Privacy and intellectual property rights

Whose Dissertation Is It, Anyway?

Balking at a requirement to upload a copy of his doctoral thesis to an online database run by library services company ProQuest, one student pushes back.

By Lindsay McKenzie

Rob Schlesinger is not your typical college student. A lawyer who worked in higher education administration for more than 25 years, he decided to take time off from his day job two years ago to pursue a doctorate degree in education at Manhattanville College in Purchase, N.Y.

Getting an Ed.D. degree is a lifelong dream for Schlesinger. He defended his dissertation proposal, “Ethics Education in the Undergraduate Curriculum: An Action Research Analysis,” earlier this year. He said his experience at the college has been mostly positive, but it recently took an unexpected turn.

In an article published on the blog The Scholarly Kitchen last month, Schlesinger wrote of the shock he felt upon learning that all doctoral students at Manhattanville are required to submit their dissertations to an online database run by for-profit library services company ProQuest.

Schlesinger was even more surprised by the reaction he received from faculty members, administrators and fellow students when he voiced his objection to this policy.

“One would think that I was Oliver Twist asking for more porridge or I had said that I was writing my opus in crayon,” he wrote.

Requiring students to publish dissertations, particularly online, may put vulnerable students who have been victimized, threatened or stalked at risk, said Schlesinger. He believes it could also jeopardize the safety of people mentioned in the research, even if they are anonymized.

“My legal -- and moral -- concerns about this practice stem from the issues it raises with privacy and intellectual property rights, as well as contract law,” he said.

Aside from privacy concerns, Schlesinger believes that as the author of his dissertation, he should have the right to decide how his work is published and distributed. He also questions whether it is defensible under contract law for colleges to make the publication of a dissertation a degree requirement.

“My argument here is not against publishing online; rather, it is for giving dissertation authors -- the doctoral students themselves -- a say in the disposition of their work,” wrote Schlesinger.

Ray Harris, director of the law firm Fennemore Craig, said Schlesinger raises valid concerns about privacy, but Harris notes issues around anonymity in qualitative research can usually be identified and resolved early on through discussions about appropriate research design.

If the candidate and the university cannot reach agreement, then the candidate is left with a “Hobson’s choice” of risking harm or withdrawing from the degree program.

Harris expects that most universities would be willing to accommodate serious concerns about publishing students' work online because it is the right thing to do, and because of the liability risk institutions face if harm results from a publication.

“If the university insists on publication in exceptional circumstances where publication is objectively inappropriate, then I believe courts should deal with that situation under traditional contract doctrines,” he said.

The requirement for students to upload their doctoral theses to ProQuest is “bordering on universal” at U.S. institutions, said Rick Anderson, associate dean for collections and scholarly communications at the Marriott Library at the University of Utah.

“This practice amounts to outsourcing the digital archiving of locally produced theses and dissertations,” Anderson said in an email. By putting dissertations in a virtual space that is curated by another entity, institutions can free up institutional server space and staff time for other uses, he said.

“I don’t have a problem with this system being the default arrangement, but I think students should have the option to decline,” said Anderson. “A thesis or dissertation is the author’s original work, and it should be treated as such -- not institutional property. At the very least, if the institution is going to impose such a requirement on its graduate students, that fact should be made very clear before the student matriculates, and an agreement to that effect should be made in writing.”

Barbara Fister, a librarian at Gustavus Adolphus College in Minnesota (who also blogs for Inside Higher Ed) noted that this is not the first time scholars have voiced concern at the requirement to publish their work with ProQuest. In the past, scholars have been surprised to learn that their work was being sold by ProQuest through third-party retailers such as Amazon. ProQuest stopped selling dissertations on Amazon in 2014 following a number of complaints.

People forget that it is a long-standing practice for hard copies of doctoral theses to be made available in libraries for anyone to read, Fister said by email. “It’s public proof of your attainment of knowledge and your membership in the discipline. It was never controversial so far as I know,” she said.

When dissertations started to become widely available online, however, the situation changed. Some publishers became hesitant about publishing commercial books from authors who had recently published their doctoral thesis on the same topic, said Fister.

