Wright State Adopts Curriculum Without Lectures

Crager’s and Bensabeur’s novel learning experiences are components of the WrightCurriculum, an innovative educational model that was five years in the making before being rolled out at BSOM in 2017.

Psychiatrist Brenda Roman, M.D., associate dean for medical education at BSOM, said that the curriculum is based on state-of-the-art “science of learning.” (Peer instruction, for instance, was developed by Eric Mazur, Ph.D., a Harvard physics professor dissatisfied with the traditional model of “read, lecture, memorize, regurgitate.”)

Roman said that she believes the curriculum is the first in the nation to be entirely without lectures. “We expect students to read the material prior to class and come to class sessions to solve problems and think critically about the content that they should have already learned,” she told Psychiatric News.

Teaching by the faculty becomes focused on probing for deeper understanding and clarifying misconceptions, and classroom time is intended to be highly interactive. “It results in a much richer conversation than typically happens during a lecture. The science of learning has taught us that learning from lectures is in fact highly inefficient. People retain only 5 to 10 percent of what they are told.”

Rather, she said, evidence from cognitive psychology has shown that people learn best through “retrieval-based learning.” “Every time you are forced to retrieve something from your brain, you strengthen the neural connections associated with memory, so that the next time you are expected to retrieve it, it should be easier.”

Other innovative aspects of learning at Wright include an “interleaved” curriculum in which disparate topics (say, anatomy and the pathophysiology of a particular disorder) are woven together, switched between, and revisited at intervals throughout the year. Another is “distributed practice” in which learning about a particular topic or aspect of medical practice is spaced out over time. Both of these replace the traditional method of block learning, in which students cover one topic at a time, and the time-honored practice of “cramming” to memorize blocks of material—now regarded by cognitive scientists as an especially bad way to retain information.

WrightQ is the school’s version of “problem-based learning,” in which a clinical case is discussed in small groups with a faculty facilitator. Students develop their own objectives for the case, research those objectives, and then present to each other a week later. “This form of learning requires that the students research the literature to find evidence-based treatments,” Roman said.

Multiple-choice exams throughout a course are taken by students individually, followed by students working in the team-based learning groups and taking the same exam again. “We use scratch-off cards—kind of like lottery cards—in which students, after discussion, scratch off as a team what they feel the best answer is,” Roman said. “If they don’t get it the first time, they try again, receiving partial credit for a correct answer.”

The innovations at BSOM are part of a trend in which traditional medical learning—based largely on an educational model more than a century old—is being reexamined. “The reforms at Wright State BSOM are reflective of a wider movement across medical schools and residencies to modernize the way doctors are trained,” said APA Director of Education Tristan Gorrindo, M.D. “Cognitive science is informing the way we approach learning throughout higher education. This kind of innovation is exciting, and the continued study of these approaches will help us understand the impact of this learning on the wards and in residency.”

WrightCurriculum will be refined over time, and the students and educators at Wright are “learning about learning” as they go. “We are the first class to experience this new model of medical education,” said Crager. “There have been some challenges, but the nice thing is that the administration and faculty are recognizing the challenges as they come up and are willing to make adjustments. Within five years, the program should be streamlined, and they will have a good sense of what really maximizes learning.”

Certainly, the medical education that Crager and Bensabeur are experiencing is a departure. Said Roman, “This is a very different experience from the one with which practicing physicians today are familiar.” ■