Active Learning and the Need to Equip Medical Students with Cognitive Skills
The analogy – however apt – of the prototype Pakistani student to a clockwork parrot that has been conditioned to give the one ‘correct’ answer to any question has perhaps been overused. Allow me to go with it just once more.
The selection process of medical school anything but weeds out the ‘parrots’: the majority of my fellow first year students were extremely proficient at memorizing textbooks. Sharp memory is of course an asset when first facing heavy literature with medical terminology amounting almost to a new language. But sharp memory by itself cannot constitute a foundation for learning in any branch of knowledge.
My first few pharmacology classes, all I could do was stare incredulously at teachers who found it perfectly normal to shove shopping lists of medicines and their properties down our throats, and at my fellow students who equally complacently accepted that. No overview, no explanations. Nobody had the time to slow down to bother with the conceptual basis of how any drug functions; no, instead we see its adverse effects and contraindications as pieces of trivia. And whoever can remember the most of these arbitrary disconnected fun facts, wins.
Being realistic, (now that I am well into my first year of med school), can I say ‘let’s do away with all the mindless memorization’? Not entirely. The classic texts of Robbins and Gray’s remain to this day, a fundamental part of basic medical education. However, in view of the digital age where any drug right down to its molecular structure can be looked up in seconds, what we really need is a paradigm shift. Let’s go from asking ‘what’ to ‘why’, ‘how’ and ‘what if’. Rather than memorization as the Pavlovian response to new information, our medical education system should stress critical thinking, logic and scientific reasoning.
Recently, I came across the subject of epistemology. Briefly defined as the study of acquisition of knowledge, it generally concerns questions of belief, truth and justification of a ‘fact’. I have always been drawn to the fields of neurolinguistics and cognitive sciences, which deal with how our brains process and store data, so I decided to delve deeper into the subject. Although epistemology falls into the domain of philosophy, my internet browsing led me to explore something more relevant: models for the learning process.
What we presently have in most medical colleges in Pakistan is a situation where the sole focus is on swallowing relentlessly large amounts of data and insignificant details, such that students inevitably fail to relate this knowledge to the larger framework of the human body. What I suggest is that we divert some time from the tight schedules of initial months of medical school to teaching these novice learners how to conceptualize knowledge, how to construct mental schemas of say, physiological pathways. It is important to identify whether one is a visual, auditory or kinesthetic learner; and to understand how new information is incorporated in short-term memory first, and eventually through periodic reinforcement, into long-term memory.
A few hours of rudimentary research on cognitive and metacognitive learning theories and biological processes of learning turned out to be surprisingly fruitful, helping me develop more effective studying skills.
Here is one website that proved invaluable to me:
Learning itself is a science, and understanding the methods of this science will help students become active rather than passive learners, as they feel more empowered and less overwhelmed by the knowledge they acquire.
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