12 Semper Discens – by Brian D. D’Monte

Brian D. D’Monte

Years ago, when asked to give my first lecture to undergraduate medical students in biochemistry, I realized halfway through that most of them seemed to have lost interest.

It was then that I devised a method to encourage them to attain—on their own—whatever it was that I had been trying to get across to them so that they may get motivated to learn it better. I split the class into three groups and asked each to select a group leader. I then handed each group a set of learning objectives that were hinged around a short clinical history of three patients. The learning objectives reflected information that our departmental faculty felt was important to attain. At the same time, I made it clear to each group that they had the freedom to change and substitute these learning objectives with others of their choosing, and that they were free to go about this on their own. The groups were encouraged to contact senior students (undergraduate or postgraduate) or any member of faculty (in the clinical or basic sciences), to consult books in the library, and to access any other learning resources they wished. When they finished, they would come back to the lecture room on the scheduled date to present their findings. I told them that I would also come if they wanted (or needed!) me, but that they were welcome to conduct the session by themselves. They wanted to know whether all subsequent sessions would be conducted in similar vein, to which I replied that I sincerely hoped so, but that I would have to abide by the ruling of the academic administration.

The students suggested that I come for the first session. I did and was astounded by the fervor displayed and the enormous collaborative effort that the students had made. They asked that I plead for all lectures to be replaced by similar sessions. When I asked why, they enthusiastically responded “it was interesting to find out things by ourselves,” “function as a group”, “occasionally disagree for a common goal”, “we now realize the relevance of biochemistry to our training to become a doctor”, “it was more fun than listening passively to a lecture”, “we loved the freedom given to us to explore other issues not spelt out in the syllabus”, “we respected the trust shown to us as adults”, “we found it fun to seek information from books and to interact with other students and faculty”.

In the second phase of my medical school training, one department had a system of student seminars wherein we had to prepare and deliver, in 45 minutes, a topic of our choice to the rest of the class; I chose antihistaminic drugs. To this day, this topic remains one of my favorite subjects in Pharmacology, and it is one that I remember best.

Forward to many years later. As a tutor in a medical school practising a problem-based learning (PBL) curriculum, I used to stress that learning ought to be enjoyable, and students were quick to take me literally. One day they suggested that their tutorial sessions should be conducted outside the medical school premises. The first tutorials were held in my flat, and later, in restaurants (once in a Hard Rock Cafe, where the other customers complained of the noise we were making—this in spite of the loud music!). Sometimes tutorials were held as a prelude to a movie, but wherever they occurred, there was always an air of expectation about every session to come. Once, a student brought along a petri dish showing a diagnostic method used to characterize the sensitivity of bacterial colonies to different antibiotics. On another occasion, a lot of time was spent figuring out why a young woman (the subject of the clinical problem in that learning unit) who had been immobilized for a long time had developed chest pain; it was truly a delight to observe the students arrive at a plausible hypothesis for this clinical presentation.

On another occasion, the students picked me up at the airport as I arrived home after my vacation; their plan was to have dinner and then hold the tutorial that night (it was scheduled for the next morning). I readily agreed and time sped by so fast that, before I knew it, it was time for school the next  morning. Those tutorial sessions were the highpoint of my professional career. At the end of one unit, the group commented that they had never enjoyed themselves so much, and that, in the process, had developed a sense of trust and respect for their colleagues and for me. To this day, all of us keep in touch and whenever I visit my school.

I make it a point to meet up with as many of the students as are still there; needless to say, an impromptu tutorial for old times’ sake is part and parcel of our get-togethers.

Self-sufficiency, enjoyment of learning, and interaction with peers are key ingredients in the formation of a well-rounded person. The realization that learning is a life-long process is also very important.

In medical schools where anatomy, biochemistry, and physiology are taught in isolation from pathology, microbiology, pharmacology, medicine, and surgery, students cannot appreciate the interdependence of these disciplines nor the relationship between the normal and abnormal.

The ability of an undergraduate student to learn by himself is often underestimated by faculty.

Young minds are like sponges looking for and absorbing new bits of information, sifting out the unnecessary from the relevant in the process. Student-centred contextual learning is key to a holistic education and to the formation of a total personality. This has now become all the more important in the context of the times in which we exist—we are in an uncertain and unpredictable age, fraught by dwindling natural resources, drastic environmental hazards, global warming and its dire consequences, and threatening social, political, and economic climes. It is imperative that the citizen of today be equipped with the necessary skills to combat these problems. We must learn to be compassionate to fellow beings, to engage and inspire communities, and to be aware of our own and another’s potential. The process of adaptation needs to begin at an early age: in primary schools so that by the time our children reach an advanced school/college environment, they are already aware of and capable of using their self-learnt abilities in the building of a cooperative effort to forge a livable and better world.

Fifty years ago, what Postman & Weingartner (1969) wrote in Teaching as Subversive Activity becomes all the more relevant and necessary to cope with a time of technological advancement but moral decline.

References

Postman, N. & Weingartner. (1969). Teaching as a Subversive Activity. New York, NY: Delta Publishing Co., Inc.