“Ownership per se is not at issue here. Authors retain copyright,” said Fister. “The issue is the nonexclusive right to distribute copies of a dissertation. ProQuest pays royalties on sales and dissertations may be embargoed, but that appears to be a decision made by institutions rather than individual authors or ProQuest.”

Jessica Horowitz, director of academic relations at ProQuest, said the company publishes dissertations and theses from more than 3,100 universities.

“The universities we work with set their own policies on publication requirements, and while we can’t give exact numbers, we find that many do require their students to publish with ProQuest,” she said in an email.

Publication with ProQuest benefits universities because it boosts the visibility of their graduate programs and makes their research widely available, said Horowitz.

“Most dissertation authors welcome the added visibility that dissemination through ProQuest offers,” she added.

ProQuest Dissertations and Theses Global, as the database is officially called, has been a designated off-site dissertation repository for the U.S. Library of Congress since 1999. All dissertations sent to ProQuest become part of the official national collection.

ProQuest is committed to offering flexibility to authors, said Horowitz.

“Authors’ agreements are nonexclusive with ProQuest. Authors retain copyright and full control of their work and may submit it anywhere they wish,” she said. “ProQuest is governed by any embargo that the author or university places on a work and can, upon request, remove online works within 24 hours.”

After speaking with his advisers, Schlesinger was granted an exception to the requirement to publish with ProQuest. He has encouraged other students to request the same but said none have yet done so.

Students should be made aware of the requirement to publish with ProQuest at the beginning of their studies, said Schlesinger. He also objected to the college encouraging students to have their work professionally edited to meet ProQuest’s standards, which he considers an unfair and costly expense.

Schlesinger said he objected to publishing his work online because it hampered the ability of his research interviewees to speak openly with him. When he shared this concern, his supervisors suggested he was “not masking his data well enough.” He argued it is often very easy to unmask anonymous sources in educational research, particularly if they are identified as college presidents or deans.

By not publishing online, Schlesinger is not saying he doesn’t want others to benefit from his research. In fact, he wants the opposite.

“For practitioners, dissertations and journal articles aren’t that helpful,” he said. “If I identify useful information in my dissertation, I want to boil it down into articles and practice guides that will likely be much more widely read.”

Manhattanville's School of Education has since revised its dissertation policy to say that “should a student appeal electronic filing, then a bound copy would be required.”

Tracy Muirhead, interim vice president for institutional advancement at Manhattanville, said in an email that filing with ProQuest is "not a graduation requirement" but doctoral students are "very strongly encouraged to use the electronic filing option."

She said the college's doctoral faculty members will be discussing the issues raised by Schlesinger at an upcoming retreat. But faculty members generally support uploading dissertations to ProQuest and believe it "helps to share with others, both externally and internally, the research that Manhattanville doctoral students have undertaken."

While he is happy he doesn't have to publish his dissertation online, Schlesinger said he wants the college to make it clearer to other students that they also have the option to make an appeal. Many students are still under the impression that filing with ProQuest is mandatory, he said.

"I can see the argument for encouraging students to publish their dissertations on ProQuest, and have spoken with several faculty members who believe that it is a really good thing for the students' careers," said Schlesinger. "But to gloss over the situation does not do the issue, or the college itself, justice."

Poetry to treat and heal

How Doctors Use Poetry

A Harvard medical student describes how he is learning to both treat and heal.

By Danny W. Linggonegoro

One part of the Hippocratic Oath, the vow taken by many physicians, requires us to “remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”  When I, along with my medical school class, recited that oath at my white coat ceremony a year ago, I admit that I was more focused on the biomedical aspects than the “art.” I bought into the mechanism of insulin lowering blood sugar. I bought into the concept of diabetes-induced kidney damage. I bought into the idea of small intestinal bacterial overgrowth in patients with diabetes. But art’s—poetry’s—role in the modern practice of medicine?

 

I’ve changed my mind. Physicians are beginning to understand that the role of language and human expression in medicine extends beyond that horizon of uncertainty where doctor and patient must speak to each other about a course of treatment. The restricted language of blood oxygen levels, drug protocols, and surgical interventions may conspire against understanding between doctor and patient—and against healing. As doctors learn to communicate beyond these restrictions, they are reaching for new tools—like poetry.

