Providing objective information to lecturers would help them create better lectures in the future. It would also be a great improvement over the current lecture feedback system in which students display their disapproval physically, either rolling their eyes or nodding off in class.
Technology is great, but suppose all these sorts of ideas were carried to their extreme. Perhaps all preclinical medical teaching (i.e., the first 15–20 months of medical school) could be taught exclusively online. There may be a bright side to this proposal. Couldn’t online teaching slash ballooning medical school tuition costs by nearly half? Just wondering.
The Business School Model
It may be time to contrast our new way of teaching with another format, the business school approach. Most graduate business schools require attendance at all lectures. In fact, most use assigned seating, allowing professors to call on students by name. Class participation factors significantly into the final grade, generally accounting for about 30% of the score. Business school students seem to relish this approach, and most surveys indicate they consider this form of Socratic teaching and the need to attend, rather than skip, class as critical elements in their intellectual and social development as future business leaders. After all, getting to know the right people, and learning how to network and to work in teams will help define their future successes. These mature views may be abetted by the reality that most MBA students have already worked after graduating from college and are, on average, four years older than the typical 23-year-old freshman medical student.
In contrast, medical students are rarely encouraged and certainly rarely rewarded to work in teams. Social interactions with classmates are optional. Getting through medical school remains, for the most part, a solo affair. How can we expect that our residents and fellows will be ready to work collaboratively and interact effectively with nonphysician members of the healthcare team when these traits have not been nurtured during their formative years in training?
Long Live the CPC
What does all of this have to do with the CPC? At its core, the CPC is a form of storytelling. Over the years, versions of it have been used effectively in various genres, including television shows, such as House or ER, or in literary forms, including The Tales of Sherlock Holmes, novels by Patricia Cornwell, Robin Cook and many other medical mystery writers. Executed properly, the CPC enhances all the requisite traits required by the aspiring physician: engagement in solving a problem, curiosity, critical thinking and teamwork. As the designers of the new curriculum at Stanford Medical School in Palo Alto, Calif., observed:7
