[Kalium]

The author prefers to believe that it was poor instruction. The implication is that because they were willing to show up for a 7:30am lecture, they were capable of making it.

On the one hand, the author is on to something. Most people learn much better with intensive, one-to-one instruction than with large lectures. The real issue, as with all educational programs, is the cost in time and money to teach. More personalized, intensive training from more specialists in teaching a specialized subject simply costs more to get the to the same goals as bulk lectures. Nobody wants to say "There was a very rational cost-benefit analysis and I lost out". Instead, it's all framed as a need to dedicate more time and money at an already demonstrably drawn-out and expensive process.

On the other hand, a person's ability and willingness to show up at 7:30am are probably irrelevant. No matter how relevant it feels to a person who wants to show their dedication, passion, and drive.

[wisty]

They were complaining about a weed-out class being a weed-out class. The students wanted to get into an extremely prestigious career. Weed-out courses exist because there's a limited number of prestigious spots, or because most students need the pressure to work harder. It would make sense if she then explained that we should make medicine less prestigious (letting far more students become doctors) but that wasn't the point.

The point was that learning the fundamentals was prioritised, instead of "deep learning". However there's a ton of research that suggests that in many cases, learning the fundamentals is one of the best ways to get students to start the process of deep learning. Obviously there's a point where overtraining the fundamentals is no longer a good thing (e.g. trying to memorise every possible edge case and combination) but that's a rare edge case. In most cases, simply getting the grips with the basics quickly, then thinking for yourself (e.g. looking at hard cases rather than asking how someone can teach you how to think at a higher level) is what works.

Education has a long-running holy war between implicit vs. explicit instruction (though "implicit instruction" has a lot of name changes as it always seems to lose credibility and need rebranding). Saying "we need to stop teaching students what to think, but how to think" isn't deep, it's a cliché, and it needs a lot more than vague criticisms of explicit instruction to be worth listening to.

Probably the worst thing about the "deep learning" crowd is that so many of them are in medicine, where it kind of works. You can teach medical students badly, and they'll figure things out. Giving them more independence and teaching badly (while pretending to be wise) can perversely work, in some ways, for medical students who've survived the weed-out classes. But then a few academic studies on how to teach medical students better (apparently they haven't yet learnt how to learn, or how to think critically?) is then used to convince politicians, education academics, and other people who understand little about teaching that it's the best way to teach reading in underprivileged elementary schools.

[CobaltFire]

In the military we train this as being “brilliant on the basics” with the follow on, as you said, that it is the way to train an adaptable and competent professional who works in high stress situations.

[dap]

But, assuming we take the facts of the post at face value, there clearly wasn’t a rational cost-benefit analysis that resulted in only teaching large lecture-style courses and deliberately serving only those who could thrive that way. The instructor’s claim was not that the author needed more instruction that wasn’t available (indeed, they turned her away from seeking such instruction). Rather, it was that people like her simply can’t “hack it”, which the author demonstrated to be false.

[Kalium]

There was no cost-benefit analysis on offer, you are correct. This is not the same as there being none, though. Weed-out courses are a classic example implemented at the institutional level - they exist to find as early as possible who is likely to be compatible with the educational program to come. Like any system working on messy humans (who like to defy neatly delineated categories), there are marginal cases who just need a little help to flip from one category to the other. The author calculated that they were such a marginal student and invested accordingly. This should not be confused for assuming that every passionate, driven student is a marginal case who just needs a little help.

The author is essentially arguing at length for a greater emphasis on benefit and less on cost. Not just in o-chem, but at every stage of medical training.

[gopher_space]

I just wish I had known that o-chem gets easier if you start first thing in the morning.

[p1esk]

The real issue, as with all educational programs, is the cost in time and money to teach.

LLMs should help with that.