Researchers have demonstrated with functional magnetic resonance imaging that reciting poetry engages the primary reward circuitry in the brain, called the mesolimbic pathway. So does music—but, the researchers found, poetry elicited a unique response.¹ While the mechanism is unclear, it’s been suggested that poetic, musical, and other nonpharmacologic adjuvant therapies can reduce pain and the use and dosage of opioids.²

 

One randomized clinical trial by researchers at the University of Maranhão studied the effect of passive listening to music or poetry on the pain, depression, and hope scores of 65 adult patients hospitalized in a cancer facility. They found that both types of art therapy produced similar improvements in pain intensity and depression scores. Only poetry, however, increased hope scores. The researchers conjectured that poetry can break the so-called law of silence, according to which talking about one’s perception of illness is taboo. After listening to poems from Linhas Pares by Claudia Quintana, one participant said “I feel calmer when I hear those words. That agony, that sadness passes. They are important words, they show me that I’m not alone.”³

Poetry is a way to both embrace the hospital encounter, and escape from it.

In another study, 28 Iranian women undergoing chemotherapy for breast cancer participated in eight weekly sessions of group poetry therapy. Their quality of life, as measured by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, showed improvements.⁴

 

Insights like these are already making their way into the clinic. Sarah Friebert, a physician at Akron’s Children’s Hospital, has integrated poetry into her clinical practice. She runs a pediatric palliative care center where children are visited by a writer-in-residence who helps them create poems and stories. On discharge, patients and families can request home visits on a monthly basis, and patients can submit completed work for publication.

I learned about Friebart’s program at a poster session at the 9^th Annual Hippocrates Poetry and Medicine Symposium, which I attended this year in Chicago along with three of my medical school classmates. We were all supported by the Poetry Foundation and the Poetry in America Initiative. Armed with a bit of training in how to use a video camera and how to do an interview, we camped out in the lobby of Northwestern Medical School, interviewing a slate of researchers and poets alike. In one interview, we met with Catherine Belling, an associate professor of medical education, and asked her how she thinks poetry can be used in the medical sense.

 

“Poetry is a beautifully condensed form of what all of language does, which is what captures the real world and turns it something manageable and meaningful,” she told us. Physicians and patients can sometimes assume that the other party is on the same page, she said, when they are not. Language is not always transparent and sometimes our vocabulary is insufficient to describe our mood. Poetry is, in some ways, uniquely capable of addressing this problem. “Poetry has a structure, which is something we can experience with our bodies,” Belling says. The medical evidence suggests that this is true in more ways than one.

 

We also interviewed the poet Eric Elshtain, who uses poetry on the wards to teach children the power of self-expression at Children’s Hospital University of Illinois. He’s found that many of his patients (whom he likes to call “students”) write haikus about the things that make them human, like sports or their favorite stuffed animal, rather than their experience in a hospital bed. Poetry, he said, is a way to both embrace the hospital encounter, and escape from it.

Rafael Campo and Mark Doty in conversation at the 9th Annual Hippocrates Poetry and Medicine Symposium.

 

Midway through the conference, we filmed one of the plenary events of the day: a discussion between our mentor, the physician and poet Rafael Campo, and the poet Mark Doty, a National Book Award winner who came to prominence with his poems about the AIDs epidemic. Campo and Doty lamented that medical professionals can get too easily caught up in treating disease. When pharmacology and procedures end, there is still a space for healing. While a sonnet a day won’t help a diabetic’s blood glucose, it might help with preventing diabetes burnout—the state in which he grows tired of managing his condition. When physicians care for their patients, they have a responsibility both to treat, and to heal. And poetry can help with healing.

As Campo and Doty talked, I thought about Doty’s poetry reading the night before, when his sublime words prompted all of us to gaze at the horizon of our mortality.  One of the poems he shared was “This Your Home Now,” set in a barbershop called Willie’s:

… the men I have outlived …
—though in truth I have not forgotten one of you,
may I never forget one of you—these layers of men,
arrayed in their no-longer-breathing ranks.
Willie, I have not lived well in my grief for them;
I have lugged this weight from place to place
as though it were mine to account for,
and today I sit in your good chair …

The poem reminded me that each person has a story of griefs and happiness; that my mundane day at the hospital may be someone’s worse day of their life. In my first year of medical school, I’ve been taught how to conduct a thorough history. That means asking patients about their illness, medical history, medications, and about how their illness is affecting their life. The problem is, all of this needs to fit inside the boundaries of an electronic medical record template.

 

I’ve decided that I’ll learn how to meet my patients beyond the chart documents; that I’ll encourage them to write their own empowering stories; that I will heal as well as treat. In other words, that I’ll honor each and every word in the oath I took last year.

* Danny W. Linggonegoro is a medical student at Harvard Medical School.

This article was supported by the Poetry Foundation, an independent literary organization and publisher of Poetry magazine.

References

1. Wassiliwizky, E., Koelsch, S., Wagner, V., Jacobsen, T., & Menninghaus, W. The emotional power of poetry: Neural circuitry, psychophysiology and compositional principles. Social Cognitive and Affective Neuroscience 12, 1229-1240 (2017).

2. Huang, S.T., Good, M., & Zauszniewski, J.A. The effectiveness of music in relieving pain in cancer patients: A randomized controlled trial. International Journal of Nursing Studies 47, 1354-1262 (2010).

3. Arruda, M.A., Garcia, M.A., & Garcia, J.B. Evaluation of the effects of music and poetry in oncologic pain relief: A randomized clinical trial. Journal of Palliative Medicine 19, 943-948 (2016).

4. Gozashti, M.A., Moradi, S., Elyasi, F., & Daboui, P. Improvement in patient-reported outcomes after group poetry therapy of women with breast cancer. Social Determinants of Health 3 (2017).

Is Active Learning Always Effective?

Active Learning That Distracts from Learning

By: Adriana J. LaGier, PhD

Because I teach mixed demographic courses, I often look out at a sea of distracted and unmotivated faces. Motivation is a large part of learning (Pintrich and deGroot, 2003). So, I use active learning activities, such as think-pair-share, to not only motivate students (Marbach-Ad et al., 2001), but also to enhance student learning (Bonwell and Eison, 1919; Freeman et al., 2014). If I’m being honest, active learning also has the added perk of distracting students from the monotony of my voice. Yet, in the past few years, I have begun to wonder if I have taken it too far? Am I simply using active learning as a way of keeping bored students active?

Recently, I created a set of tactile active learning activities developed to capture my kinesthetic learners. These activities range from using balloons to work on why cells are small to playing with PVC pipes to feel the rigidity of a microtubule.

I have been happily entering the classroom with my tactile-inspired kits being absolutely certain that I would engage students and enhance their learning. However, I have noticed a rather curious and alarming trend.  When I implement my kinesthetic activities, more students are missing the corresponding test question. For example, on one particular question about cell size, when I used my balloon activity, I went from 53 ± 3% students getting it right to 35 ± 4% students getting it right. So instead of capturing more students, I lost upwards of 15% of them.

This led me to ask the question: in my attempt to capture and motivate students, am I distracting them from learning? I feel that I use active learning appropriately because I align learning activities with well-constructed learning goals and/or critical inquiry ideals. Therefore, I believe that I am engaging unmotivated students rather than simply keeping them busy. However, I do wonder if by engaging them in the activity, I am taking their attention away from learning the content.

Noticing this trend in my assessment outcomes has been eye-opening. For now, I watch for activities that are negatively impacting student success on assessments. When I notice that the activity distracts from student learning, I dial back on the active learning and work on capturing student attention prior to teaching them the content. Based on this experience, I continuously remind myself that engaging students doesn’t always mean that the engagement is useful for learning the material at hand. In my attempt to have an enjoyable, maybe even fun, class, I may be sacrificing student attention and learning.

