Online education versus real learning

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I’ve been doing some teaching recently.

The final meds have been coming in for some last-minute prep for their exams. They’re a smart bunch and, for the most part, confidant, warm and don’t take themselves too seriously. Much as I’m enjoying the experience, they sure do ask a lot of questions and seem to spend a lot of time on their phones.

<blockquote> <div> <p class=”QUOTEtextalignedrightMIstyles”>This bloody generation’, I thought to myself.  Before I know it, I’ll be asked to pose for a selfie 

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This week, while passing on some of my hard-earned pearls of wisdom, I was more than a little annoyed to see that my student for the day was typing away at his mobile phone as I spoke. Whereas I am well used to being ignored in my own home by social media-addicted teenagers glued to their devices, this felt a little different. ‘This bloody generation,’ I thought to myself.  Before I know it, I’ll be asked to pose for a selfie.

“Anything interesting happening on Facebook?” I asked.

“It’s not Facebook,” he remarked, looking completely unfazed, and even a little disappointed in me. “It’s Facebook Messenger. My classmates are messaging me to let me know that I’ve got a tutorial with Prof in an hour. I’ve also been taking notes on the short cases you’ve been showing me on Evernote and sharing them with my friends who are on the wards. I was also checking something you said earlier,” he remarked, without a trace of embarrassment.

“According to this article, the incidence of the HLA B-27 gene in ankylosing spondylitis in Asian populations is a good bit higher than you mentioned. Do you remember where you got that figure?”

My, how things have changed. In my day, no-one but the swottiest, show-offy, and most annoying medical students would take their lives into their own hands by attempting to challenge a consultant’s assertions. No matter how ridiculous or made-up they sounded. To do so would have involved a trip to the library, a manual <em>Index Medicus</em> search, and a two-week wait for the paper to arrive though an interlibrary loan. These days, anyone with access to a phone can do it. It’s a pain in the ass.

Today’s students are of a generation brought up on technology with ‘always on’ access to the Internet. Because they have access to all of the information they need online (ie, they don’t have to memorise everything), they can instantly check facts as they go along and, moreover, they are not afraid to challenge nonsense when they hear it. That has got to be a good thing — even if it means someone like me occasionally being challenged.

Nonetheless, my pride demanded that I have the final word.

“Medicine in the real world,” I announced, in a voice pitched half an octave higher than usual, “is not just about having information, you know. It is about being present, really present with another person, listening, really listening, and doing our best to apply whatever knowledge and technical expertise from that information to human beings.”

Then, after pausing for emphasis: “That takes time, experience, and a degree of humility that you can’t learn from Wikipedia. Now, if you could just put down your phone for a minute and listen, you might learn something.”

The speech, of course, took place in my head as I drove home alone in my car, feeling more than a little dejected and redundant. You wouldn’t dare have an outburst like that in front of a student these days. You might end up on YouTube.

But as it happens, I have some sympathy for the final meds this year. I’m going to be taking part in the exams myself, for the first time since 1989, when I last sat them. I’m more than a little nervous about the whole affair. Not as nervous as them, of course.

At least I’ll be able to bring my phone.

<em>Postscript: The details have been changed to protect the identities of those involved. But I have a good memory for faces.</em>