Medical Biochemistry Without Rote Memorization: Multi-Institution Implementation and Student Perceptions of a Nationally Standardized Metabolic Map for Learning and Assessment

Despite the growing number of patients worldwide with metabolism-related chronic diseases, medical biochemistry education is commonly perceived as focusing on recall of facts irrelevant for patient care. The authors suggest that this focus on rote memorization of pathways creates excessive cognitive...

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Published inMedical science educator Vol. 29; no. 1; pp. 87 - 92
Main Authors Spicer, Douglas B., Thompson, Kathryn H., Tong, Michelle S., Cowan, Tina M., Fulton, Tracy B., Lindsley, Janet E.
Format Journal Article
LanguageEnglish
Published New York Springer US 01.03.2019
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Abstract Despite the growing number of patients worldwide with metabolism-related chronic diseases, medical biochemistry education is commonly perceived as focusing on recall of facts irrelevant for patient care. The authors suggest that this focus on rote memorization of pathways creates excessive cognitive load that may interfere with learners’ development of an integrated understanding of metabolic regulation and dysregulation. This cognitive load can be minimized by providing appropriate references during learning and assessment. Biochemistry educators collaborated to develop a medically relevant pathways of human metabolism map (MetMap) that is now being used at many medical schools as a nationally standardized resource during learning and assessments. To assess impact, students from three medical schools were surveyed about its benefits and disadvantages. Responses were obtained from 481 students (84%) and were examined using thematic analysis. Five main themes emerged as perceived benefits of using the MetMap: (1) aids visual and mental organization, (2) promotes deep learning and applied understanding, (3) decreases emphasis on memorization, (4) reduces anxiety on exams, and (5) aids recall. Perceived disadvantages were (1) fear of underpreparation for licensing exams, (2) overwhelming nature of the map, and (3) reduced motivation for and time spent studying. Results affirm that students’ perceive use of the MetMap promotes focus on broader metabolic concepts and deep versus surface learning, supporting a shift in cognitive load toward desired goals. Although the long-term impact on learning needs to be further studied, the use of the MetMap represents a step toward open-reference exams that reflect “real-world” practice.
AbstractList Despite the growing number of patients worldwide with metabolism-related chronic diseases, medical biochemistry education is commonly perceived as focusing on recall of facts irrelevant for patient care. The authors suggest that this focus on rote memorization of pathways creates excessive cognitive load that may interfere with learners’ development of an integrated understanding of metabolic regulation and dysregulation. This cognitive load can be minimized by providing appropriate references during learning and assessment. Biochemistry educators collaborated to develop a medically relevant pathways of human metabolism map (MetMap) that is now being used at many medical schools as a nationally standardized resource during learning and assessments. To assess impact, students from three medical schools were surveyed about its benefits and disadvantages. Responses were obtained from 481 students (84%) and were examined using thematic analysis. Five main themes emerged as perceived benefits of using the MetMap: (1) aids visual and mental organization, (2) promotes deep learning and applied understanding, (3) decreases emphasis on memorization, (4) reduces anxiety on exams, and (5) aids recall. Perceived disadvantages were (1) fear of underpreparation for licensing exams, (2) overwhelming nature of the map, and (3) reduced motivation for and time spent studying. Results affirm that students’ perceive use of the MetMap promotes focus on broader metabolic concepts and deep versus surface learning, supporting a shift in cognitive load toward desired goals. Although the long-term impact on learning needs to be further studied, the use of the MetMap represents a step toward open-reference exams that reflect “real-world” practice.
Author Lindsley, Janet E.
Fulton, Tracy B.
Thompson, Kathryn H.
Cowan, Tina M.
Spicer, Douglas B.
Tong, Michelle S.
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Cites_doi 10.1097/ACM.0b013e318183e2fc
10.1037/0022-0663.99.4.808
10.1007/s10459-005-1404-7
10.1097/ACM.0000000000000977
10.1007/s11165-012-9331-0
10.1187/cbe.16-06-0193
10.1007/BF03341749
10.3109/0142159X.2014.889290
10.1097/ACM.0000000000002101
10.1016/0307-4412(93)90089-I
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References Young, Van Merrienboer, Durning, Ten Cate (CR5) 2014; 36
CR2
Minasian-Batmanian, Lingard, Prosser (CR3) 2005; 10
Stull, Mayer (CR6) 2007; 99
Ling, Swanson, Km, Bucak (CR4) 2008; 83
Offerdahl, Arneson, Byrne (CR8) 2017; 16
Fulton, Ronner, Lindsley (CR1) 2012; 22
Durning, Dong, Ratcliffe, Schuwirth, Artino, Boulet, Eva (CR11) 2016; 91
Kragten, Admiraal, Rijlaarsdam (CR7) 2012; 43
Moynahan (CR10) 2018; 93
CR9
AT Stull (631_CR6) 2007; 99
M Kragten (631_CR7) 2012; 43
LC Minasian-Batmanian (631_CR3) 2005; 10
TB Fulton (631_CR1) 2012; 22
Y Ling (631_CR4) 2008; 83
JQ Young (631_CR5) 2014; 36
631_CR9
EG Offerdahl (631_CR8) 2017; 16
KF Moynahan (631_CR10) 2018; 93
SJ Durning (631_CR11) 2016; 91
631_CR2
References_xml – ident: CR9
– volume: 83
  start-page: S82
  issue: 10
  year: 2008
  end-page: S85
  ident: CR4
  article-title: Retention of basic science information by senior medical students
  publication-title: Acad Med
  doi: 10.1097/ACM.0b013e318183e2fc
  contributor:
    fullname: Bucak
– volume: 99
  start-page: 808
  issue: 4
  year: 2007
  end-page: 820
  ident: CR6
  article-title: Learning by doing versus learning by viewing: three experimental comparisons of learner-generated versus author-provided graphic organizers
  publication-title: J Educ Psychol
  doi: 10.1037/0022-0663.99.4.808
  contributor:
    fullname: Mayer
– volume: 10
  start-page: 279
  issue: 4
  year: 2005
  end-page: 290
  ident: CR3
  article-title: Differences in students’ perceptions of learning compulsory foundation biochemistry in the health sciences professions
  publication-title: Adv Health Sci Educ Theory Pract
  doi: 10.1007/s10459-005-1404-7
  contributor:
    fullname: Prosser
– volume: 91
  start-page: 583
  issue: 4
  year: 2016
  end-page: 599
  ident: CR11
  article-title: Comparing open-book and closed-book examinations: a systematic review
  publication-title: Acad Med
  doi: 10.1097/ACM.0000000000000977
  contributor:
    fullname: Eva
– volume: 43
  start-page: 1785
  issue: 5
  year: 2012
  end-page: 1800
  ident: CR7
  article-title: Diagrammatic literacy in secondary science education
  publication-title: Res Sci Educ
  doi: 10.1007/s11165-012-9331-0
  contributor:
    fullname: Rijlaarsdam
– volume: 16
  start-page: es1
  issue: 1
  year: 2017
  ident: CR8
  article-title: Lighten the load: scaffolding visual literacy in biochemistry and molecular biology
  publication-title: CBE Life Sci Educ
  doi: 10.1187/cbe.16-06-0193
  contributor:
    fullname: Byrne
– volume: 22
  start-page: 29
  issue: 1
  year: 2012
  end-page: 32
  ident: CR1
  article-title: Medical biochemistry in the era of competencies: is it time for the Krebs cycle to go?
  publication-title: Med Sci Educ
  doi: 10.1007/BF03341749
  contributor:
    fullname: Lindsley
– ident: CR2
– volume: 36
  start-page: 371
  issue: 5
  year: 2014
  end-page: 384
  ident: CR5
  article-title: Cognitive load theory: implications for medical education: AMEE guide no. 86
  publication-title: Med Teach
  doi: 10.3109/0142159X.2014.889290
  contributor:
    fullname: Ten Cate
– volume: 93
  start-page: 963
  issue: 7
  year: 2018
  end-page: 965
  ident: CR10
  article-title: The current use of United States medical licensing examination step 1 scores: holistic admissions and student well-being are in the balance
  publication-title: Acad Med
  doi: 10.1097/ACM.0000000000002101
  contributor:
    fullname: Moynahan
– volume: 83
  start-page: S82
  issue: 10
  year: 2008
  ident: 631_CR4
  publication-title: Acad Med
  doi: 10.1097/ACM.0b013e318183e2fc
  contributor:
    fullname: Y Ling
– volume: 99
  start-page: 808
  issue: 4
  year: 2007
  ident: 631_CR6
  publication-title: J Educ Psychol
  doi: 10.1037/0022-0663.99.4.808
  contributor:
    fullname: AT Stull
– volume: 16
  start-page: es1
  issue: 1
  year: 2017
  ident: 631_CR8
  publication-title: CBE Life Sci Educ
  doi: 10.1187/cbe.16-06-0193
  contributor:
    fullname: EG Offerdahl
– ident: 631_CR2
– volume: 10
  start-page: 279
  issue: 4
  year: 2005
  ident: 631_CR3
  publication-title: Adv Health Sci Educ Theory Pract
  doi: 10.1007/s10459-005-1404-7
  contributor:
    fullname: LC Minasian-Batmanian
– ident: 631_CR9
  doi: 10.1016/0307-4412(93)90089-I
– volume: 93
  start-page: 963
  issue: 7
  year: 2018
  ident: 631_CR10
  publication-title: Acad Med
  doi: 10.1097/ACM.0000000000002101
  contributor:
    fullname: KF Moynahan
– volume: 22
  start-page: 29
  issue: 1
  year: 2012
  ident: 631_CR1
  publication-title: Med Sci Educ
  doi: 10.1007/BF03341749
  contributor:
    fullname: TB Fulton
– volume: 91
  start-page: 583
  issue: 4
  year: 2016
  ident: 631_CR11
  publication-title: Acad Med
  doi: 10.1097/ACM.0000000000000977
  contributor:
    fullname: SJ Durning
– volume: 43
  start-page: 1785
  issue: 5
  year: 2012
  ident: 631_CR7
  publication-title: Res Sci Educ
  doi: 10.1007/s11165-012-9331-0
  contributor:
    fullname: M Kragten
– volume: 36
  start-page: 371
  issue: 5
  year: 2014
  ident: 631_CR5
  publication-title: Med Teach
  doi: 10.3109/0142159X.2014.889290
  contributor:
    fullname: JQ Young
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Title Medical Biochemistry Without Rote Memorization: Multi-Institution Implementation and Student Perceptions of a Nationally Standardized Metabolic Map for Learning and Assessment
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