References:

Bonwell, C. C., and J.A. Eison. 1991. Active learning: creating excitement in the classroom. ASHE-ERIC Higher Education Report No. 1, Washington, D.C.: The George Washington University, School of Education and Human Development.

Freeman, S., Eddy, S.L., McDonough, M., Smith, M.K., Okoroafor, N., Jordt, H., and M.P. Wenderoth. 2014. Active learning increases student performance in science, engineering, and mathematics. Proceedings of the National Academy of Sciences, 111, 8410-8415.

Marbach-Ad G., Seal O. and P. Sokolove. 2001. Student attitudes and recommendations on active learning: a student-led survey gauging course effectiveness. J. Coll. Sci. Teach, 30, 434–438.

Pintrich P.R. and E.V. De Groot. 2003. A Motivational Science Perspective on the Role of Student Motivation in Learning and Teaching Contexts. Journal of Educational Psychology, 95, 667-686.

Adriana LaGier is associate professor of biology at Grand View University.

Medical school

Medical students are skipping class in droves — and making lectures increasingly obsolete

By Orly Nadell Farber 

The future doctors of America cut class. Not to gossip in the bathroom or flirt behind the bleachers. They skip to learn — at twice the speed.

Some medical students follow along with class remotely, watching sped-up recordings of their professors at home, in their pajamas. Others rarely tune in. At one school, attendance is so bad that a Nobel laureate recently lectured to mostly empty seats.

Nationally, nearly one-quarter of second-year medical students reported last year that they “almost never” attended class during their first two, preclinical years, a 5 percent increase from 2015.

The AWOL students highlight increasing dissatisfaction and anxiety that there’s a mismatch between what they’re taught in class during those years and what they’re expected to know — or how they’re tested — on national licensing exams. Despite paying nearly $60,000 a year in tuition, medical students are turning to unsanctioned online resources to prepare for Step 1, the make-or-break test typically taken at the end of the preclinical years.

These self-guided med students are akin to a group of American tourists wandering through Tokyo without a map. Like a tour guide hired on the street, the online learning tools — including memory aids, videos, and online quizzes — can enhance the educational journey, or send the students down a dead end.

Lawrence Wang, a third-year M.D.-Ph.D. student at the University of California, San Diego, and the National Institutes of Health, said he relied heavily on these resources during his first two years of medical school.

“There were times that I didn’t go to a single class, and then I’d get to the actual exam and it would be my first time seeing the professor,” he said. “Especially, when Step was coming up, I pretty much completely focused on studying outside materials.”

Wang isn’t alone. According to 2017 data from the Association for American Medical Colleges, 1 in 4 preclinical students watches educational videos — like those on YouTube — on a daily basis. And according to two video developers, tens of thousands of medical students subscribe to their products — one of which costs $250 for two years, the other $370 for one year.

Leaders in medical education have begun to scramble. Some medical schools, like Harvard, have done away with lectures for the most part. Instead of spending hours in an auditorium, Harvard students learn the course content at home and then apply the knowledge in mandatory small group sessions.

Other institutions, like Johns Hopkins, are moving in the same direction, but have yet to make a full switch. Hopkins cut down on lectures and boosted sessions that require active student participation. Preclinical lecture attendance hovers around 30 to 40 percent, according to Dr. Nancy Hueppchen, associate dean for curriculum.

For many students, she said, licensing exam prep begins on day one of medical school: “They have this parallel curriculum going along with what we’re teaching them.”

Step 1, an eight-hour multiple choice test, is a big deal. Performance on the exam, though it’s taken before most students even begin training in a hospital, heavily influences which medical specialties they can eventually pursue after school and at what hospitals they can pursue them.

With medical schools grading pass-fail, the Step 1 score is an increasingly significant piece of information that’s used to sort through residency applications, Hueppchen said. When she took the exam, it was only used as a pass-fail test. Today, residency programs rely on the score more heavily; students and faculty suspect that it’s used as a cutoff for making admissions decisions.

Ryan Carlson, a third-year M.D.-Ph.D. student at the University of Washington, said that his school focused on teaching “what they thought was important for a physician to know.” But medical students have to know more than what is relevant to a practicing clinician to succeed on Step. The exam focuses on rare diseases and other minutiae, said Carlson, who now tutors for the test.

