To the Editor:
The concept of design thinking has gained popularity as a method for human-centered problem solving where designers work closely with end users to inform new innovations. Applying this approach to medical education, design thinking in curriculum reform would engage students, as end users, in the coproduction of learner-centered education. Considering changes in pedagogy that are occurring within medical curricula nationwide, we identify ways that design thinking may enable opportunities for students and faculty to collaborate toward learner-centered medical education.
Design thinking is a cognitive and analytic approach to problem solving. First popularized by Tim Brown and David Kelley, the method begins with designers empathizing with the difficulties and hardships of individuals embedded in the problem environment. Based on observations and analysis of the problem, the designer creates an innovative solution, working directly with the people most affected by the issue. This new design is then rapidly tested and evaluated using feedback from end users to assess improvement. One example of design thinking noted in the Harvard Business Review found that when Kaiser Permanente used input from nurses and patients to create a new process for nursing shift changes, they were able to reduce mean nursing handoff times by 50%.1 The characteristic that sets design thinking apart from other problem-solving methods is the emphasis on the end user’s experience. This approach has gained traction among technology and consumer goods companies as well as hospitals to improve patient experience and outcomes.
Applying design thinking to medical education focuses our attention on how the student, as end user, can provide insight into his or her own learning experience. Researchers have observed that during medical curriculum transition from lecture-focused to learner-centered and collaborative pedagogy, both medical students and instructors experience a number of adaptations as they adjust to the new pedagogy.2 A design-based approach to curriculum reform would engage the student early and often in the reform process and allow faculty to design their courses, learning materials, and teaching styles based on feedback from student end users.
Since 2015, as Harvard Medical School first prepared and then launched a new curriculum focused on collaborative interactive learning, student leaders have worked with faculty to develop a consultative model for communicating the learner’s perspective regarding pedagogical changes. Within this model, faculty are able to consult students for a variety of purposes, including structured review of course materials, one-time meetings to discuss proposed activities, and even working longitudinally to cocreate teaching sessions. In one instance, students were able to provide constructive feedback on their experience using online video instruction to improve the quality of teaching materials.
Participating faculty have modified courses based on student feedback, and students have noted an appreciation for being involved in the process. Amidst the many changes in curriculum reform, engaging the perspective of the learner enables exciting innovations designed with the student in mind.
Jordan Anderson, MPhil
Third-year student, Harvard Medical School, Boston, Massachusetts.
Christopher F. Calahan
Third-year student, Harvard Medical School, Boston, Massachusetts.
Holly Gooding, MD, MSc
Assistant professor of medicine and pediatrics, Harvard Medical School, Boston, Massachusetts; [email protected]
References
1. Brown T. Design thinking. Harv Bus Rev. June 2008.
https://hbr.org/2008/06/design-thinking. Accessed December 13, 2016.
2. Moffett J. Twelve tips for “flipping” the classroom. Med Teach. 2015;37:331336.
