![]() ![]() I propose that this rapid shift over the past decade is our own creation, one that sets up conditions for a perfect cognitive storm. Rather, I focus on our role in creating and sustaining this “rapid-fire, short-attention-span-provoking, overstimulating, largely visual, information-spewing environment” in medical education. This is not another hand-wringing exercise on the difficulties we faculty face in capturing the attention of Millennial or iGeneration medical students, nor is it a charge that today’s students are anti-intellectual, irrevocably damaged by excessive attention to the digital world. What I propose here is not a lament of this culture. In a recent article in Inside Higher Education, Judith Shapiro 1 paid homage to Susan Jacoby’s book The Age of Unreason, one of the most recent lamentations regarding the “culture of reading being replaced by a rapid-fire, short-attention-span-provoking, overstimulating, largely visual, information-spewing environment.” Neither Shapiro nor Jacoby was addressing medical education but rather a major cultural force throughout the United States that deeply affects university life. Where is the wisdom we have lost in knowledge? Where is the knowledge we have lost in information? ![]() The author proposes that the rapid shift over the past decade to a technology-driven, competency-oriented environment in medical education is the medical educators’ creation, one that sets up conditions for a perfect cognitive storm. This article confronts these phenomena singly and then at their intersection, which may discourage, even dismantle, many of these habits. Finding themselves placed at this intersection, students encounter fewer and fewer opportunities to practice some of the very cognitive and affective habits medical educators say they value in physicians, particularly critical reflection and deliberation, an eye for nuance, context, and ambiguity, and an appreciation that becoming a doctor involves more than learning content or performing skills. Three distinct phenomena are currently at play in medical education: (1) the pervasive use of PowerPoint in teaching, (2) the wholesale application of competency models, and (3) the shift from paper reading to screen reading regardless of course, text, or genre. ![]()
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