"As we cross into the next millenium, there are two big challenges facing our education system".
     - Dr Aline Wong

Dr Aline Wong, delivered the second NUH lecture at the NUS Clinical Research Centre on 1 August 1998. Her lecture focused on the challenges of the 21st century facing our education system. An abridged version is reported below.

Our Education System

Dr Wong began the lecture with a reflection of our education system. "Singapore has indeed undergone many changes over the past three and a half decades. Likewise, our eduation system has also adapted over the years to meet many new challenges. Education has helped our transition from the labour-intensive economy of the sixties and seventies, to the skill-intensive economy of the eighties and nineties. Now, we are in the throes of a transition to the knowledge-based economy of the 21st century. The next century will witness the increasing use of information and knowledge as engines of productivity and economic growth.

To thrive in this future world of the 21st century, Singaporeans must learn to reach out and go beyond our physical boundaries, beyond our community to the region and the wider world. We must also learn to think beyond the obvious, to think creatively, and to come up with new ideas. We must be comfortable with new technologies and be able to exploit them to open up new frontiers of knowledge and entrepreneurship.

Education holds the key to our future, just as it held the key to our past success. It is no exaggeration to link education with the wealth of nations, as an article in the 29th March 1997 issue of The Economist suggests. Nor is it entirely off the mark to equate the league of nations with the league table of educational achievements, though critics would say that it is an over-simplification."

Two Big Challenges

She continued, "As we cross into the next millennium, there are two big challenges facing our education system. One is the rapid advancement of knowledge and technology, particularly information technology. The IT revolution is already well underway. It is changing the way we live. Studying and working in this knowledge-based environment requires a set of skills and mental attitudes, which is quite different from what we used to acquire in school. It will not be adequate for our students to simply absorb knowledge. In fact, it will be impossible to teach students everything they ought to know before working. Instead, they need to be skilful in accessing knowledge, using knowledge and creating knowledge. They need to become independent life-long learners who will come up with creative solutions to whatever problems they face in life."

The other challenge is balance, that is to balance the acquisition of core knowledge with room for creative and critical thinking, or what is known as higher-order thinking skills. The challenge is also to balance breadth with depth. All these will require time to implement. Nevertheless, as an interim measure, we have decided to reduce the curriculum load on students by 10% _ 30% for most subject syllabuses. This will free up time for project work, collaborative learning, and the use of process skills.

University’s Initiatives

Dr Wong said, "I am delighted to know that our two universities have introduced a number of initiatives in the last few years, in parallel with MOE’s initiatives for schools and post-secondary institutions. These include the extensive use of IT as a tool for teaching and research, linkups with sister institutions abroad, developing administrative and management excellence, etc. There are also moves to reduce the curriculum to allow more time for students to learn through project work and hone their creative and thinking skills. The universities are also actively considering introduction of a core curriculum, which is cross disciplinary in nature and will help students adopt a much broader perspective to their own areas of concentration. National education will also be introduced as part of the core curriculum. At the same time, students’ admission criteria are being reviewed."

Medical Education

On medical education, Dr Wong noted that, "The undergraduate medical curriculum has been reviewed. Factual overload will be reduced, particularly in the pre-clinical phase of the course. This will be achieved by defining a core curriculum at the Faculty level (How I wish of course that medical students could also participate in the core curriculum of the other faculties, which provides them with exposure to not just basic science, but also to history, philosophy, politics, economics, sociology and so on!). But to dream this is to dream too much, given the fact that medical training in the local context is an undergraduate degree, not like the post-graduate MD that, say, the USA has.)

Another element of the curriculum review by the Faculty of Medicine is that teaching will be more integrated along the organ-system approach. Basic science teaching and clinical instruction will be integrated through providing students with significant exposure to clinical medicine very early on in the course. Equally important is a new emphasis on self-directed learning and problem-solving approach, as well as training in communication skills, and more opportunities for student research projects.

With these changes, I am confident that we will see a new generation of doctors prepared for the challenges posed by rapidly advancing medical knowledge and technology, and ever rising levels of patient expectation. What I wish to emphasise is: IT can be a great help in delivering the training, as well as encourage self-learning and life-long learning by the students."

Medical Ethics

Dr Wong also touched on medical ethics in the training of the doctor. She said, "Even with the finest system of remuneration and the right kinds of incentives to shape behaviour, ultimately, good medicine must depend on good medical ethics. Medicine is no longer practised in the legal-ethical-moral context of the past alone. Medicine is increasingly practised within the context of healthcare becoming a business. Obviously, there has to be clearer, more focused teaching of medical ethics against this new environment. As well, medical ethics is taught both by precept and by providing role models. It takes much more than requiring all students take a seminar or two in ethics, or requiring graduating doctors to say the Physicians’ Pledge at a solemn ceremony. How many doctors will still remember the words of this Pledge, say, a few years down the road is anybody’s guess. But they will remember the examples set by their teachers and mentors."

Continuing Medical Education

The need for CME was also highlighted, "Basically, the professions owe their high social standing to the high professional standards they set for their members. Medicine is no exception. Standards are not things that stand still throughout time. Given an increasingly educated public, there will be greater demands for up-to-date knowledge and rising standards of professional competency on the part of doctors. Hence, doctors must continuously learn new knowledge and skills throughout their careers."

Research and Research Culture

On research, Dr Wong said, "For research to flourish, students must develop critical thinking skills, and be encouraged to come up with creative solutions to problems. The MOE is trying to do these for all our students. In addition, we have been trying to infuse a research orientation among our top students, through the GEP programme that is now into its 12th year. The universities and the polytechnics have been active partners in our push to nurture research abilities through the various mentorship schemes under the GEP initiative. Many of these schemes are now open to non-GEP students as well. In addition, NSTB has supported the Undergraduate Science Research Programme (USRP) with the Faculty of Science, and the Undergraduate Research Opportunity Programme (UROP) with the Faculty of Engineering. I am glad to note that the Faculty of Medicine is considering opening up UROP opportunities for its medical undergraduates.

For research to flourish there is also the need to develop a culture. "To develop a vibrant research culture, we must recognise certain basic features of science as avocation."

Dr Wong alluded to Max Weber, a German sociologist who spoke of "science as avocation" as long ago as 1918. His view was that science requires not only the "cool intellect" but also "one’s heart and soul". Scientific ideas are developed out of both hard work and enthusiasm. There is a personal element, namely, a sense of calling in the pursuit of science. There is also a need for the spirit of experimentation and criticism.

"Role models are important in cultivating the scientific spirit among our young. "We need good science teachers who can make our students more curious about the world and find ways to satisfy and deepen their curiosity. In the same manner, university lecturers need to inspire in students the love for independent learning and the job of discovery. Students should have the opportunity to watch and participate in the research activities of the lecturers. They will then be infected by the spirit, the dedication and the exhilaration of scientific discovery

Dr Wong also observed and concluded that "a vibrant research culture cannot emerge overnight. But if we truly aim to be a centre of educational excellence, we cannot afford not to nurture it, along with our attempts to create a thinking and learning nation." K

A/PROF GOH LEE GAN