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Basics in medical education

By Zubair Amin and Khoo Hoon Eng


399 pp., World Scientific, Singapore, 2003, ISBN 981-238-209-7, 38
There is a large amount of both theory and research about teaching and learning, but many
teachers, perhaps especially those in medical schools, continue to teach as they were taught.
When the present generation of medical teachers were being taught, there was little emphasis on
life-long learning or self-directed learning. Their instinctive reaction is to give lectures to large
classes and to worry about 'covering' the curriculum. This is of course not uniformly true: many
medical schools in the U.K. have adopted an integrated or systems-based curriculum, and a few
have gone for problem-based learning (PBL). In N. America, where the situation is somewhat
different because most of medical education is at graduate level, many schools use PBL.
Nevertheless, as the Foreword of this book states, medical schools have been remarkably
resistant to adopting the science of medical education, and yet, in contrast, seem to be successful
in cultivating society's best minds and transforming them into mature physicians.
This book aims to provide a reasonably concise guide to modern ideas about medical education.
Its target is the medical teacher, and, the authors say, it aims to strike a balance between the why
and the how of medical education. Many scientists in bioscience departments also teach to
medical students, and so this book would be of interest to them also. Hopefully it is not so full of
educational jargon that it misses its target readership, and since it is written jointly by a scientist
and an MD, it will have credibility among medical teachers. Thus although words such as
'metacognition' are used, one does not feel overwhelmed by having to learn a new language to
understand what is being said.
There are 38 short chapters dealing with various aspects and this is a book that can be dipped
into perhaps rather than read from beginning to end. A chapter can easily be read at a sitting.
Thus is you want to know about multiple-choice tests, or PBL, for example, you can quickly read
the couple of chapters on these. For those wishing to go further, each chapter offers a few
references, and these are to key publications by leaders in the field of medical education. For
example, if you want some details about Bloom's taxonomy, then you can find it here. Key ideas
for teaching practice are "boxed and bulleted" for easy reference as checklists. Thus, in the
chapter on the skills of learning, the authors say that an individual learner needs to reflect on the
'knowledge gap' as follows:

What do I already know about the topic?

What do I not know about the topic?

What is the knowledge gap?

What is the most important topic that I need to address?

Methods of teaching are reviewed with graphs (from educational research) to show the
percentage ability to recall information delivered by lecture, by reading, by doing, for example,
and the importance of feedback is similarly emphasised in the sequence:
Theory - plus demonstration - plus practice - plus feedback - plus coaching
going from 510% for theory alone, to 80% for the sum of all the above. John Dewey is quoted
as saying: True learning is based on discovery guided by mentoring rather than the transmission
of knowledge. Therefore, one hopes that even the busiest medical teacher can look at the simple
data provided and reach conclusions about teaching methodology. When we do research (in
science) we look at the conclusions from previous research and modify our subsequent behaviour
(i.e. design our next experiments) accordingly. Why don't we do this in our teaching practice
when faced with evidence about how people learn?
The first part of the book sets the scene with a broad overview of the aims of medical education,
some history, current trends and controversies, and some teaching and learning theory. The
'learning cycle' is emphasised: learning objectives defined - strategies for achieving these set out,
followed by - assessment to check whether these objectives have indeed been achieved.
It is characteristic of educationalists (indeed this is perhaps one of their more endearing
characteristics) that they produce quotations on which to reflect, and this book is no exception in
this respect. Quotations range from Confucius to Churchill, and I cannot resist re-quoting some
of them here. Thus Timothy Goldsmith is quoted as writing:
Discussions on curriculum are often limited to who 'covers' what, an approach more suited to
barn painting than to education.
(We have all heard "Rather than covering the whole curriculum, uncover part of it", I am sure.)
Another quote comes from Winston Churchill:
Personally, I am always willing to learn, although I do not always like being taught.
There are many more, and all are thought-provoking. I think that teachers of both medical
students and science students would enjoy reading some or all of this book, and hopefully having
done so they will reflect on their teaching practice to the benefit of their students.

