Being Too Focused on the Test is Dangerous

Being Too Focused on the Test is Dangerous

GUEST POST from Arlen Meyers

Like most premeds, I got into medical school, mostly, because I am good at taking standardized tests, I can memorize lots of information , I had some cultural and economic advantages and I knew what to say to interviewers who did not know how to interview. It certainly was not about my being creative or imaginative.

Fortunately, for this generation, that is gradually changing.

As more and more medical educators try to reform the structure, process , goals, learning objectives and outcomes of medical undergraduate and post-graduate education, they run into some recurring questions:

  1. How do we find the right people to teach new subjects?
  2. How do we find the time to teach all of this new information when we are already constrained by the explosive growth of new basic science and clinical information?
  3. How do we make sure that our students and residents pass the tests required to graduate and get board certified so that they can practice and so that the education and training programs get accredited? In other words, how do we practice educational ambidexterity
  4. Should we change how and who we admit?
  5. How do we bridge the now, with the next with the new?

The latest trend in management theory is what’s called organizational ambidexterity. It’s the social scientists take on being a switch hitter, and is defined as an organization’s ability to be aligned and efficient in its management of today’s business demands while simultaneously being adaptive to changes in the environment. In other words, being able to simultaneously lead the now, the new and the next. Some describe it as bimodal people management.

While some are very vocal about eliminating standardized tests, it is unlikely they will be eliminated. The rate of growth of scientific and clinical information will increase. New faculty develoment is always a challenge. So, what are some answers?

  1. Faculty development programs that are people-centric and expand their knowledge, skills, abilities and competencies about introducing and integrating new subjects into their existing subject matter expertise. Engage the champions, build innovation teams around them, set the standards and goals then get out of their way. Identify the skeptics and either convert them or just let them do what they do best now. Sabateurs should be quickly exposed and “rehabilitated”.
  2. Recruit, develop, promote and reward for skills, like innovation, entrepreneurship , data analytics and artificial intelligence
  3. Create interdisciplinary and cross functional teaching teams
  4. Encourage industry collaboration
  5. Decrease, don’t increase, lecture time and give students the flexibility to learn when and how they do it best.
  6. Focus on competencies, while at the same time making it clear to students what they will be tested on to practice medicine
  7. Reform the standardized test and maintenance of certification process
  8. In the age of search, teach students how to learn, not what to memorize. Take advantage of how students learn, not how you think they learn.
  9. Accelerate up the hierarchy of learning from recall to interpretation to problem solving to creativity
  10. Take small steps in integrating the new subjects into the traditional four year/three year curriculum
  11. Test new ideas and incorporate the results into the next iteration
  12. Encourage students to be prosumers (producer/consumers) and help you build the product
  13. Rethink how and who you admit to medical school. In one recently opened school, 75% of the first year class have engineering or computer science degrees.
  14. Integrate and continue to build medical school education with post-graduate education and training
  15. Change and define GME required competencies and accreditation standards to meet contemporary needs.

Here are themes/motifs that are becoming part and parcel of the practice of medicine and are incrementally being intergrated into the medical school curriculum:

Some new schools are leapfrogging the old ways and launching entirely new curriculum maps from the start.

We should strive for educational ambidexterity and evolve from teaching and learning to the test and forgetting about all the rest.

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