Medical education programs in Africa should follow the trend and start doing homework in the classroom.

The Khan Academy is changing the way the world approaches education. Sal Khan (an MIT grad) provides 10-minute online tutorials on thousands of topics. He makes complicated topics easy to understand. He’s a gifted teacher, he doesn’t charge tuition and you can listen to him at your own pace. You can stop, rewind, fast-forward or replay.  This is revolutionary. While the traditional model is you go to school to hear the lecture and then go home to apply the knowledge, Bill Gates and Sal Khan, through the Khan Academy are suggesting that we should switch those activities around.  We should get the best teachers in the world to provide lectures online, then students can listen at their own pace. Students come to the classroom to do problems, apply their knowledge and get tutored/mentored by the teacher when they get stuck.  It’s already being tested in schools across America.

Now think about this in the context of medical education in Africa. Throughout Africa the biggest challenge is the lack of faculty…not enough teachers. In Ethiopia the government plans to train 20 thousand doctors by 2020 so medical schools are challenged by trying to teach upwards of 300 students in a class. In Zambia though the classes are not so big, there just aren’t enough basic science faculty to teach in the pre-clinical years.  So what if we apply this model. Take the best teachers in the school, city or region and tape the lectures. Give students access to these lectures by video, CD, intranet or internet. If the resources are really limited, you can just give them the reading material but expect them to come to class prepared.

Then when students gather in the class, they spend their time doing what used to be their homework, i.e. solving problems. Working through a case. Teaching each other and trouble-shooting together. The strong students will help the weak students. Together they will make their knowledge come alive. They don’t need experts in the room to teach, they just need facilitators to answer questions – these could be post-graduate students, senior students, junior faculty etc.

This model is already being used in some schools referred to as Team-Based Learning (TBL). At my institution, George Washington University, we use TBL in Anatomy. There are already schools in Africa such as the Kilimanjaro Christian Medical School using it in medical education.

As countries throughout Africa try to train more doctors with few faculty, they need to consider new models of delivery. It’s learner-centered, team-based and efficient on faculty time and expertise.  The Khan Academy is really on to something….

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