BASICS IN MEDICAL EDUCATION


by Zubair Amin (National University of Singapore) & Khoo Hoon Eng (National University of
Singapore)
Contents (64k)
Preface (70k)
Chapter 1: Questions and Questioning Technique (103k)
Dr Zubair Amin is Assistant Professor in the Department of Pediatrics at the National
University of Singapore (NUS) and Associate Consultant in the Department of Neonatology at
the National University Hospital (NUH). He obtained his Masters in Health Profession
Education (MHPE) from the University of Illinois at Chicago. Dr Amin is actively involved in
faculty development programs for medical teachers and is a member of the Problem Based
Learning Committee and Medical Education Unit of NUS. He serves as a reviewer for a number
of international medical education journals.
Dr Khoo Hoon Eng was Vice-Dean in the Faculty of Medicine for Pre-Clinical and Graduate
Studies and is Associate Professor in the Department of Biochemistry at the National University
of Singapore (NUS). She is a Founding Member of the Medical Education Unit at the NUS. She
has a BA from Smith College, USA, and a PhD from the University of London. Dr Khoo has
conducted electives on Scientific Writing and Critique of Papers and serves in a leadership
capacity in numerous undergraduate and graduate education programs. She is actively involved
in the introduction and propagation of the Problem Based Learning (PBL) curriculum at the
NUS. She is widely published and has been editor and reviewer for several journals.

Medical education, the art and science behind medical teaching and learning, has progressed
remarkably. Teaching and learning have become more scientific and rigorous, curricula are based
on sound pedagogical principles, and problem-based and other forms of active and self-directed
learning have become the mainstream. We have progressed from the role of problem-identifier to
that of solution-provider.
This book provides a balanced overview of the why of medical education, emphasizing the
need for change and adaptation, and the how, by demonstrating the way concepts and theories
of medical education can be of immediate benefit to the medical teacher.
In short, this is a simple and non-intimidating book for general medical teachers to enhance their
understanding of medical education and to improve their teaching.
Royalties from the sale of this book will benefit basic health care needs of children in
developing countries.
Contents:

Basic Competencies in Medical Teaching

Historical Perspectives in Medical Education

Educational Concepts and Philosophies

Curriculum and Learning Cycle

Educational Objectives

Instructional Methodologies: General

Instructional Methodology: Clinical Teaching

Instructional Methodology: Problem-Based Learning

Assessment and Evaluation

Internet and Medical Education

Research in Medical Education

Readership: Medical teachers from all disciplines as well as basic science and clinical teachers.
writing is simple, concise and free of jargon They do an excellent job of covering the field
of medical education is well organized and easy to read and their use of good instructional
design techniques not only helps facilitate comprehension of the material, but also provides a
good example for the reader to emulate I highly recommend this book for anyone entering the
field of medical education. It would also serve as an excellent text in faculty development
fellowship programs and would be a good addition to medical libraries in teaching hospitals,
residency programs and medical schools.
David J Solomon, PhD
Office of Medical Education Research and DevelopmentEditor of Medical Education Online
Michigan State University
handy volume of description the book has references at the end of every chapter to satisfy
the need. If you are too busy for daily activity to read a thick book, this book will help and
attract you very much.
Hirotaka Onishi MD MHPE
Chief, Medical Education Development Committee
Japan Society of Medical Education
I particularly like the way the 11 sessions, 38 chapters and all the subheadings have been
clearly listed in the Contents so that the reader should have little trouble in discovering where to
look for the topic of interest. The section on Assessment and Evaluation is one of the better

written sections as it provided practical points in guiding medical teachers in the conduct of
student assessment and evaluation The authors are to be warmly congratulated for having
written a very useful book. I strongly recommend this textbook to medical teachers.
Annals, Academy of Medicine
Basics in Medical Education represents a refreshing contribution to the current literature on
education the beauty of the book lies not so much on its contents but on its simplicity of
language and its reader-friendly style of presentation.
Singapore Medical Journal
the authors have produced a text that is a useful introductory tool for the general medical
teacher with references to further material if the reader wishes to explore the topics at a deeper
level.
Education for Health
I think that teachers of both medical students and science students would enjoy reading some
or all of this book, and hopefully having done so they will reflect on their teaching practice to
the benefit of their students.
Bioscience Education E-journal
Teachers of both medical students and science students would enjoy reading some or all of this
book, and hopefully having done so they will reflect on their teaching practice to the benefit of
their students.

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