Medicine

Using ICTS to improve medical education and training

Ashley Macleod, Memorial University of Newfoundland

Problem

There has been a noted decline in the number of students seeking to become medical practitioners in rural areas because of professional isolation (Palmer & Dodson, 2011). Because of this potential for isolation, it is essential for medical professionals to collaborate and discuss relevant current issues and cutting edge practices with experts and authorities beyond their inner circles (Manning & DeBakey, 2001). Also relevant in rural communities is that real life challenging diagnostic cases can be rare, depending upon the pool of patients which the student can access (Chen, Cheng, Weng, Chen & Lin, 2009). With regards to the aforementioned current issues and cutting edge practices, as hospitals and clinics continue to evolve, students who have only been trained to complete hardcopies of medical reports may find themselves unprepared for the reality of a present day health care environment (Curry, 2010).

In developing countries, it can be exceptionally difficult for medical students to access patients to complete the practical component of their training, as poor road conditions, long and severe winters and lack of public transportation are all limiting factors (Amarsaikhan, Lkhagvasuren, Oyun, & Batchuluun, 2007).  It can be problematic to accommodate a sizeable number of students in a hospital training area because access to patients willing to allow students to participate in their care is limited, thus restricting the contact time each individual learner can spend honing their craft (Nagunwa & Lwoga, 2012).  Often patient hesitancy to permit medical students to practice on them stems from the fact that the medical field can be a high risk, high stakes environment where novice student errors can potentially be life threatening to a patient (Curtis, DiazGranados & Feldman, 2012).  Exacerbating this situation the reality that duty hour restrictions have been implemented and students could be spread out over a large geographic area, causing problems with the scheduling of face to face, on the job evaluations (Olson, Mata & Koszalka, 2013).

Role of ICTs

One of the most substantial advantages of using innovative technology is the fact that students can repeatedly work on problems, diagnoses or skill sets until they get it correct (Chen, Cheng, Weng, Chen & Lin, 2009). Learning the subtle nuances of human anatomy have typically been acquired by studying cadavers but this learning can be improved upon by technology because while cadavers can be dissected only once, simulations allow for an infinite number of cuts and manipulations to be made while the student explores the body (John, 2007). Learning through technology is very useful for medical students, as access to materials is not limited by classroom availability but can be practiced at the learner’s convenience (Curran, Hoekman, Gulliver, Landells & Hatcher, 2000). Virtual environments provide trainers with a safe, controlled environment for students to refine their newly learned skills without the risk of serious injury or death to a vulnerable patient (Curtis, DiazGranados & Feldman, 2012). Virtual patients hold value for many medical students because they provide an avenue which promotes realism but takes away the stress of working on a sick or injured patient with rudimentary skills (Consorti, Mancuso, