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This issue of CDTL Brief is the first of a two-part Brief that features the teaching practices of the 2005/2006 Annual Teaching Excellence Award (ATEA) winners.
August 2007, Vol. 10 No. 3 Print Ready ArticlePrint-Ready
A Perspective on Medical Education
Dr Loh Kwok Seng
Department of Otolaryngology

Traditionally the teaching of medicine has followed the principle of apprenticeship. Through a long and often arduous process, knowledge and skills are imparted to students by getting them to work under a more experienced doctor for a particular period of time. Once a student has reached a predetermined level, he begins his practice and continues to gain experience. In time, if the student so decides to teach, he takes on disciples and imparts to them skills and values based on his own learning experience.

The master and apprentice method of teaching and learning has served medical education well. There is, however, a realisation that teaching medical students is no longer a random process where we conduct lessons in the way we were taught years ago. Thus, there are questions whether the master and apprentice method is still relevant in the modern era where one can choose from a variety of teaching methodologies and tools.

I do not consider the master and apprentice method an erroneous philosophy in teaching. However, it is only one method, not the only method. The key to medical education lies in being flexible and most of all, being able to critically appraise the different ways in which information can be conveyed and absorbed. In the final analysis, the key to medical education lies in learning through experience and is hence, a lifelong process.

In medical education, gaining knowledge is but only one small component which is perhaps the easiest to achieve. For example, getting students to list 20 causes of hepatomegaly is no challenge to our undergraduates who have had extensive practice in the art of organised thinking from young. Helping students understand how to distinguish these 20 causes is slightly more complicated but still easily accomplished. However, what will stand out at the end of the day is a medical student who, when confronted with a patient, is able to distinguish the most likely cause of hepatomegaly from the 20 potential causes. This remains the greatest challenge in medical education. As long as this aim can be achieved, the teaching method used is really irrelevant.

For example, when teaching students about venepuncture, there is no better way for them to learn than getting students to perform the real procedure itself. The rate at which students learn increases exponentially when they get to perform the same procedure repeatedly on different patients. Yet the reality of healthcare services in the modern world has drastically reduced such opportunities for our students. As a result, vivid descriptions, digital media, videos and even simulation by mannequins, are used to improve the learning process. These tools have their strengths and merits in the teaching process; they help engage students in learning the accepted method of performing a venepuncture.

Every teacher has a different style of teaching. Some use didactic sessions very well because they have thought about the objectives they want to achieve and are able to present the information concisely. Others may be comfortable and experienced enough to conduct a teaching session in an interactive style with little or even no digital illustrations. Yet others may want to utilise simulators to bridge the gap of reduced clinical material available to students in the modern era. All these methods require the teacher to give careful thought to the learning objectives and prepare the lessons well.

In summary, I continue to advocate that every physician who engages in the education of medical students must firstly be prepared to learn how to teach. He must be able to appraise the various methods of teaching and not be swayed by what is 'fashionable' in the teaching community. If the teacher is familiar with methods which are useful in achieving the desired learning outcomes repeatedly, he must not shy away from these methods but keep improving on them even if others consider them archaic. As much as we are eager to embrace the new, we must not neglect the wisdom of the old.

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Inside this issue
Talking the Talk and Walking the Walk: Teaching History at NUS
Teaching: Share Your Passion and Have Fun
Taking Charge of Learning— Ownership, Learning and a Conducive Environment
Can Computer-aided Instruction Effectively Replace Cadaverbased Learning in the Study of Human Anatomy?
A Perspective on Medical Education
Excuse Me, Are You an Excellent Teacher?
The Empirics of Teaching Quality