Sunday, May 15, 2011
Disrupting Medical Education
One of the things that we need to tackle as a nation is what to do about healthcare. The last big grab bag by Congress was not what many Americans wanted; while a lot said, it was better than nothing. There is truth to both sides. The problem is, there is no such thing as a “quick fix” when it comes to healthcare reform. If reform is going to be lasting and sustainable, then it must be disruptive. We do not pretend to have all the answers, but we do have some ideas, and that is where this whole blog got started in the first place.
People know we are a big fan of Clayton Christensen, so we want to merge a couple of his books, in the broadest sense, to provide some fodder for the ideas arena on disruptive measures concerning healthcare. To that end, we want to look at Disrupting Class and The Innovator's Prescription. There is a joke, which is quite true, if not humorous that goes, “What do you call the guy who graduates medical school with a D?” The answer is, “Doctor”. Hopefully, and most probably, this is the person who gets weeded out during the rigorous internship process. But what about the educational process that allowed him to graduate in the first place?
In Disrupting Class, Christensen brings up two different training techniques comparing one of the Big Three in Detroit and the Toyota plant in Canada. We will not belabor the points here, but the Toyota plant training was to start with Step 1. When you had mastered Step 1, you were granted the privilege of going on to Step 2 and so forth. If Step 1 took you one minute, then in one minute you would move on to Step 2. If Step 1 took you a day, then tomorrow you would move on the Step 2. The attitude here is that it does no good to teach you step two, if you have not mastered step one. Any yet, the American education system continues to move people through Steps (Grades) 3, 4, 5, and on before they have mastered the current level of work.
In The Innovator's Prescription, Christensen talks about the training of doctors and other medical professionals, and brings in some of the main points, and that is what we want to concentrate hereupon. How can we implement student-centric education, first with our nurses (LPN, RN, etc.) and then with our physicians? I do not think there is anything that will substitute for the hands-on clinical experience that each class of professionals go through at the end of their classroom education. So let's focus on the classroom education.
This needs to be student-centric; and by that, I mean the student should control the pace, the place, and the time. Even with “distance learning” from today's educational institutions, there is still a time-line that has to be met. You have the option of doing your classwork around your schedule, but it still has to be done in the allotted amount of time. For the purpose of argument, what would happen if each healthcare student who arrived for internship had mastered every class in every field they had taken? Would not, then, the internship process be much more profound and rewarding for both the budding professional and the patient alike?
Student-centric learning, with the latest technology, whereby a student does not move on to Step 2 until they have mastered Step 1, is the disruptive step we need in medical education. This will promote higher quality, less critical shortages, and eventually lower prices.