Hueppchen acknowledged that students at Hopkins and elsewhere “express some distrust that they’re getting everything they need — or that we’re being meticulous in pointing out what they need — to study for and excel on the Step 1 exam.”

SketchyMedical produces visual memory aids with elaborate illustrations, like this one of the major drugs targeting the sympathetic nervous system. Stephen Wang at SketchyMedical

 

The medical tour guides

That distrust has spawned a cottage industry of online study aids. Most are a far cry from your high school SAT prep course.

SketchyMedical is one of the most popular guides. The company, built in 2013 by three then-medical students at the University of California, Irvine, produces visual memory aids with elaborate illustrations to help students learn and retain the voluminous material they’re expected to know.

Dr. Andrew Berg and his co-founders, Drs. Saud Siddiqui and Bryan Lemieux, started sketching pictures and pairing them with stories while taking microbiology in their second year of medical school.

“We were just bombarded with different names of bacteria, viruses, and fungi, and we were having a tough time keeping them all straight,” he said.

The sketches helped them, and now other students are using them, too.

Imagine it’s test day and a med student is asked which drug she would use to treat a patient’s postoperative gastrointestinal blockage. The student closes her eyes and mentally enters the world of “Acetyl-Cola,” a bustling port town that’s depicted in one of SketchyMedical’s cartoons. Outside a storefront, the student finds construction workers, motorcyclists wearing brain-shaped helmets, piles of dripping-wet fish, and a man sporting an adrenal gland-shaped beanie.

A colon-shaped mixing truck pouring out cement is an unfortunate, but effective, symbol for defecation, and a worker wearing a name tag reading “Beth” and drinking a cola reminds the student of the drug bethanechol, given to treat intestinal obstructions.

The illustrations are turned into narrated videos, which teach drug names and their mechanisms and side effects. SketchyMedical has also produced videos on microbiology and pathology.

Berg compares the work of Sketchy to hieroglyphics in ancient Egypt. But for many, Sketchy evokes a different technique used a thousand years later in ancient Greece: method of loci, also called a memory palace or journey.

Memory palaces are typically imagined spaces in which a person can store information like a string of numbers or a series of words. Each piece of information is placed somewhere inside the palace. When the palace builder wants to recall an item, she can take a mental stroll through the space to retrieve it. This technique famously enabled Cicero, the Roman statesman and philosopher, to commit his speeches to memory.

“We accidentally stumbled upon these visual learning techniques, but now looking back we see there’s a lot of evidence supporting visual learning,” Berg said.

“That was the biggest learning curve of med school — it wasn’t so much how do I do well in it, it was, how do I use all these crazy resources that are being marketed to me to best meet my goal of passing Step.”

Ryan Carlson, third-year M.D.-Ph.D. student at the University of Washington

SketchyMedical is not the only extracurricular resource students rely on. An entire industry cropped up in the last few years, marketing videos and self-quizzing features to preclinical students. Dr. Jason Ryan, the creator of Boards and Beyond, is a name (and voice) familiar to medical students across the country.

Ryan, a faculty member at University of Connecticut School of Medicine, creates explanatory videos that track along with the content in First Aid, a Step preparatory book that Ryan said is more like “an encyclopedia of terms” than a real study aid. Ask any medical student if they use First Aid, and they’ll point you to their heavily annotated, tattered copy.

While both Ryan and Berg consider their products supplements to regular medical education, many students view them as necessary investments for success. Choosing which ones to use can be a challenge, however.

“That was the biggest learning curve of med school — it wasn’t so much how do I do well in it, it was, how do I use all these crazy resources that are being marketed to me to best meet my goal of passing Step,” Carlson said.

 

The old players react

This expanding corner of the medical education industry is both a product of a new attitude among students — born from anxiety surrounding exam prep — and a disrupter of the traditional classroom education. Med schools now have to think more creatively about how they train their future doctors, Berg said.

In 2015, Harvard Medical School revamped its curriculum for the first two years to enable clinical exposure and boost class attendance with a flipped-classroom model: Students learn the content at home, and then apply it during in-class exercises. Dr. Richard Schwartzstein, director of education scholarship, said the program now emphasizes problem-solving and critical thinking — skills seen as essential to practicing medicine — instead of factual recall.

But while medical schools are de-emphasizing pure memorization, the national licensing exams have yet to reconsider, he acknowledged. Still, Schwartzstein is not a huge fan of external resources, citing their focus on memorization and pattern recognition as major weaknesses.

“You don’t have to actually teach pattern recognition,” he said. “We all are born with the capability of recognizing pattern.” He advises students to stick to Harvard-developed videos and their recommended readings. Like many medical schools, Harvard gives students a dedicated study period — six to eight weeks without coursework — to “prepare in whatever way they deem most appropriate to take the boards,” he said.

Hueppchen said that the outside resources “may have value in day-to-day studying, they may have value in studying for Step 1,” but Hopkins has not vetted them so it doesn’t recommend them to students either.

The National Board of Medical Examiners, which works with state medical boards to set the minimum standards for medical licensing and administers the Step exam, also doesn’t endorse these products — or their use as hard lines for residency admissions, said Dr. Michael Barone, vice president of licensure programs. The group “is aware of some secondary uses of scores,” he said, but the test’s primary purpose is to report licensure alone.

So long as Step still requires intensive rote memorization, companies like SketchyMedical and Boards and Beyond will likely remain in business.

Both Berg and Ryan agree that physicians no longer need to memorize as much as they did in the past. Ryan’s grandmother was one of the first female physicians to graduate from her medical school in the 1940s. Back then, he said, she had to remember everything. “If she had to go to a book every time she saw a patient, she’d never be able to work through the day.”

Today, there’s much more to know, and medicine is evolving so rapidly — with new drugs, guidelines, and practices — that physicians can’t possibly remember it all. Instead, they look information up on their cellphones, using a variety of apps on the clinic floors. But preclinical students still need to commit board-tested material to memory, a task often compared to drinking from a firehose.

Needing to memorize for boards and learn in parallel for their institutions is the breeding ground for anxiety that Hueppchen said “has truly detracted from the joy of learning.” It has even detracted from the joy of teaching, she added.

Berg said he tries to bring joy to memorization: “I think that what I hope to contribute the most is making studying more fun.”

Integração Ensino-Serviços

UEM e Regional de Saúde discutem projetos em parceria

Paulo Pupim

Ideia é desenvolver ações que fortaleçam a saúde pública na região via SUS

Coordenadores dos cursos de Enfermagem e Medicina, da Universidade Estadual de Maringá, se reuniram, hoje (6), no Gabinete da Reitoria, com representantes da 15ª Regional de Saúde, e o reitor e o vice-reitor da UEM, Julio Damasceno e Ricardo Dias Silva, respectivamente.

Participaram do encontro, além de Damasceno e Silva, o diretor da 15ª RS, Ederlei Alkamim; servidores técnicos de departamentos da Regional; e os coordenadores dos cursos de Enfermagem, Grace Jacqueline Aquiles, e de Medicina, Roberto Esteves, ambos professores.

Os participantes discutiram a questão da integração e parcerias da UEM com a Regional de saúde para desenvolver ações voltadas ao desenvolvimento regional da saúde pública e do ensino de graduação em saúde.

Outra pauta foi a elaboração de propostas visando o fortalecimento da Educação Permanente em Saúde na região. Alguns assuntos de relevância para a saúde pública da região, como a atual crise que envolve o Laboratório de Ensino e Pesquisa em Análises Clínicas (Lepac), da UEM, e o Hospital Universitário Regional de Maringá (HUM), também estiveram na pauta.

A reunião ainda serviu para a discussão de propostas de avanços na integração da UEM com a 15ª RS e outros setores estratégicos do município e região, que resultem em ações de melhoria e consolidação do Sistema Único de Saúde (SUS) na região.

Com sede em Maringá, a 15ª Regional de Saúde, ligada à Secretaria de Saúde do Paraná (Sesa), engloba 30 municípios, incluindo o de Maringá.