Peer Review

Scientific Thinking, Integrative Reasoning Skills, and the New MCAT

This issue of Peer Review reflects the vision and efforts of several colleagues who recognized that AAC&U members would be eager to learn more about the significant changes in the design of the Medical College Admission Test (MCAT). With the generous support of the Howard Hughes Medical Institute, we have been able to commission an interesting and timely collection of articles; we have also been given the opportunity to reach beyond our normal circles and engage a broader audience of educators who have not, perhaps, had regular occasion to think about the connections among preparation for graduate education, employment in a wide variety of health professions, and the current state of undergraduate liberal education.

Significant changes in the MCAT were announced at the Association of American Medical Colleges (AAMC) annual meeting in November 2011 and were finalized by the AAMC Board of Directors in February 2012. Among the review committee recommendations are to

  • Add biochemistry to the physics and chemistry component of the examination
  • Add cellular and molecular biology to the biology examination
  • Add a behavioral and social sciences component—tentatively called the Psychological, Social, and Biological Foundations of Behavior
  • Integrate a new Scientific Inquiry and Reasoning Skills (SIRS) framework into the two natural sciences components as well as the new behavioral and social sciences component

More broadly, the review committee recommends that the MCAT focus more on learning outcomes and competencies than on specific course content. In fact, even as they recommend that new subject areas be included in the examination, the committee does not recommend increasing the number of credit hours that students need to complete.

These changes in the MCAT reinforce for the authors in this issue and for AAC&U an already urgent need for significant curricular revision in these fields, especially to focus more on competencies within lower-division prehealth coursework. The authors suggest strongly that the MCAT revision marks a once-in-a-generation opportunity to break through some of the disciplinary rigidity that has come to characterize prehealth education—a rigidity that has been linked to high levels of attrition from science courses/departments and to complaints by graduate programs that undergraduate students have not been encouraged to make creative connections between and across disciplines and divisions.

In the context of health professions and the study of issues related to health, in particular, such graduates need to be able to

  • Use scientific reasoning to gather and evaluate evidence
  • Understand how scientific and social science studies are designed and executed and recognize the implications of design choices
  • Use statistical reasoning to evaluate data and use data to communicate effectively
  • Base decisions on analysis of evidence, logic, and ethic

AAC&U is delighted to announce a new project that targets these skills. Expanding on AAMC’s new SIRS framework, AAC&U’s Scientific Thinking and Integrative Reasoning Skills (STIRS) project will help leaders across all sectors of higher education foster scientific thinking as a way to intentionally integrate knowledge, skills, and action across the undergraduate experience and through the widest array of disciplines. Over the course of the next two years, the STIRS framework will inform a national conversation and will provide coherence to the development of case studies, course modules, sample first-year seminars, integrative learning assignments, and other curricular models that integrate evidence-based thinking across general education and into the major. These resources will be developed and tested at all types of institutions, peer reviewed, and shared nationally through AAC&U’s meetings and publications. STIRS Scholars—named and rewarded for excellence in this important curricular arena—will provide additional leadership to an emerging community of practice. Please see Richard Riegelman’s article on page 10 of this issue for additional details of the STIRS project. STIRS will be led by staff in AAC&U’s Office of Integrative Liberal Learning and the Global Commons; to get involved, please contact Kevin Hovland at

I would like to conclude by situating this project in the context of some broad observations I made during recent strategic planning conversations across AAC&U and PKAL.

  • Many of the changes AAC&U seeks to advance (for example, more intentional, integrative learning; hands-on, problem-centered inquiry and research; and global, civic and ethical responsibility) can be effectively illustrated in the context of STEM teaching and learning. The MCAT revision is an important example in an arena widely seen as crucial to America’s future. We should take advantage of all such opportunities to make STEM a an exemplary site for demonstrating the value of liberal education to professional excellence.
  • Even as STEM and medical education are the focus of intense reform attention, the assault on the humanities and many of the social sciences continues apace. It is critical that we underscore the connections between the full range of the liberal arts and sciences and students’ capacities to make reasoned judgments about public issues. I sincerely hope that AAC&U’s STIRS project will be the first of many proactive efforts to revitalize the liberal arts and sciences disciplines, both as fields of study and as component elements in general education.
  • AAC&U’s vision for robust liberal education, civic learning, global learning, and STEM learning requires a coherent and vibrant general education. While that is not the primary goal of the MCAT revisions, it is a fundamental aim of the STIRS project. I hope that such efforts will encourage the new leadership we need to advance twenty-first-century designs for general education and to connect those designs with civic learning, global acumen, STEM proficiency, and illustrative problems we face as a society. Certainly, without strong foundations in scientific thinking and evidence-based reasoning, such designs will not be successful.

Time will tell if revision of the MCAT does, in fact, represent a once-in-a-generation opportunity. We can neither afford to waste any opportunity to improve undergraduate learning, nor view this opportunity as limited to certain disciplines or majors. Instead, we should recognize the common purpose that connects myriad generative and transformative change efforts I see every day as I visit AAC&U member campuses and attend meetings and conferences—efforts to create undergraduate learning opportunities that more closely match the complexity of big questions and the urgency of today’s challenges.

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