BEE-j Volume 5: May 2005

http://www.bioscience.heacademy.ac.uk/journal/vol5/beej-5-R1.pdf

Book review

Basics in medical education

by Zubair Amin and Khoo Hoon Eng
399 pp., World Scientific, Singapore, 2003, ISBN 981-238-209-7, 38 There is a large amount of both theory and research about teaching and learning, but many teachers, perhaps especially those in medical schools, continue to teach as they were taught. When the present generation of medical teachers were being taught, there was little emphasis on life-long learning or self-directed learning. Their instinctive reaction is to give lectures to large classes and to worry about covering the curriculum. This is of course not uniformly true: many medical schools in the U.K. have adopted an integrated or systems-based curriculum, and a few have gone for problem-based learning (PBL). In N. America, where the situation is somewhat different because most of medical education is at graduate level, many schools use PBL. Nevertheless, as the Foreword of this book states, medical schools have been remarkably resistant to adopting the science of medical education, and yet, in contrast, seem to be successful in cultivating societys best minds and transforming them into mature physicians. This book aims to provide a reasonably concise guide to modern ideas about medical education. Its target is the medical teacher, and, the authors say, it aims to strike a balance between the why and the how of medical education. Many scientists in bioscience departments also teach to medical students, and so this book would be of interest to them also. Hopefully it is not so full of educational jargon that it misses its target readership, and since it is written jointly by a scientist and an MD, it will have credibility among medical teachers. Thus although words such as metacognition are used, one does not feel overwhelmed by having to learn a new language to understand what is being said. There are 38 short chapters dealing with various aspects and this is a book that can be dipped into perhaps rather than read from beginning to end. A chapter can easily be read at a sitting. Thus is you want to know about multiple-choice tests, or PBL, for example, you can quickly read the couple of chapters on these. For those wishing to go further, each chapter offers a few references, and these are to key publications by leaders in the field of medical education. For example, if you want some details about Blooms taxonomy, then you can find it here. Key ideas for teaching practice are boxed and bulleted for easy reference as checklists. Thus, in the chapter on the skills of learning, the authors say that an individual learner needs to reflect on the knowledge gap as follows: What do I already know about the topic? What do I not know about the topic? What is the knowledge gap? What is the most important topic that I need to address?

Methods of teaching are reviewed with graphs (from educational research) to show the percentage ability to recall information delivered by lecture, by reading, by doing, for example, and the importance of feedback is similarly emphasised in the sequence:

BEE-j Volume 5: May 2005

http://www.bioscience.heacademy.ac.uk/journal/vol5/beej-5-R1.pdf

Theory plus demonstration plus practice plus feedback plus coaching going from 510% for theory alone, to 80% for the sum of all the above. John Dewey is quoted as saying: True learning is based on discovery guided by mentoring rather than the transmission of knowledge. Therefore, one hopes that even the busiest medical teacher can look at the simple data provided and reach conclusions about teaching methodology. When we do research (in science) we look at the conclusions from previous research and modify our subsequent behaviour (i.e. design our next experiments) accordingly. Why dont we do this in our teaching practice when faced with evidence about how people learn? The first part of the book sets the scene with a broad overview of the aims of medical education, some history, current trends and controversies, and some teaching and learning theory. The learning cycle is emphasised: learning objectives defined strategies for achieving these set out, followed by assessment to check whether these objectives have indeed been achieved. It is characteristic of educationalists (indeed this is perhaps one of their more endearing characteristics) that they produce quotations on which to reflect, and this book is no exception in this respect. Quotations range from Confucius to Churchill, and I cannot resist re-quoting some of them here. Thus Timothy Goldsmith is quoted as writing: Discussions on curriculum are often limited to who covers what, an approach more suited to barn painting than to education. (We have all heard Rather than covering the whole curriculum, uncover part of it, I am sure.) Another quote comes from Winston Churchill: Personally, I am always willing to learn, although I do not always like being taught. There are many more, and all are thought-provoking. I think that teachers of both medical students and science students would enjoy reading some or all of this book, and hopefully having done so they will reflect on their teaching practice to the benefit of their students.

Reviewed by E J Wood
School of Biochemistry and Molecular Biology University of Leeds Woodhouse Lane Leeds LS2 9JT e.j.wood@leeds.ac.uk