Allen B. Rawitch, PhD

University of Kansas Medical Center

Kansas City, Kansas

Teaching Biochemistry for Physicians – What Works and

Who Should Be Doing It

What teaching / learning modalities are good for medical biochemistry?

Lecture

1. Ability to get a lot of material covered in a limited time (particularly with modern technology, e.g. PowerPoint, etc)

2. Ability to emphasize or re-enforce key points

Advantages:

1. Either students rely on notes or their memory to take home or study from – unless you provide them with complete handouts or they have a note service transcript.

2. Holding their attention for one or more hours and competing with wireless web surfing, text messaging, etc

Lecture

What teaching / learning modalities are good for medical biochemistry?

Disadvantages

Well Designed Web Modules

What teaching / learning modalities are good for medical biochemistry?

1. Self paced

2. Links to web resources, animation, audio, video

3. Available 24 / 7

4. Facilitates group study

Advantages:

Well Designed Web Modules

What teaching / learning modalities are good for medical biochemistry?

Disadvantages:

1. Requires student discipline to spend time

2. If in competition with lecture, fosters absenteeism

3. Significant investment up front if other than an electronic page turner

4. Requires computer and internet access

What teaching / learning modalities are good for medical biochemistry?

Podcasts??"I don't think it's going to be a fad," said Michael Lieberman, a biochemistry professor and dean of instructional and research computing, who led the UC experiment after reading about Purdue's podcasting.

And then there's the question of whether this is a fad. Will students really jog down the street or chill out in their dorm rooms to the voice of their biochem prof? That last question might get its answer at the end of the quarter, when Lieberman plans to survey the 500 or so students in podcast classes to see what they think of it.And above all, Lieberman said, the project is voluntary. If instructors don't want their words and ideas captured in a podcast, they can keep the microphones out of the room.

From the Cincinnati Enquirer, January 5, 2006

What teaching / learning modalities are good for medical biochemistry?

Podcasts

Is there any difference between verbatim podcasts and the note service many of us still have ??

Good textbook and reading assignment

What teaching / learning modalities are good for medical biochemistry?

Advantages:

1. Self paced

2. Does not require batteries or power source

3. Available 24 / 7

4. Can be easily highlighted and notes added

Good textbook and reading assignment

What teaching / learning modalities are good for medical biochemistry?

Disadvantages:

1. Costs to students increasing

2. Has to be carried around

3. Do your students buy the book?

4. Does any specific textbook exactly meet the needs of your specific course?

Group Learning Exercises Small Groups or PBL’s

What teaching / learning modalities are good for medical biochemistry?

Advantages:1. Peer pressure to learn

2. Practice in presentation and communications

3. Easily adapted to clinical scenarios

4. Active learning, student engagement

5. Can encourage self-directed learning.

What teaching / learning modalities are good for medical biochemistry?

Disadvantages:

1. Requires significant staffing and training

2. Must be carefully planned to assure the learning objectives

3. Difficult to evaluate individual students

4. More difficult to cover significant amount of material and control final outcome (PBL)

Group Learning Exercises Small Groups or PBL’s

Case Based or Clinical Correlation Activities

What teaching / learning modalities are good for medical biochemistry?

Advantages:1. Very popular with students

2. Makes the case for relevance

3. Forces content to focus on disease

4. Good opportunity to integrate basic science disciplines with a common challenge or problem.

Case Based or Clinical Correlation Activities

What teaching / learning modalities are good for medical biochemistry?

Disadvantages:

1. Sometimes not possible to find cases or patients which illustrate important biochemical principals

2. Requires clinical faculty time and effort to make it authentic

3. Limits the ability to cover basic principals

4. Limited time precludes exploring details

Does your current medical course include small group or problem based

learning sessions?

1. Yes (30, 75%)

2. No (10, 25%)

The values in red are the responses obtained at the meeting: the first number is the absolute

count, the second the percentage. This is true throughout the presentation.

Is Team Based Learning Worthwhile?

Happier students ?

Slightly lower or equal scores on USMLE Step 1 ?

Slightly better scores on USMLE Step 2 ?

Some students will thrive in this environment and move to leadership positions in the group, while others may not feel comfortable and withdraw or not participate and learn well.

Happier students ?

Who should be teaching Medical Biochemistry?

1. Basic science faculty (26, 63%)

2. Clinical faculty

3. Graduate students

4. Post-doctorals

5. Other staff

6. Senior medical students

7. A combination of the above (15, 37%)

Who should be used to teach medical biochemistry?

Regardless of your choice, to whom do the instructors report?

What is the biochemistry chair’s role?

What do we know or what do we think we know?

1. There are significant pressures being applied to change what we teach and the way we teach medical students and our discipline.

2. There is a great deal of condemnation of traditional lecture formats and the total time spent in lecture sessions.

3. The question of exactly what we should teach and who should teach it is being discussed in many medical schools.

4. The traditional departmental structure is being altered in many schools both in terms of the teaching responsibilities and research activities (multi- and interdisciplinary disciplines and research groups, e.g., neuroscience, cancer biology, reproductive biology)

5. The authority and leadership of department chairs is being challenged in many schools in the course of the development of new curricula which cross or integrate disciplines.

What do we know or what do we think we know?

6. When teaching becomes interdisciplinary, someone needs to be responsible and must also have the authority to assign faculty and to evaluate them. Do you have an office of Medical Education? Do you have a Medical School Curriculum committee? If so, what do they do and what do they control?

7. Is there a battle between basic science disciplines and the physicians as to who will control the curriculum? If so, who has the high ground?

8. If we are transitioning to curricula which are based on any of the several small group teaching / learning models, where are we going to get all of the facilitators or tutors for the groups. Will this lead to an increased teaching load or a shared teaching load and what kind of training is required to do this well?

9. What is the best strategy that basic science department chairs can adopt in addressing these challenges – can we transition from a competition to a partnership and if so, how do we get there?

What do we know or what do we think we know?

More Questions – Are there simple answers ?

1. What drives the shape of our curriculum? The role of the LCME accreditation process.

2. Is there a danger of throwing out the baby with the bathwater? For example, will most of metabolism be considered irrelevant as we try to include all of the neat new stuff of genomics, proteomics and any of your other new “omics” approaches?

3. Is it important that our students understand the molecular basis of disease or just diagnosis based on signs, symptoms and laboratory values?

4. What position should biochemistry chairs take on whether biochemistry should be a prerequisite for admission so that students will have at least an exposure to some of the things that we may not be given the time to present to medical students. Is this an important issue?

Are there significant pressures being applied at your school to change the way you teach

medical students biochemistry?

1. Yes (25, 60%)

2. No (17, 40%)

If you have an office of medical education:

1. They play an active role in curriculum design (14, 32%)

2. They do not play an active role in curriculum design (17, 39%)

3. I don’t know what they do (5, 11%)

4. We don’t have one (8, 18%)

Which one of the following best describes the role of your curriculum committee?

1. Absolute authority over curriculum contents (1, 2%)

2. Works with course directors to determine curriculum content (31, 70%)

3. Rubber stamp for whatever the course director wants (9, 20%)

4. Rubber stamps the wishes of the Dean (3, 7%)

Should biochemistry be a prerequisite for admission to medical school?

1. Yes (33, 72%)

2. No (13, 28%)

Discussion and Action Steps

Create an Online Course Content Structure

Create an Online Shared Content Repository

Create an Online Group Learning Project Database

Create an Updated - Online USMLE-type Question Bank

If the AMGDB wants to do this, who will be responsible for the work?

How much would it cost?

How would it be financed?