I recently saw an NPR clip about a highly innovative approach to medical education launching with this year’s entering class at the University of Vermont’s Larner COM. In a nutshell, the goal is to eliminate lectures. The head of this initiative, Dr. William Jeffries, is our guest today.

Dr. Jeffries is the Senior Associate Dean for Medical Education at University of Vermont’s Larner College of Medicine. He earned his PhD in Pharmacology from the University of the Sciences in Philadelphia and then went on to serve as Associate Dean of Creighton University. He arrived at UVM in 2009 and has served since then as the Senior Associate Dean for Medical Education. He was also on the board of the IASME, the International Association of Medical Science Educators, from 2008 – 2015. And he is the co-editor of the book, An Introduction to Medical Teaching, where he authored the chapter on lectures. Welcome!

Can you give us an overview of the three major levels of UVM’s curriculum? [1:55]

The first portion is Foundations – it’s geared towards establishing the scientific foundations of medicine. It’s 15 months long. Students learn basic science in a medical context. Next is the clerkship level – it’s about a year long. Students rotate among the traditional medical disciplines and get a first-hand look at the disciplines and healthcare for patients. They also have the option of taking an alternative Longitudinal Integrated Clerkship, where students are embedded in a primary care practice and manage a panel of patients for the whole year, and learn the disciplines through that.

The third level is Advanced Integration – it’s a combination of required and elective courses to prepare them for residency and their boards.

Is there clinical exposure during Foundations, and is there coursework during the clerkship portion? [4:20]

Yes and yes. There’s an integrated community preceptor experience. The first day that students see a patient is the first day of orientation.

What is active learning? [5:25]

It’s the process of putting the learner in a situation where they’re compelled to apply knowledge to solve problems. It’s often group oriented but not necessarily. For example: memorizing a map is passive learning; putting that knowledge to work by driving somewhere new is active learning.

You literally wrote the book on lectures in medical education. Why dump lectures? [6:30]

There’s nothing wrong with lectures as an information delivery unit – it’s just the difference between using a knife or a food processor to cut vegetables. Lectures aren’t the most efficient way to learn.

Our medical knowledge is growing rapidly. It’s impossible to tell students everything they need to learn. We need to focus on giving students the tools they need to be effective physicians. We know active learning is better for retention.

Can you give an example? How would it work, say, if you’re teaching the basics of pharmacology? [10:20]

In pharmacology, in medical education right now, the students have been driving a derivative approach – they want to know what drugs are on the test, which basically reduces all of pharmacology to a table. Which is helpful in categorizing drug action, but will be completely unrelatable in the future. A better way would be to have the students themselves create such a table from their own notes or notes you provide to them – and then use that table to solve problems about patients, drugs, etc.

Unless you apply knowledge and understand why it’s important, you’re not going to retain it.

The more we use an active learning approach,