(30) TARRANT COUNTY PHYSICIAN
January/February 2021
The EVOLUTION
can brag on myself as I have been involved
with medical education for over 40 years now.
Thirty-seven of those years were spent working
as an assistant and then an associate professor
of medicine at the Texas College of Osteopathic
Medicine (TCOM) within the University of North
Texas Health Science Center. I was the first full-time
gastroenterologist there. I left private practice in Dayton,
Ohio, where I was adjunct faculty at the Ohio University
College of Osteopathic Medicine. I wanted to be more
involved in medical education than that position offered.
So why am I telling you all this? So you know that I have
been around a long time and have seen a lot of changes,
including monumental ones in medical education, from the
classroom to clinical bedside clerkships.
UNTHSC developed an Academy of Medical Educators
where physicians, other health care providers, and basic
scientists at TCOM have learned and discussed the
theories and principles of medical education including
Bloom’s educational approach and Miller’s framework for
assessing clinical competence.
After we learned the fundamentals, we now concentrate
on other aspects of medical education. One of the of most
significant changes that has transformed how we educate
is that we no longer “lecture.” Indeed, it is now considered
a four-letter word—lecturing is seen as passive learning.
Also gone are reading assignments from textbooks. Other
forms of education now rule the roost. This includes online
education and interactive forms of learning.
So, what is so wrong with textbooks? About 10 years
ago, I read a letter to the editor in the New England Journal
of Medicine, where two second-year UCLA medical
students calculated the total number of pages assigned by
instructors for one semester. A staggering 10,000 pages
were assigned and were fair game when testing occurred at
the end of the semester. Too much? Yes!
A recent Google search stated the doubling of medical
technology in 1950 was 50 years, in 1980 seven years, in
2010 three and a half years, and in 2019 one and a half
years. Now in 2020 it is 73 days; not even three months.
I recently told this to a fourth-year medical student on my
service and as his eyes widened, he exclaimed, “That’s
scary!” So, to revisit what is wrong with textbooks,
here it is: The editors work with other experts to write a
designated chapter, all work is edited and corrected, it is
then published, printed, distributed, and purchased, etc.,
I
by Monte Troutman, DO - Publications Committee
of Medical Education
THE