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Thursday, September 12, 2013

Better Biochemistry: Teaching to the MCAT?


Better Biochemistry
I view science education as a way of teaching students how to think critically. In that sense, it's not any different than education in the arts and humanities. In my opinion, biochemistry should be taught as a bunch of fundamental concepts and principles that will help students understand the basics of life at the molecular level. The course will demonstrate how to think critically and how we come to know what we know—if we teach it correctly. I believe that biochemistry should be taught from an evolutionary perspective since that's the best way to achieve fundamental understanding.

The last thing we should be doing in an undergraduate biochemistry course is to ask students to memorize enzymes, structures, and pathways and regurgitate them on an exam. We should not just be teaching the biochemistry of humans since that does not provide students with a broad view of life and where humans came from. Such an approach also makes biochemistry seem like it's only important because it can contribute to health. We have plenty of evidence that this is the wrong way to teach.

The MCAT (Medical College Admission Test) is an exam given to students who want to enter medical school, especially in North America. It is administered by the Association of American Medical Colleges (AAMC). Many American colleges and universities have "premed" programs that are designed to help students get into medical school.

The form of the MCAT exam is changing in 2015 to include more biochemistry. This has prompted several reviews of undergraduate curriculum by various organizations such as the American Society for Molecular Biology and Biochemistry. For example, a recent report is summarized in ASBMB premedical curriculum recommendations.
Many college students plan their curricula based on medical-school admissions requirements. Enrollment in undergraduate biology, chemistry, physics and calculus courses contributes to science, technology, engineering and mathematics (STEM) literacy even if many premedical students turn to fields other than medicine. The practice of medicine and the education of physicians continue to evolve. In 2008, the American Association of Medical Colleges established the MR5 Committee to revise the MCAT, which was last revised in content areas in 1991, 10 years before the first human genome sequence was available (1 – 3).

The MR5 Committee has made recommendations that will result in testing of core concepts in biochemistry and social and behavioral sciences, and it also will test critical thinking in ethics and multicultural studies. In preparation for the revised MCAT to be administered in 2015, many colleges of medicine are changing course requirements for students who will begin medical school in 2016 and beyond.

Enrollment in college STEM and other courses is expected to shift. Universities may need to provide resources to courses on subjects that will be tested in the revised MCAT. Moreover, disciplines already represented in the MCAT may be influenced by the MR5 Committee’s recommendations. For example, because biomedical research and practice depend increasingly on statistics, bioinformatics and imaging, the mathematics and physics background provided to premedical students should emphasize these subject areas. Leaders in mathematics and physics will need to determine what material is most germane to future physicians. Similarly, social and behavioral scientists are encouraged to engage in the MR5 process to provide core concepts to premedical students.

The American Society for Biochemistry and Molecular Biology represents thousands of faculty members who teach and conduct research in departments of biology, chemistry, biochemistry and molecular biology. We offer four recommendations for restructuring premedical curricula. If these recommendations are enacted, millions of college students will acquire an education that will improve biomedical literacy and better prepare students for the field of medicine in this genomic, proteomic and metabolomic era.
This way of thinking has been common in American chemistry, biology, and biochemistry departments for many years but I didn't realize it until just this year. Apparently, biochemistry teachers think it's okay to let AAMS dictate what needs to be taught in undergraduate science programs.

This point was shockingly evident when I read an article in Biochemistry and Molecular Biology Education (BAMBED) last Spring. The article, by Henry Jakubowski and Laura Zapanta (2013) was a response to the new MCAT exam scheduled in 2015. It began with ...
Anyone teaching biochemistry to undergraduate students is well aware of the concomitant need to develop course content, pedagogy, goals, and student outcomes for their courses and to prepare students for the Medical College Admission Test (MCAT).
Well that's not exactly true. This is an international journal and I suspect that the vast majority of biochemistry teachers don't even know what an MCAT is. But setting aside the parochialism, should this even be true in American colleges and universities? If the goal is science education and preparing students to be scientifically literate citizens, doesn't that conflict with teaching to the MCAT?
Even for those not interested in a medical education, the biochemistry content found in the MCAT covers the fundamental concepts of biochemistry and related fields.
This is demonstrably false. It's easy to show this by looking at the websites recommended by AAMC and by examining test questions. The biochemistry being examined in the MCAT is 40 years out of date and emphasizes facts not concepts (e.g. "How many molecules of ATP are produced during respiration?", "Does SDS allow separation of proteins by; charge, molecular weight, shape, or solubility?").

Many existing pre-med programs don't require a biochemistry course. That's because the MCAT exam didn't used to have very many questions on biochemistry and many students felt they could could memorize the relevant material by reading a textbook or by taking an MCAT prep course. They were mostly justified in taking this approach since many got into medical school without ever taking biochemistry. When they did take a biochemistry course, it was often in their final (senior) year.

If university teachers were truly interested in teaching biology then it's clear that biochemistry is a fundamental part of modern biology and it should be taken as soon as possible. It's a required second year course in almost all biology programs in Canadian universities.

Should biochemistry teachers be designing courses with an emphasis on preparing students to take the MCAT and get into medical school? Should there be pre-med programs in universities if is this in conflict with the most important goals of science education?

Maybe the people who design the MCAT should be reflecting the best teaching practices in biochemistry rather than dictating what undergraduates need to learn about science?

Jakubowski, H.V. and Zapanta, L.S. (2013) The Pre-health Collection Within MedEdPORTAL's iCollaborative: Helping Faculty Prepare Students for the Competencies In the New MCAT2015 Exam. Biochem. Mol. Biol. Educ. 41:76-78.


Rosie Redfield said...

So are your exams open book?

Anonymous said...

I doubt memorising has anything to do with learning. I've memorised the answers for many exams, but as soon as time's up and the pen drops, all that 'knowledge' is erased from my memory. I've never understood how any examining body thinks this is an appropriate way to assess 'knowledge'.

No, I agree with you (it's one of the reasons why this is one of my favourite blogs!): knowledge comes from understanding. I was fortunate to take biochemistry at undergraduate level that was taught from general principles (albeit somewhat limited in scope!). The rest kind of follows; I was never required to memorise pathways, but I found myself doing so on my own initiative -- because the interactions were so interesting, and I wanted to know more and figured seeing a larger picture in my head would help.

I doubt have sufficient grounding in biochemistry (despite just having finished my degree) to compete with any genuine biochemists (I approached it from the biology-side of things), but I'm getting there. (I'm especially helped by your writings; your blog has opened my eyes to so many things; as a student, I am most grateful!) :)

Larry Moran said...

Yes, when I taught biochemistry my exams were open note exams, Students could bring all their notes, including my handouts, to the exam.

KStRNA said...

Have you thought about take home exams? I use a combination of in class questions and take home exams works well in Biochemistry. With take home questions, you can really challenge students to really delve and think about the material at a level that an in class exam doesn't permit. Students also spend more time on Biochemistry than they would studying for an in class exam and are more productive per unit time of studying.

Larry Moran said...

There were 100 students in the class when I was teaching biochemistry. I didn't have time to grade take-home exams.

It's a good idea, though.

RBH said...

See also Steve Rissing's article in the American Society for Cell Biology's "Life Sciences Education, titled Correlation between MCAT Biology Content Specifications and Topic Scope and Sequence of General Education College Biology Textbooks.

Unknown said...

Every subject is same in my opinion may be its arts and humanities or science the only thing is the students need to understand what they are reading else mere reading and mugging up takes you nowhere and as biochemistry is concerned it must be understood well rather than just reading it up and memorizing for exams!!!
Thanks for this lovely post..

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