“How Might We…” Redesign Medical Education?

By Jennifer J. Salopek

IMG_4430What does “medical education” really mean? In its current form, it means four years of medical school, mostly synchronous, live instruction by a faculty member, followed by three to seven years of residency. But what if we took all of our existing notions about medical education and threw them out the window? What if we went back to the drawing board, to design from scratch a new model of medical education that no longer assumes that knowledge acquisition happens in a single, continuous four-year span? That no longer assumes that faculty members are the arbiters of that knowledge? That no longer assumes that teachers and learners must be co-located? That no longer assumes that people learn by sitting and listening?

In her keynote address at Stanford Medicine X | ED this morning, Sarah Stein Greenberg, executive director of the d.school at Stanford University, outlined what happened when her team took apart similar assumptions about college. They then created a new model using design thinking tools and techniques. [The title of this post references a key design thinking technique: problem solving by asking, “How might we…?”] The resulting construct, known as Stanford 2025, relies on four “provocations:” open loop university, paced education, axis flip, and purpose learning. The latter suggests that students pursue educational paths based on a mission rather than a major.

“Most everyone has had some kind of experience with education, and these core ideas really seem to resonate with people from a wide variety of fields,” Greenberg says. She also noted that much invention and innovation is coming from outside the academy.

The d.school is “radically interdisciplinary,” bringing together students from all seven schools at Stanford to equip them with a common vocabulary that allows them to navigate the complexity of working within diverse teams. Its approach encourages a bias toward action, to experiment and prototype and test, and to think through challenges incrementally. Its deployment engenders creative confidence and resourcefulness in practitioners, Greenberg says, and leads to “profound learning experiences” as well as “spectacular failures.” Health-related d.school projects have looked at encouraging organ donation, medication adherence post-cardiac arrest, devices for children with club foot, and a breathing apparatus made of paper for children with asthma.

The Med X | ED emphasis on patient inclusion as planners, experts, and participants echoes design thinking principles. “The end user is always at the heart of a project, and that doesn’t mean we send out a survey,” Greenberg says. “That means that we really try to go and walk in the shoes of the end user, to have empathy for the experience of the end user. The idea that people are subject matter experts in their own lives is a core tenet of design.”

Jennifer-1990-webJennifer J. Salopek is founding editor of Wing of Zock. She can be reached at jjsalopek@cox.net, or follow her on Twitter @jsalopek.

One thought on ““How Might We…” Redesign Medical Education?

  1. The sentiment is appreciated! These arguments are not new, and my hope is that articles like the one below, the ongoing Academic Medicine conversation about med ed reforms, the work of Pamela Wible, MedX and talks like these will result in actionable changes to which we will bear witness in my lifetime. There are deep assumptions within the culture of medicine that need to be challenged and changed, axiological assumptions that are driving unhealthy practices. Design changes will need to be a result of or concomitant with medical cultural change.


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