DukeMed Alumni News
Fall 2007

Curriculum Q&A
with Edward G. Buckley, E'72, MD'77, HS'77-'78,
Chair of the Medical Curriculum Committee

Edward G. Buckley, E'72, MD'77, HS'77-'78

1.How do adults learn differently as opposed to younger people, and how does this knowledge shape the design of Duke’s MD curriculum?

In order for adults to really learn they have to perceive that the material is in context with what they think they need at the moment. And they need to use it relatively shortly after they’ve learned it.

Not every adult learns the same way, so we offer a variety of modalities for getting the material—by sitting in the lecture and asking questions, getting the class notes, and reviewing streaming lectures at home on the computer.

Certain kinds of material lend themselves to the lecture hall setting, and others don’t—we all know there are some folks here at Duke who are just very entertaining. For learners to miss out on that experience would be sad.

2. What are the new technologies and simulation equipment you want to bring into the M.D. curriculum?

Right now simulation is pretty expensive. It’s labor intensive, and we don’t have as much of it in the curriculum as we would like. The good news is it’s getting cheaper, and the technology is better—what used to cost $40-$50,000 is now much, much cheaper. With patient simulators and surgical simulators, instead of doing the operation the first time on the patient you may do it the first time on the virtual patient. And for all intents and purposes it looks, feels, and smells like the real thing. We’re not there yet but we’re getting there.

One area that is exciting and we’re kind of pioneering is using gaming theory as an educational modality. A whole generation of students now entering the system have grown up playing video games, and they’ve learned a new whole skill set. Faculty member Jeff Taekman, an anesthesiologist who also is assistant dean for educational technology, is currently working on some gaming modules in the area of patient safety. For example, certain concepts are presented in a gaming environment and you come in, have some knowledge of what is going on and start practicing your skills, and you don’t get to Level 2 until you’ve mastered Level 1.

3. What is the most important aspect of a Duke medical education
that will not change?

What’s unique about Duke is that we’ve devoted a quarter of our curriculum—a full year—to give the student the opportunity to explore health care and medicine. Whether it’s doing basic science research at the bench side or getting a dual degree—a PhD or masters in public health—or whether it’s getting involved in a global health initiative or taking advantage of the opportunities with the Singapore initiative. The fact that the school embraces this will stay.

4. Why is it important for Duke to offer new degree programs in Global Health, Computational Medicine, and Molecular Medicine?

It’s no longer adequate to set your horizon at your country’s borders. With global health, the impact of what we do in the lab here at Duke University is going to have a reach much further than you might imagine. With the web and communications it’s very easy for stuff that’s done today to be in India tomorrow and Japan on Friday. The problems that we face here aren’t necessarily unique to us, and solutions that we develop here are going to be solutions that can be applied to other situations as well. We’ve learned with SARS and HIV that what happens in the rest of the world is going to have an impact on us. We have to develop a group of physicians who are aware that they have to think globally.

The future of medicine is changing, the future of how we’ll learn and deal with problems is changing, so computational medicine—the whole concept of looking at medicine from a mathematical standpoint, from a system standpoint—is really kind of exciting. We need to be at the front. We’ve got leaders in computational medicine here, and we need to keep those kinds of activities in our educational programs.

5. How do you plan to strengthen the current MD/PhD Program?

The MD/PhD Program is in transition right now. We were one of the first in the country to develop an MD/PhD Program and it has been very successful under the excellent leadership of Sal Pizzo, who is now the chair of pathology. We are transitioning to new leadership. Our administration is very committed to making the MD/PhD program one of the best in the country, and some increased funding has been directed to it. At the end of the day, we want Duke to have one of the top MD/PhD programs in the world.

6. What role, if any, do you see alumni playing in a Duke medical education?

Our alumni are a very distinguished group of individuals, so there are lots of different ways they can contribute. They can serve as ambassadors.
They can get involved in the admissions process, which means folks who are interested in coming to Duke can ask them what was it like, how did you benefit from it, etc. Also, they are a resource about what we might want to do differently here at Duke from an educational standpoint.

A lot of alumni have volunteered some of their expertise to actually come back and teach the physical exam skills course. That has been great. These men and women have been out there working for years, and you can see the excitement they have to connect with eager young folks who are just beginning to learn the skills that they have mastered so well.

7. What else do you think is important to note about the future of the Duke medical curriculum?

The basic message is that that Duke Medical School and the medical curriculum is a living, breathing, entity, and it’s constantly undergoing change. The faculty here are really committed to turning out a world-class product, and they work very hard at it. You can see it in the quality of the material that is presented and the energy with which it is delivered, and the enthusiasm they have when they interact with our students.

The other thing has to do with Singapore. We’re looking at the Singapore
initiative to serve a couple of goals. One is it allows students and faculty to have access to another health care system and another educational enterprise. The Singapore curriculum mimics the curriculum here at Duke to a certain extent, but they are integrating some educational modalities which we haven’t tried yet. So at some level this is going to be a very symbiotic relationship—if these new approaches prove successful I fully see some of them being incorporated here.

One example is that the primary didactic material will be delivered as streaming web videos of our lectures. The students in Singapore will be given a module of lectures and told to go view them along with some reading lists and other material. The time spent in lecture hall environments will be Team-Based Learning. Students will come in prepared to discuss and use the material they’ve already reviewed. So rather than spending an hour lecturing to them, we spend an hour taking that material and saying, here are a series of problems we want you to address so let’s talk about how you would do that given what you know. We actually break up the lecture hall into a series of groups and each group tackles the problem and comes up with a solution. And then we talk about why you picked solution A or solution B. It changes the dynamic from passive information receiving to active interaction.