PREMATRICULATION COURSE

Following is a brief description of a course offered to students who are about to embark on the first year of a 'traditional' medical school education. The primary objective of the course is to assist students in meeting the 'unique' challenges of medical school and 'coping' with the problems they are likely to encounter as they transition from the kind of learning typical of pre-medical education to the demands of self-directed learning that they experience in undergraduate medical education. The precise list of topics to be covered, and the timing, can be adjusted to suit the needs/structure of a variety of settings. Thus, for example, the course can be given to a small (10-12) group of students before they actually start first semester classes, or can be integrated into the initial segment/module of a traditional Histology/Microscopic Anatomy course and offered to a much larger cohort. The actual topics and the facts conveyed are less important than the 'focus' on Skills and Attitudes (see below) but, for those who wish a sense of the framework, the following is a listing of the topics I cover in a 'standard' offering:

Session#      Topic

1,2           Introduction to Cell Biology; Membranes and Organelles
3,4           Early Embryonic Development
5,6           Basic Tissues, Epithelia
7,8           Connective Tissues, including Adipose
9             Cartilage and Bone
10            Muscle
11,12         Nerve; PNS and CNS
13            Organs; Glands
14            Organ Systems; Skin
15,16         Examination and Post-exam analysis

The list of topics can be compressed somewhat or can be expanded to include essentially all of the material covered in a traditional Microscopic Anatomy Course, but my preference is to give a rather concise course, as outlined above.

My objectives in presenting this course are best understood with reference to the conventional notion that Medical Education should seek to convey Knowledge, Skills, and Attitudes (KSA). Most medical students with whom I have interacted are able to 'learn' large amounts of facts (K) but are have considerable difficulty in the Skills and Attitudes arena. And their limitations in S and A cause many if not most of the problems they encounter, especially in the first months of their undergraduate medical education. Therefore, I expend considerable effort - while covering the facts they expect to be taught - presenting/discussing many pieces of information they do NOT expect to be taught. I do this, as much as possible, one-on-one with individual students, or in groups until I am able to convince individual students that it is to their benefit to meet with me. Some of the points/issues I try to cover with students (not necessarily in this order) are:

- Each medical student is, or should be, a self-directed learner. S/he is in charge of her/his education. Faculty are there to help them, not pour knowledge into them, and the faculty can only help if the student ASKS for help.

- Students should understand the concept of metacognition and the notion that they should think about how they learn, so as to improve the return on the effort they put into their studies.

- Most medical students work much harder than is sensible and do things that are not good for their health (insufficient sleep, little exercise, poor diet, etc.). Correcting the poor habits and using more effective study techniques are surprisingly simple, but surprisingly difficult to 'sell' to the students.

- Students do not understand the importance of precise use of words/language. They also have very limited skills in areas such as outlining complex subjects, assigning relative levels of importance to fact-threads, making sketches of specific structures or processes, etc. And, of special significance, they need help in learning to make the 'verbal-visual link', but are very resistant to addressing this.

- There is so much factual information covered in undergraduate medical courses that few if any students can learn all the material covered. They need to assimilate the notion of stepping back from the details and 'seeing' the bigger picture. How this is done is best conveyed by using analogies, both to everyday life and to the functions that they already know that they - as physicians - must be able to perform.

- Most students do not analyze the mistakes they make on exams. Instead of looking for ways in which they can use information they HAVE learned more effectively, they tend to assume - often erroneously - that they did not memorize enough material and therefore need to study even harder. I spend a great deal of time discussing the notion of studying smarter, rather than harder, and using material they HAVE learned more effectively. Students are often unprepared for failure (even of a very limited nature) and do not understand how essential 'failures' - and learning from them - are to the educational process. A careful post-exam analysis can help many students begin to deal with the realities of limitations and the process of moving beyond the 'defeat' of missing one or more test questions to the learning that comes from understanding why/how a given student 'missed' a given test question.

- Most topics in medical school curricula are covered multiple times in many different courses/contexts. Students need to understand that one must not simply learn material in order to pass a specific test and then put that material away 'on the shelf'. They also need to become comfortable with the implications of the learning spiral: the idea that a topic may be covered many times, that learning often proceeds in stages, and that complete understanding/mastery of a given subject may only occur after many steps/courses. I stress the principle that most presentations include some review, some new material, and some preview of what is to come. Hence learning almost any material is a process that takes time and proceeds in stages that may or may not correspond to course schedules, exams, semester breaks, etc.

Copyright, Educational Assistance, 2010

Last modified: Friday, July 30, 2010