To remain competitive in medical education, Duke Medicine has adopted an integrative and collaborative learning method originally applied in Singapore.
Team Learn, Engage and Develop—a program currently in its seventh year at Duke University-National University of Singapore Graduate Medical School—is finishing its first full-fledged year at the School of Medicine in Durham. TeamLEAD is a learning model that deviates from traditional lecture-based medical education by using more interactive methods, such as working in small groups and conducting learning outside of the classroom. Despite some criticism surrounding the program, administrators reported that the Durham program was a success and plan to continue it next year.
Dr. Robert Kamei, vice dean of education at Duke-NUS, noted that he is pleased with the integration of the program in Durham.
“As we watched the students use the learning method, we were floored by the high level of classroom discussion,” Kamei wrote in an email Thursday.
The purpose of TeamLEAD is to simulate the field of medicine in the real world by having students learn in collaborative environments and apply learned knowledge to solve complex scenarios, said Dean of Duke-NUS Dr. Ranga Krishnan. The model stresses application over sheer memorization.
“Every day you come into class is a high stakes day,” he said. “You are arguing and debating the material—you learn much better because you are reinforcing the learning.”
As part of the new method, students are expected to learn the material beforehand and come to class prepared to collaborate with their peers and answer difficult questions. In class, students first take a test using a clicker—a system that allows professors to gauge how well the class and individuals understand the concepts. The class then divides into groups to discuss the test questions and solve a complex issue, Krishnan said.
The program has been successful in Singapore, where students are performing beyond expectations on standardized U.S. licensing assessments, Dr. Edward Buckley, vice dean of medical education at the medical school, wrote in an email Thursday,
Kamei commended the administration’s initiative to examine current teaching methods and implement changes for the benefit of students.
“The simple act of re-examining what [medical school professors] were doing as educators is very healthy and makes this initial venture a success,” Kamei said.
Still, some faculty members expressed reservations that medical school faculty have not been thoroughly consulted.
“A lot of the faculty that actually teach in the medical school don’t even know what TeamLEAD means,” said Dr. Mariano Garcia-Blanco, professor of molecular genetics and microbiology. “They feel like they’re being kept in the dark—this is not fair for the people who are actually doing the teaching.”
The success TeamLEAD has had in Singapore does not necessarily translate to success for the medical school, given the vastly different institutional circumstances, Garcia-Blanco added. Duke launched the program when Duke-NUS was in its beginning stages and had no pre-established curriculum. When TeamLEAD was implemented in Durham, the medical school faced the additional challenge of integrating new methods into a system that had been ongoing for many years, he added.
Kamei noted that the program deviates from traditional teaching and may pose a steep learning curve on faculty.
“We were fortunate to have experienced educators working on TeamLEAD and a group of students who understood not only why this was a better way to learn, but courageous enough to bear with us as we worked out the kinks,” he said.
Moving forward, administrators are developing ways to improve the pre-class learning resources for students, Kamei said. They will provide mobile and electronic systems for students to consolidate and personalize their learning. Administrators plan to partner faculty, students and residents in both Singapore and Durham to create an open resource of learning materials that will benefit not only the program, but also medical students around the world.
“Medicine is changing so fast that it is not about the knowledge as much as it is about the ‘thinking,’” Buckley said. “We need to teach our future doctors how to get information, analyze data and formulate solutions to problems that don’t have obvious answers.”
Correction: A previous version of this article incorrectly stated Dr. Ranga Krishnan as executive vice dean of Duke-NUS. He is actually dean of Duke-NUS. The Chronicle regrets the error.
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