The Academic Life in Emergency Medicine (ALiEM) Faculty Incubator was hard at work during the pandemic to bring you the fifth volume of the Education Theory Made Practical series. This series strives to make theory accessible to educators by distilling the background and key literature of each theory and grounding them in practical education scenarios.
The Faculty Incubator is a year-long professional development course for medical educators centered around a virtual community of practice (a concept we have all started to appreciate during quarantine). Teams of 2-3 participants from around the world authored primers on education theories and different teams offered a first round of peer review on each post. As in prior years, they will be serialized on the ICE Blog for review and comment. You can learn more here.
They have published three e-book compendiums of this blog series (Volume 1, Volume 2, Volume 3) and you can find the Volume 4 posts here (the e-book is in progress!) As with the previous iterations, final versions of each primer will be complied into a free eBook to be shared with the health professions education community.
Your Mission if you Choose to Accept it:
We would like to invite the ICE Blog community to peer review each post. Your comments will be used to refine each primer prior to publication in the final ebook. No suggestion is too big or small – we want to know what has been missed, misrepresented, or misconstrued. Comments as small as grammatical errors all the way to new scenarios for practical applications or new citations are welcome. (Note: The blog posts themselves will remain unchanged.)
Scroll down for the first post of Volume 5!
Authors: Eva Niyibizi (@evni_MD); Susan Fraymovich
EDITOR: Simiao Li-Sauerwine, MD MSCR (@THESIMIAO)
Main Authors or Originators: Paolo Freire “Pedagogy of the Oppressed” 1970, Brazilian educator, christian socialist, political activist (1921-1997)
Part 1: The Hook
Sarah was excited to start medical school. Her road to medical school was not the typical one. When she attended college, she majored in biology and had expected to work as a basic science researcher. She completed her master’s degree in biology and even worked in the university lab for two years. She ultimately decided her passion was in medicine and after going back to school to complete her requirements, she was finally starting medical school.
Sarah’s first month in medical school did not live up to her expectations. She found her physiology class boring and repetitive. Her class was held in a large auditorium with four hundred first-year medical students feverishly taking notes while the professor stood in the front of the classroom lecturing. She was disappointed that there were no engaging conversations or exchange of ideas during class time, as she had during her seminar classes during college.
Sarah had an advanced biology degree and the material being covered in class was something she herself had already taught while being a teacher’s assistant in graduate school. Sarah felt like she didn’t have an opportunity to share her knowledge nor develop additional skills in this type of learning environment. Sarah was frustrated. Is this what medical school was going to be like for the next four years?
Part 2: The Meat
The Banking Model by Paolo Freire described the teaching theory of students being “banks” for teachers. Teachers deposit knowledge in students while students memorize and repeat what they are taught. The teacher plays an active role while the student plays the passive role of absorbing the information. Preexisting knowledge of the student is ignored and all students are taught on the same level.
Paolo Freire was a Brazilian educator, socialist, activist (1921-1997). Freire’s theory is based on a Marxist approach and his view of anti-colonialism stemming from his poor upbringing in Brazil. He believed his country’s population needed to have increased access to education. Education, when done the right way, would empower the repressed to regain their sense of humanity and overcome their poor conditions.
Freire’s Banking Model viewed educators as oppressors who teach students to conform to their way of thinking. Students are oppressed and learn their place in society through their teachers. They do not ask questions and accept what they are being taught; they are passive learners who learn by repeating facts without using critical thinking skills. The teacher deposits knowledge directly to the student and the student is expected to memorize it exactly as it is being taught. This method does not facilitate free thinking or transformative thought.
Freire argues instead that the utility of education is far more than the transmission of information. Instead, he views education in the broader context of liberation of oppressed peoples, as a tool for humans to discard the tools of oppression and liberate their potential. A teacher, in Freire’s view, should foster learning without dictating content, while also being open to concurrent learning themselves. A learner is continually challenged by questions posed by the teacher, critically considers content, and is fully engaged in the creative dialogue.
Modern takes or advances
The Banking Model is based on teachers recapitulating their knowledge directly to students as accepted facts. There is no thought given to the background of the student or differing levels of knowledge of those in the classroom. Students, on the other hand, play a passive role in their own education. They do not use critical thinking or interpret the facts they are given. They are expected to memorize the content and recite it when asked. To overcome these antiquated teaching styles, Freire suggests the teacher should become a student and engage with students. Students come from different backgrounds of knowledge and skill; Students can learn from each other and educators can learn from them as well. Freire recommends problem-based learning, wherein teachers pose scenarios and allow students to formulate their own questions and answers.
In recent times, Banking Theory has been considered in the context of medical education. It is true that much of the foundational content in medical school curricula deals with a specific body of knowledge that is critical to impart. Building upon this, proponents of Freire also assert that it is critical in medical education to train students to have a deep understanding of the culture surrounding medicine as well as a commitment to supporting the humanity of all people. In Problem-Posing Education, teachers should lead by facilitating discussions and providing support, and should contribute information only after group dialogue takes place. In this way, educators empower learners and consolidate knowledge from shared experiences in order to translate and apply content to the real world. This approach lends itself in particular to medical school formats such as problem-based learning, and topics such as community health.
