How do medical students really learn?

Like any startup, edupreneurs creating new educational programs or medical school curriculum reform need to 1) identify the different stakeholders, and 2) create a value proposition based on design thinking and understanding the jobs they want done, how they want them done and the problems they want solved. You need to be a problem seeker, not a problem solver in the initial stages.

There are many ways to do customer discovery. One is by ethnographic research i.e. watching how customers do things and derive insights and ideas from the observations. In essence, you are a customer anthropologist taking field notes.

Here are some recommendations on how to learn based on adult learning theory.

The traditional apprenticeship model is "see one, do one, teach one".

So, if you were to watch how first year medical students and residents actually learn, what do you think you would discover?

Here is a paper published pre-COVID. In this study, an anonymous survey was sent to first, second, and third year medical students that included various questions about their study habits, as well as their course grades (A, B, C, or fail) and, if applicable, their Step 1 score. Results demonstrated statistically significant differences existed between Step 1 scores and grades in the second year of medical school, with A students earning higher scores. A students tended to attend class, limit use of online lectures, study for 6-8 hours a day, and review lectures the same day they were given significantly more than B and C students did. This study demonstrates that successful students consistently employ certain study habits.?

But, of course, what people say and what people do is not always the same. Plus, the post- COVID teaching and learning world is vastly different from the pre-COVID one.

My guess is that if you went into the field now you would see:

1. Fewer students attending class as the semester progresses. Now about 25% of preclinical year students don't. Have you noticed there are more AI note taking services at your Zoom calls?
2. The extensive use of online resources
3. Resentment over the fact that they have to spend money on textbooks and other materials that are free on the internet or other open educational resources
4. Students figuring out and acing the two courses in the hidden curriculum very quickly
5. A different medical student persona
6. A different mindset
7. Informal ways to learn, informed by peer-to-peer interaction, e.g. what apps to use to pass Part1 of the National Boards
8. Learning to the test but distracted by the rest
9. Focused on what they need to do get into the residency of their choice
10. Dealing with the pushback if they decide not to pursue a clinical career
11. Using artificial intelligence to teach and learn
12. About 25% of medical students skipping classroom lectures.

Medical education has been delivered "my way of the highway" for over one hundred years. If we don't change how we do things, more students will be headed for the exit ramps.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack