Empowerment of Learners through Curriculum Co-Creation: Practical Implications of a Radical Educational Theory.

Framing the Issue: Medical education programs in the U.S. rely on the aphorism that faculty own the curriculum; that is, the specialized knowledge, skills, and attitudes of a physician are the province of the faculty to be delivered to tuition-paying students. From this view, the learner's role is one of passivity and deference. A contrasting approach, termed curriculum co-creation, frames education as a bi-lateral partnership. Co-creation results from learners, in collaboration with instructors, taking an active role in creating the goals and processes of an educational program. Such a partnership requires substantial revision of the expectations for both learners and instructors. In this Observations article, the idea of co-creation is applied to medical education and an aspirational vision for the role and value of faculty-student co-creation is advocated. Description and Explication: Co-creation partnerships of faculty and students occur in many forms, varying in degree of departure from traditional educational practice. Co-creation principles and partnerships can be deployed for almost all aspects of training including selection and organization of content, effective methods of instruction, and assessment of student learning. The outcomes of co-creation occur at three levels. The most specific outcome of co-creation is characterized by increased student engagement and enhanced learning. Broader outcomes include improved efficacy and value in the educational program and institution while, at the farthest-reaching level, a co-creative process can modify the medical profession itself. Although some specific instructional techniques to promote student involvement and input have historically been deployed in medical education, there is little evidence that students have ever been permitted to share in ownership. Implications for Medical Education: When fully embraced, curricular co-creation will be recognizable through improved student engagement and learning along with a revised understanding of how faculty-student relationships can foment reform in medical education and the culture of the profession. Further scholarship and research will be indispensable to examine how co-creative partnerships can flatten hierarchies within medical education and inspire the medical profession to be more inclusive and effective. Following the model of co-creation is expected to inspire learners by empowering them to participate fully as co-owners of their own education and prepare them to lead medical education in a different direction for the future.

A Case Study of Curriculum Co-creation During a Seminar-Style Course for Senior Medical Students.

Introduction: Opportunities to learn about education theory underpinning medical education are limited in both undergraduate and graduate medical education and predominantly focus on "student as teacher." Key components of education theory relevant to medical education, including learning theory, curricular design, and assessment design, are rarely included in student-as-teacher training. Opportunities for medical students to co-create curricula with faculty are scarce. Methods: We present the case study of a month-long, seminar-style course titled, Applications and Foundations of Education in Medical Education. We describe the course, report student feedback, and identify the value of curriculum co-creation expressed in student reflections. The course was designed by a faculty member with formal medical education training; students co-created their own learning outcomes through self-selected articles and personal reflections on the topics: How do people learn; what is the best way to teach; what is a curriculum; and how should students be assessed? Results: Forty-seven post-clinical students completed the course; 28 completed course evaluations. They strongly agreed that the class met its stated goals (4.89/5) and that faculty teaching (4.93/5) and supervision (4.93/5) were appropriate. Themes from student reflections expressed that the co-creation process was insightful about the profession itself, from the perspective of their own participation in learning how to become a member of the profession. Discussion: This course offered a unique opportunity for medical students to learn medical education beyond the skill of teaching. The course allowed deep immersion into current literature and offered the chance to plan and execute one's own learning.

Practices and perceptions of cognitive assessment for adults with age-related hearing loss.

OBJECTIVES: To investigate the landscape of cognitive impairment (CI) screening for adults with age-related hearing loss (ARHL) among otolaryngologists and audiologists. To identify provider factors and patient characteristics that impact rates of CI screening and referral. METHODS: A 15 question online survey was sent to members of the Georgia Society of Otolaryngology (GSO), Georgia Academy of Audiology (GAA), American Otological Society and American Neurotology Society (AOS/ANS), and posted on the web forum for two hearing disorders special interest groups within the American-Speech-Language-Hearing Association (ASHA). Responses were collected anonymously. Chi-square tests were used to compare responses. RESULTS: Of the 66 included respondents, 61% (n = 40) were otolaryngologists and 35% (n = 23) were audiologists. Respondents were significantly more likely to refer patients for CI assessment than to screen (64% vs 21%, respectively, P < .001). The complaint of a neurological symptom, such as memory loss, would prompt screening or referral for only 27.3% (n = 18) and 51.52% (n = 34) of respondents, respectively. Forty-two percent (n = 28) of respondents suggested CI screening with the MMSE vs 20% (n = 13) with the Montreal Cognitive Assessment. CONCLUSIONS: Despite recommendations for cognitive assessment in high-risk populations, such as older adults with ARHL, the practice of CI screening and referral is not yet commonplace among otolaryngologists and audiologists. These providers have a unique opportunity to assess adults with ARHL for CI and ensure appropriate referral. LEVEL OF EVIDENCE: 5.