Earlier this year as communities braced for the impact of COVID-19, many aspects of our lives – the way we do our jobs, learn, and interact with each other – were altered in some way. As we begin to navigate reopening, many institutions are examining if those alterations have a place in future strategy.
Businesses have discovered the convenience, employee satisfaction, and economic benefits of operating virtually, churches have instituted drive-by communion and virtual services, and perhaps most impactfully, our entire education system is seemingly online. At MedHub, we constantly look toward the future of medical education, yet rarely has a shift happened so quickly and with such need. This leads us to consider what medical education will look like going forward.
The traditional high-touch nature of medicine doesn’t lend itself to a virtual or work from home model, and given that training should reflect the actual practice environment, what will formal education look like for our future doctors? How will our practicing physicians complete their continuing education requirements?
In visiting with educators and providers across specialties, and various stages of medical education, the general consensus seems to be that while some educational aspects will revert to pre-pandemic status quo, others could likely change a good bit. We see five key trends.
The best of both worlds – a blended learning approach
Education for the medical student has typically consisted of classroom/lecture and lab experiences, with increasing levels of patient care and responsibility. Given social distancing guidelines and the fact that medical students have been restricted from clinical rotations, traditional training has been upended. Organizations such as the American Medical Association and medical schools have attempted to fill the void, with online study modules from the former, and increased use of options like telehealth and simulation from the latter¹.
Technology workarounds aside, Karen Shackelford, MD, emergency physician and medical director of BoardVitals, believes this is one area that will quickly revert to status quo as soon as practical. Her view as a physician and educator is that the patient experience continuum – observing and understanding the disease process, asking and answering questions at the bedside, diagnoses – is an integral part of learning to become a doctor.
Experts believe there will be increased use of, and enhancements to, online learning – more sophisticated simulations with better interaction for heightened engagement and more effective overall learning experience. Small team-based learning in an online, interactive environment has proven to lend itself to collaboration and may in fact be used more robustly going forward.
For the attending or practicing provider, continuing education has also been turned on its head. Large-event-type meetings and Academy annual meetings where a physician could quickly fulfill nearly all their annual CME credits have been canceled, as have many other educational opportunities such as grand rounds, society meetings, in-service lunches, and others. When and if major domestic or international forums return, they could be on a smaller scale, with a shift toward more intimate and for some attendees, more manageable, agendas. This may better meet the needs of those who find smaller, more personalized learning environments more conducive to learning and retaining important information than large, conference-based education. The trend away from large scale continuing education events toward hyper personal is further supported by the use of convenient apps, podcasts, videos, and online simulation, which were on the rise before March and have been merely accelerated during the pandemic. We consistently hear from providers that the ability to easily access “digestible” bits of content is important, so we expect a growth in phone or tablet apps to access question banks and other “quick-hit” modalities.
Reactive to Proactive – The shift from emergency remote learning to planned online offerings
Online learning has been steadily growing across the higher ed sector. Federal data revealed that more than a third of all 2018 college and university students took at least one online class². By March of this year, that growth exploded as academic institutions, including medical schools, were scrambling to shift to an online model that would accommodate class sizes while meeting privacy and security concerns. It’s important to note that while the quick response has been laudable, we shouldn’t confuse this reactive jump to virtual learning with the strategic implementation of carefully architected online learning.
In the coming academic terms, we will see an increase in a more strategic use of online learning and a focus on improvements in learning environments aimed at more effectively engaging students, assessing them against measurable outcomes, and responding to individual learner needs.
From CPR Annie to AI-powered interactions, technology continues its march
A recent research³ article on the use of technology in medical education after the pandemic asserts a combination of face-to-face and technology-based learning will most likely characterize the future of medical education. It also predicts a greater use of emerging technology such as artificial intelligence and virtual reality. Over time we’ve seen a surge in advances in the types of innovation in online simulation and case studies consistent with the research predictions.
Case studies with online simulations designed to build skills as diverse as having difficult patient conversations to making complex diagnoses, are becoming increasingly sophisticated, with an eye toward making the simulation as near to real-life experience as possible. Case studies and clinical vignettes are effective tools in medical education and we can expect enhancements to keep learners engaged, offer real-time feedback, identify areas of weakness, and even foster some healthy competition with performance comparisons to colleagues and leaderboards.
Finally, some providers see continuing opportunities in practices such as continued virtual rounding to augment in person, as it allows students to participate from far away and leverages the previously untapped power of crowdsourcing for patient care5.
Smile, you’re on camera – the rise of telehealth
The era of virtual visit has been coming for some time. Although not technically an area of medical education, this new style of patient engagement will drive some unique learning needs for providers. With the right technology, and sufficient internet bandwidth, a virtual visit can be convenient and timesaving for both patient and physician. However, physicians will need to learn a range of new social and medical skills. Physicians will need to re-think how they introduce themselves, how they conduct the exams, the questions they ask and the red flags to look for as they work to connect with and engage their patient.
Continued innovation and sharing best practices
The pandemic has generated collaboration and ad hoc efforts to help continue education for the nation’s medical students. Anecdotally, we’re hearing of thought leaders in various specialties filling the clinical void to provide video lectures. Partners across Ascend Clinical Healthcare including NHA Health Careers offered free access to learning modules to MedHub clients earlier this year. Beyond the businesses, individuals have been working to craft a community without face-to-face interaction #MedTwitter and clinical professional Facebook groups create spaces to communicate, collaborate, and network. We’re hopeful this continues.
¹ Medical schools adapt to COVID-19 pandemic posted in Healio News, May 6,2020, by Erin Michael
²Online Enrollments Grow, but Pace Slows, Inside Higher Ed, Dec. 11, 2019, by Doug Lederman
³ A vision of the use of technology in medical education after the COVID-19 pandemic, published Mar. 26, 2020, by Poh-Sun Goh and John Sandars
4 No classrooms, no clinics: Medical education during a pandemic, AAMC.org, posted April 15, 2020, by Stacy Weiner