Tuesday, 7 August 2012

Teaching with a vision

 Teaching with a vision

I mentioned in a recent post that I haven’t yet detected any great vision or philosophy behind the medical teaching in Cambridge. Today, I’d like to write about a place where I have actually experienced teaching with a vision: at the university where I did my undergraduate degree.
Ok, admittedly I did not go to a large state-funded university, but the small private University Fresenius (where I did a chemistry degree), but I don’t think it’s necessarily the source of funding that makes a difference here.
In Germany, the name Fresenius (for an article on the Chemist Carl Remigius Fresenius, see here) is associated with excellence in analytical chemistry. One strong point of studying at Fresenius Uni is still a strong background in analytical chemistry to this day. However, being named after the great founder of analytical chemistry does not mean that the university is resting on its laurels. A quick visit of the website reveals that the chemistry course has undergone several transformations since my graduation year, proof of ongoing improvements and adaptations in times of change. Already when I was a student, the curriculum had been refined over the years by constant feedback from industry, ensuring that it was up to date, but also that the graduates would be happily recruited and employed. Furthermore, I found the content of the course very well constructed, both in terms of what was taught and what content was omitted (that's also important!), as well as in terms of organisation. (To be completely honest, I sometimes wished at the time to learn particular topics in a bit more detail, such as quantum chemistry, but that still has not changed even today as a student in Cambridge. So it’s obviously more to do with my personal ideas than anything else). 
It seemed as if someone had sat down initially to really think about what knowledge makes a good chemist and then built up the curriculum from first principle, open to constant improvement. The key 
philosophy seemed to be the communication of what is the most comprehensive "working knowledge" of a chemist, and to really bring across these principles. One way in which this was achieved was the high amount of practical lab teaching, more than 50% of the time if I remember correctly. Apart from the obvious different disciplines of chemistry, the overall masterplan also includes the possibility to integrate minor studies in other subjects such as economics and languages, in order to develop a well rounded set of skills.
I think this overall strategy really brings home the content and still does not prevent anyone from indulging in more detailed studies, now able to fall on the fertile ground of a sound foundation of knowledge.
Germany is different to the UK in that there aren't (m)any elite universities with longstanding traditions (although there is a discussion if this should be changed), and there is a much more common-sense attitude towards the significance of school grades. As one example, there is no restriction on the A-level average of a student wanting to study Chemistry at Fresenius or anywhere else (apart from the fact that they don't fail, of course). However, I am convinced that every student going through the Fresenius system, no matter how academic or not, won't be able to help him/herself but to emerge with a sound knowledge of chemistry in the end. I think this steady output of good graduates is quite an achievement in the light of the generous admission policy and is certainly tribute to the educational philosophy. In Cambridge and Oxford on the other hand, where only the best A-level students of the country are admitted, I don't think it's as surprising that the graduates are excellent, because they were already excellent in the first place. Sometimes I even think they are excellent despite the teaching they have encountered, not because of it.
To sum up, as a result of an overall vision, I think that the people produced at Fresenius enter the professional world with a great foundation and working knowledge of Chemistry, perhaps not excessively familiar with the academic intricacies of the most advanced chemical topics, but well rounded and ready to be placed in any lab and start working. I don’t think this is the result of chance, but of a well thought through approach to produce exactly the type of person needed in the world of chemistry.

I definitely think that every university course on offer in an institution should at least aim to stand out in some way and give their students something special along the way, and Fresenius definitely shows that this can be done, even on a smaller budget and without relying exclusively on the best students in the country.

Friday, 6 July 2012

Some aspects of studying (Medicine) in Cambridge

After two years of studying in Cambridge, I’ve made some observations about the learning experience here. I can’t help that it will be a rather negative post, but I am sure you can find plenty of articles praising Cambridge for its amazing education elsewhere.

In fact, I think the many purely positive reviews can set students up for disappointment once they identify an aspect of Cambridge education that isn’t ideal, and I’ve seen a few of the more critical students doubt themselves and feel isolated in an environment where criticism is not welcome (They ask themselves: If Cambridge is one of the best institutions in the country, how can it be that I am unhappy?).

Today, I will mention four issues I’ve identified. Some of them came as a bit of a revelation to me. Understanding what it was that bothered me and why I was not enjoying certain aspects of the course definitely helped me do something about it, or just accept the facts and get on with it. Perhaps it will help others as well.

1.     Lack of a grand vision
In terms of the overall medical course, there does not seem to be any grand vision, guiding philosophy or master plan on how to teach medicine in the best possible way. If it does exist, it is definitely not communicated well enough or not obvious in itself.

In general, there should good reasons for why and how every element of the course is taught in order to avoid inefficiency. Strategic thinking and more intense feedback from the medical profession on course structure could yield a more concise syllabus. 

As a particular example for the lack of overall structure, the different pre-clinical subjects are taught alongside each other independently, rather than in a complementary way. There is definitely need for more cross talk between the different faculties ensuring optimal timing of subjects throughout the year and lack of redundancy.

In terms of clinical teaching, there seems to be even more of a piecemeal approach and scope for inefficiency. We are often told that “medicine is an apprenticeship”, but this statement also seems to serve as a convenient catchphrase to hide behind when criticism surfaces. I am convinced that systematic approaches to teach medicine do exist and I am sure they are employed by other leading medical schools in the world. In fact, I am determined to find out more about this and will write about this topic again in due course.

2.     Convolution of information
As I already mentioned in an earlier post, information is often presented in an undigested, incoherent and badly organised format. Unless one wants to pass exams by rote learning random facts, one has to reorganise all the information. This represents an enormous time investment for each cohort of students and I am not sure if it is an important learning experience in itself.
If the building blocks of medicine could be presented in a more logical and concise manner, students could grasp the information much quicker and would have more time to really indulge in in-depth knowledge, leaving them with a firmer grasp of the subject and a better foundation for the future.

This also has practical aspects, some of which are hilarious. We all know that many components of the medical curriculum aren’t rocket science, and sometimes one almost suspects intent behind the fact that access to simple information is made difficult in some way, so that the ultimate challenge is not to know the information for the exam, but to have jumped through hoops in order to get to it.
For example, content of many physiological subjects is displayed on departmental posters during restricted viewing times. These posters are older than most of the students on the course (they have been typed on a typewriter!!) and are not available electronically. Therefore tens of students crowd in front of them at any time, scribbling down the information presented. It is almost farcical.
Another example is the clinical school’s online resource, one of the least intuitive platforms I have ever come across. People joke that once you have found something on this system once, you will never find it again, and sadly this has been true on many occasions. 

It is interesting that very few Cambridge learning materials are available to the public. Some people are convinced that if they were, the differences between Cambridge and other leading universities would become obvious very quickly.

3. Large difference in what is provided and what is expected of the students
On accepting the shortcomings of some of the teaching that is on offer, one is then struck by the great discrepancy between the leniency of the course organisers towards themselves and their teams, and the utter perfection that is expected of the students.
In my opinion, it is a major cause of demotivation, as inspiring a feeling of inadequacy among the students does not foster a desirable environment for learning.

4. Constant assessment leaving no room for learning
This is another point regarding the environment for learning. Learning obviously requires processing and understanding of the information to be memorised. At some point this processing has to take place because learning (at least of the more complicated topics of medicine) is not an instant event.

However, the questions associated with this process of learning aren't generally welcome. Too often, the answer to a question is judgmental rather than explanatory. Even though proper exams only take place at end of the academic year, students are constantly under assessment, even when they encounter facts for the first time and need some time to absorb them.
As a result, there isn’t actually much time for learning in the presence of university teaching staff, both in the departments and the colleges. While some supervisions may present an exception, in general they also take more of an inquisitive format.
What remains is for the student to do the actual learning in their own time. With a full schedule, the time for this is scarce, especially on the graduate course. If nothing else, this is another unnecessary source of inefficiency.

The more I think about it, the more I realise that Cambridge often confuses teaching and learning with assessment. But assessment alone is just not enough....
In my opinion, the atmosphere would greatly improve if there were also some protected times when students can go through and enjoy the process of learning without constant external pressure.


Anyway, these were some of my impressions over the past two years. I think Cambridge will definitely have to address some of these issues if they want to compete internationally in the long term.