Educators should tap learners’ insights, med students argue

Timothy M. Smith
Senior Staff Writer
AMA Wire
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Medical students and residents are valuable but often untapped assets in scholarly conversations about how to reshape medical education, says a recent commentary in Academic Medicine. The commentary, written by medical students, explores the unique voice learners can bring to educational innovation and provides suggestions for better incorporating the next generation of academic leaders into scholarship, curriculum development and efforts to change the culture of medicine.

Engaging Learners to Advance Medical Education” contextualized themes from more than 200 letters submitted in response to a call for student- and resident-authored submissions on topics from curricular changes to the learning environment.

“We believe learner-led medical education innovation has distinct benefits,” wrote the authors, Jesse Burk-Rafel, a fourth-year student at the University of Michigan Medical School, R. Logan Jones, a fourth-year medical student at the University of Nebraska College of Medicine, and Janice L. Farlow, an eighth-year MD-PhD student at the Indiana University School of Medicine. “Learners offer a unique firsthand perspective on curricular issues, perceiving hidden curricula and intangibles of the learning environment that may be opaque to educators.”

Burk-Rafel is primary representative of the Association of American Medical Colleges Organization of Student Representatives; Jones is chair of the AMA’s Medical Student Section Committee on Medical Education and member of the National Advisory Panel to the AMA Accelerating Change in Medical Education Consortium; and Farlow is a member of the Association of American Medical Colleges Board of Directors.

By the time they enter medical school, the authors noted, many students have “expertise from undergraduate, graduate or workplace experiences in nonmedical disciplines such as sociology, economics and general education—expertise which enables them to lead interdisciplinary approaches to medical education.”

Change agents awaiting assignments

The authors note the significance of learners’ perspectives in recent system-level changes, most notably in admissions, where students have helped promote community pipeline programs, holistic review, and diversity and inclusion.

Similarly, learners have novel perspectives on, and approaches to, student and physician well-being and the learning environment.

    “Addressing medicine’s cultural challenges will undoubtedly take engagement from all members of our profession, yet learners’ idealism and vision will be invaluable to this effort, and their courage and resilience can lead by example,” the authors wrote.

    “Our partial outsider position, however, can make voicing concerns difficult. Internally, we may face self-doubt and disempowerment, while externally we may face skepticism regarding the wisdom of our nascent views and lack the ‘social capital’ to speak out in a hierarchical system—all while trying to find our place within the profession and develop as clinicians.”

    Areas ripe for learner input

    “Most medical students are minimally aware of the field of educational scholarship … [so] few apply a scholarly framework to their innovations,” the authors wrote. “Additionally, students often lack mentors who can socialize them to the field of medical education and offer guidance for transforming their ideas into scholarly products. Those students who do find mentorship often work without funding for conducting and disseminating their work.”

    The authors also provided numerous recommendations to medical education stakeholders for empowering medical students as change agents. These include:

    For institutions: Provide institutional incentivizes and rewards for students’ efforts in leadership, advocacy and scholarship. These may include certificates of distinction and funding for students to attend conferences.

    For publishers: Consider calls for student-authored opinion pieces and original research, issues and sections dedicated to learner viewpoints, and articles focusing on more incremental innovations.

    For associations: Encourage innovation challenges, such as student-directed abstract competitions, and work to address the financial barriers to conducting and disseminating student-led educational innovation.

    “By purposefully engaging learners in national and international dialogue,” the authors wrote, “you will help learners develop a scholarly ‘academic’ mindset that will pay dividends in how we care for our patients, educate future trainees, serve our communities and tackle emerging health care challenges.”

    As part of its Accelerating Change in Medical Education initiative, the AMA last year held its first-ever Medical Education Innovation Challenge, which awarded monetary prizes to four student teams out of nearly 150 submissions for projects that answered the question, “What does the medical school of the future look like to you?

    The AMA also hosts an annual research symposium to showcase medical students’ original research and help mentor the physicians of tomorrow. All medical students are encouraged to submit abstracts of their research for the 15th annual AMA Research Symposium, Nov. 10 at the 2017 AMA Interim Meeting, in Honolulu, Hawaii. For more information, email [email protected].

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