Teaching for tomorrow

I write the following as an open letter to anyone in the educational sphere. It doesn’t matter what you are teaching, but rather how it is being taught. I am aware of the endless permutations on “a better approach” to teaching versus the standard didactic format. I am also aware of some very innovative styles of teaching that blend AI into a self teaching format. But I still have lots of questions.

Any doctor who relies solely on his or her medical school education without self updating, will be useless within a few years after graduating. The pace at which standards of care change, and guidelines are updated is dizzying. For example, a family physician has to be well acquainted with the management of hypertension, heart disease, diabetes, geriatric conditions, pediatric conditions and so on. A family physician who relies solely on their residency training will simply be providing substandard care within a short time after putting up their shingle. So it is clear to everyone that continuing medical education [CME] is not a luxury nor an administrative checkbox, but rather a critical part of continuing to provide proper health care.

Personally, the way I stay up-to-date is by reading material from a wide number of sources. I am subscribed to a number of email newsletters and I regularly get lists of abstracts from a number of the top medical and technology journals. I spend two hours a day on average reading and preparing material for others. I consider this part of my basic responsibility in the practice of medicine. This however is very different than tackling an entirely new topic.

For example, I have little hands-on experience with the management of patients with AIDS. In part, this has to do with my residency experience being primarily in urology during the time that the AIDS epidemic was still early on. I had no formal hands-on training in infectious disease. Also, during my practice here in Israel in urgent care, we rarely saw a patient with a specific complication of AIDS. Therefore, if I wanted to develop a basic level of comfort in this (or any other) field, I would need to read up on the topic and then do practical clinical work for at least a number of months, if not more.

Obviously, I could simply read a textbook to update my knowledge. Or, I could go to a couple of conferences. I suspect though that I would want to tackle the topic from multiple points of view. I would probably end up watching a whole series of lectures on YouTube having to do with

  • the basic science of the immune system [which would require me to refresh my out-of-date medical school knowledge on the topic]
  • the specifics of the AIDS virus at the microbiological level
  • the overt clinical manifestations of the disease with specific lectures on each specific problem and its treatment
  • a complete review of all the medications used for AIDS patients and a review of their specific pharmacology, and
  • at least a few lectures by patients describing their personal experiences with the disease.

Hopefully with this background, which would definitely take many weeks of study to complete, I would be ready to start a (supervised) clinical rotation.

One of my questions about education is as follows: Is the way in which I would study up on AIDS, any different than the way a young student could learn the next level of math? In both cases, we have a basic understanding of the topic, but we are entering into a new field with which we have limited practical experience. What if a high school student decided to learn algebra by listening to a series of lectures on YouTube? The student could listen to multiple lectures on the same topic in order to get multiple perspectives on the same issue. It could very well be that one teacher teaches one aspect of algebra very well, but another teacher teaches a different aspect of algebra very well. The advantage of having so many resources to draw from, is that it allows each and every student to find the path that is most appropriate for him or her.

After the young student finishes this lecture portion of learning Algebra, the student could then be directed to an online practice system that allows the student to practice on as many problems as desired. The student could perform 50 of the practice problems or 150. The student could return to this practice page at any time to review his or her skills. The student could listen to one of the YouTube lectures again and then practice the problems. When the student decides on his or her own that the time has come to be formally tested, that could be done in the school or in some other controlled manner.

It strikes me that in this day and age, limiting any student to the singular experience of one teacher or professor on any topic, is out of date. At least for myself, I know that I would not do well with an eight hour series of lectures on a given topic. I would nap through at least one of the hours, partially listen to another one of the hours and probably take incomprehensible notes on many of the other hours being taught. On the other hand, in the comfort of my own home with the ability to listen and re-listen to portions of various lectures, I could learn at my own pace, at times of the day that are comfortable for me. It really does sound to me like this is a far more ideal way to educate.

So I end this post with a request. If anyone reading this blog post is an educator, I would very much like to hear what today’s standard is for educating the young and the old. Do high school teachers assume that students have access to online materials? Are high schools creating their own material and posting it online? Are classes taped and then posted? I truly do not know the answers to these questions and I would love to hear from a professional educator rather than search on this topic on my own.

Thanks for listening, and in advance, thank you for any feedback.

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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