Evolutionary science as a method to facilitate higher level thinking and reasoning in medical training

Abstract

Evolutionary science is indispensable for understanding biological processes. Effective medical treatment must be anchored in sound biology. However, currently the insights available from evolutionary science are not adequately incorporated in either pre-medical or medical school curricula. To illuminate how evolution may be helpful in these areas, examples in which the insights of evolutionary science are already improving medical treatment and ways in which evolutionary reasoning can be practiced in the context of medicine are provided. To facilitate the learning of evolutionary principles, concepts derived from evolutionary science that medical students and professionals should understand are outlined. These concepts are designed to be authoritative and at the same time easily accessible for anyone with the general biological knowledge of a first-year medical student. Thus, we conclude that medical practice informed by evolutionary principles will be more effective and lead to better patient outcomes. Furthermore, it is argued that evolutionary medicine complements general medical training because it provides an additional means by which medical students can practice the critical thinking skills that will be important in their future practice. We argue that core concepts from evolutionary science have the potential to improve critical thinking and facilitate more effective learning in medical training.

Core principles of evolutionary medicine

“…Although there have been previous efforts to delineate the important concepts in evolutionary medicine, our efforts represent the first systematic study to do so with the involvement of over 50 individuals. The list of core principles is generally consistent with those emphasized in previous articles based on less systematic methods [ 25 , 29 , 31 , 53 ]. While these articles did not necessarily aim to define core principles with the same definition adopted here, or have a focus on being exhaustive, it is nonetheless instructive to examine the over-lap between list here and principles discussed in previous work.…”

“…Sometimes referred to as Darwinian Medicine or Evolution and Medicine, it has grown exponentially since the early 1990s [ 8 ], contributing to a greater understanding of topics paramount to human health including aging [ 9 , 10 ], reproductive health [ 11 , 12 ], immune function [ 13 , 14 ], infectious disease [ 15 , 16 ], cancer [ 17 , 18 ], behavioral disorders and mental health [ 19 , 20 ], microbiomes [ 21 ], veterinary medicine [ 22 ], inflammation [ 23 ] and diet [ 24 ]. An evolutionary perspective has not only proven to be a powerful and broad lens for medical advancement, but can also be used as a comprehensive scaffold for organizing medical knowledge that otherwise remains unconnected [ 25 ].…”

“…By organizing vast amounts of information into a smaller network of key ideas, a curricular focus on core principles can help students to understand the significance and interrelationships among bits of information. Further, focusing learning goals on core principles, which often represent more abstract ideas as opposed to facts, can help move instruction away from lower level cognitive goals such as rote memorization [ 25 ]. The American Association for the Advancement of Science’s (AAAS) Vision and Change report recommends pedagogy that teaches students to think through the big ideas of scientific fields, rather than teaching isolated facts [ 1 ].…”

“…Their recommendations stemmed from years of discussions among diverse experts in evolutionary medicine. Building off of the recommendations from Nesse et al [ 29 ], Graves et al [ 25 ] further outlined how evolutionary concepts are important for medical education, including the importance of using Bloom’s Taxonomy to ensure deep level understanding of evolutionary concepts [ 30 ]. Nesse and Schiffman [ 5 ], and later Hidaka et al [ 4 ], surveyed medical school deans about the inclusion of evolutionary principles in their curriculum.…”

Integrating evolution into medical education for women’s health care practitioners

“…There are many public health issues with strong links to evolution. For example, given the relevance of climate change in the context of disease, most recently as a purported element in the spread of Zika virus [20], understanding the future implications of evolution in the field of medicine is vital to addressing emergent health care concerns [21]. Antimicrobial resistance is another public health challenge that has intrinsic evolutionary underpinnings.…”