Other examples of where this theory might apply in both the classroom & clinical setting
The Banking Model of imparting foundational medical knowledge is commonly seen in the first two years of medical school curricula, where an instructor is tasked with imparting a collection of facts in a time-constrained lecture format. In a push to combat this traditional approach, many schools are now adopting more innovative techniques such as problem-based learning.
Much knowledge and experience is also gained during residency training. Banking Model’s converse, Problem-Posing Education, is more frequently employed in the graduate medical education setting. Examples of forums allowing for lively discussion and shared knowledge include morning report, small group discussions during resident conference, bedside teaching, and on-the-fly discussions amongst residents and attending physicians.
Annotated Bibliography of Key Papers
Freire, P. Pedagogy of the Oppressed. 
This is Freire’s original text in which he outlines the 10 defining features of the Banking Model of Education:
- The teacher teaches while the students are taught.
- The teacher knows everything while the students are ignorant.
- The teacher thinks while the students are thought about.
- The teacher narrates and the students listen.
- The teacher disciplines and the students are disciplined.
- The teacher chooses and the students comply.
- The teacher acts and the students observe.
- The teacher sets the curriculum and the students adapt to it.
- The teacher claims authority to oppress the students.
- The teacher is the subject while the students are objects
Drew, C. The Banking Model of Education: Pros and Cons. 
The Banking Model of Education is a metaphor in which students are viewed as passive vessels in which teachers deposit knowledge. The opposite of this model is Problem-Posing Education, in which students learn with and from each other in problem-oriented exercises. This resource describes the advantages and disadvantages of Banking Theory.
Shor, I. Freire for the Classroom: A Sourcebook for Liberatory Teaching. 
This book is an anthology of essays written by teachers on the application of Freire’s methods to classroom teaching. The essays in the book describe the creative practices employed by teachers as well as benefits to students as a result of applying Freire’s
DasGupta, S., Fornari, A., Geer, K. et al. Medical Education for Social Justice: Paulo Freire Revisited. 
This publication frames the work of Freire in the context of incorporating social justice curricula in medical education. The authors posit that Freire’s non-hierarchical strategies can foster socially conscious medical professionals who are engaged in their communities.
Torre D., et al. Freire’s view of a progressive and humanistic education: implications for medical education. 
This article highlights the importance of Freire’s model to medical education, and posits that Freire’s approach: 1) supports many underpinnings in medical education such as problem-based learning; 2) encourages educators to confront the tension between teaching for conformity and preparation of future physicians to question existing assumptions; and, 3) encourages the expansion of traditional approaches to medical education.
Some students need the structure and may learn best in a banking model, especially those in the beginning of their students who are learning frameworks and foundations. These students do not yet know enough to question or engage. Some concepts also lend themselves to direct instruction such as safety precautions in a laboratory or how to fill out a death certificate. Careful and direct instruction is necessary to avoid fatal errors.
Part 3: The Denouement
After multiple classes in her first semester seemed to be structured the same way, Sarah had enough. She was not learning anything new and felt herself slowly disengaging from the classroom to the point where she was no longer showing up to class. Sarah decided to do something about it. She made an appointment and spoke to her professor.
At her meeting, Sarah discussed her disappointment in the classroom structure. She made it clear that she had a lot more to add than sitting and taking notes in the back of the class. Her professor listened intently and, together, they made some changes. They instituted small group learning. Instead of the lecture- style classroom, the entire class was split into groups of 10 people. Each group was given a topic with a question to answer. Each group was in charge of researching their idea and formulating a series of solutions to present to the class next week. Each team member was asked to contribute, engaging all players on the team. Sarah was able to use her prior experience from her master’s program to help her team. In return, she was able to learn from her team mates who were each able to bring something unique to the group due to their varied past experience.
Don’t miss the second post in the series, coming out Tuesday, June 29, 2021!
PLEASE ADD YOUR PEER REVIEW IN THE COMMENTS SECTION BELOW
1. Freire, P. (1970). Pedagogy of the Oppressed. New York: Continuum.
2. Drew, C. (2021) The ‘Banking’ Model of Education – Pros & Cons. Helpful Professor, 28 Apr. 2021, helpfulprofessor.com/banking-model/.
3. Shor, I. (1987). Freire for the Classroom: A Sourcebook for Liberatory Teaching. New Hampshire: Heinemann Educational Books.
4. DasGupta, S., Fornari, A., Geer, K. et al. (2006) Medical Education for Social Justice: Paulo Freire Revisited. J Med Humanit 27, 245–251 (2006). https://doi.org/10.1007/s10912-006-9021-x
5. Torre D, Groce V, Gunderman R, , et al. (2017) Freire’s view of a progressive and humanistic education: Implications for medical education. MedEdPublish, 6, , 5.
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