The Self-directed Medical Student Curriculum

Abstract

In recent years, medical students have been assuming increasing control over their preclerkship education. According to a survey involving 13 099 US medical students, the percentage of second-year medical students who reported "almost never" attending lectures in person continued to increase, from 26.3% to 37.0% between 2018 and 2020. 1 Concurrently, medical school curricula evolved to promote learner autonomy. Apart and distinct from increased reliance on recorded rather than live lectures, the curricular events allocated to independent learning nearly doubled between 2013 and 2020, from an estimated 3.35% to 6.38%. 2 These trends are unlikely to abate anytime soon. Current medical students accomplish the bulk of their learning outside the classroom, a practice likely solidified by adaptations to the COVID-19 pandemic. As others have noted, the reconfiguration of the preclerkship component of medical education is all but inevitable. 3 In this Viewpoint, we highlight the growing role of medical students in shaping their own education and outline the measures required to ensure that the increase of medical student-directed learning remains aligned with the educational aims of the medical discipline.Since the advent of Accreditation Standard 6.3 of the Liaison Committee on Medical Education (LCME), medical schools have taken to emphasizing selfdirected learning to complement lecture and casebased instruction. The LCME standard in question requires the inclusion of unscheduled time and independent learning components "to allow medical students to develop the skills of lifelong learning." 4 The emphasis on self-directed learning aptly encourages a more active role for medical students in the educational experience. These changes, along with the pressures imposed by the numeric score reporting of the United States Medical Licensing Examination (USMLE) Step 1, led to the emergence of a parallel, medical studentdirected curriculum that is dominated by resources geared toward studying for the USMLE. 5 Contemporary medical students now navigate a vast sea of didactic resources wherein institution-specific materials constitute but one of many sources.

Medical students describe their wellness and how to preserve it

“…These sentiments have been echoed elsewhere [ 14 , 15 ]. Furthermore, we are seeing a national trend for students preferring to learn content individually and through mixed resources as opposed to traditional scheduled classroom didactics [ 41 ].…”

Teaching evidence-based medicine in Mexico: a systematic review of medical doctor curriculums at a national level

“…This is paramount for severe health problems because they are managed with the scarcity of resources 31. Thus, the opening and quality of new curriculums must be thoroughly reviewed to meet the patient and community needs,25 32 33 especially when educational resources vary substantially in quality 7 34–37. Hence, we will direct medical education and practice towards excellence to overcome global health challenges 8 36…”

Learning or Memorization: Self-Directed Medical School Curriculum and the Dangers of Overemphasizing Student Selected Ancillary Resources

“…In the aforementioned opinion article [2], the authors make the claim that there has been a decrease in the number of students attending lectures and engaging with the standard curriculum at different medical institutions. They go on to suggest that instead of continuing to utilize the standard curriculum at these institutions, the departments of medical education should instead incorporate student-developed didactic resources [2].…”

“…In the aforementioned opinion article [2], the authors make the claim that there has been a decrease in the number of students attending lectures and engaging with the standard curriculum at different medical institutions. They go on to suggest that instead of continuing to utilize the standard curriculum at these institutions, the departments of medical education should instead incorporate student-developed didactic resources [2]. While this sounds appealing, there are five key thoughts that are lost when focusing only on the attendance rates of lectures in relation to how students utilize school-based resources versus that of the "High Yield" resources.…”

“…With the COVID-19 pandemic end date being uncertain, and continued profound advancements in online medical learning, there are questions as to how medical education should move forward. This article discusses historical views of medical education and examines several of the changes seen as a direct result of the digital age and COVID-19 in response to a recent opinion article, authored by Wu JH et al and published in JAMA 2021, vol 326 (20) [2].…”