moving preclinical classroom instruction online is that there is more to preclinical medical education than basic science lectures. However, basic science courses still comprise 80% or more of preclinical medical education. Much of the additional material—small group discussions, cadaver dissection, and classes on ethics, professionalism, cultural competency, the health system, and the introduction to clinical medicine—also could be well addressed online.”

Challenge of completing online training, need for achievement and higher stakes to improve comletion rates.

Future of Medical Training

“With more seamless, reliable technology and, more importantly, advances in augmented reality (AR) and virtual reality (VR), it will soon be possible to “feel” as if everyone in a virtual group is in the same room participating in a single discussion.

In the future, there will be greater use of telemedicine, virtual office visits, and other online contacts. Nevertheless, medical care will remain largely an in-person, face-to-face interaction between patients and physicians or other clinician.

Furthermore, when correctly structured with collective projects or discussion groups, online courses can allow and foster the formation of deep, shared learning connections among students.”

COVID-19 Education Climate

Online training requirements for COVID-19 will change education across school and professional settings, not just in healthcare. The challenge is not just how to deliver interactive and engaging education, but how to translate online into the clinical environment to demonstrate understanding and meet competency standards.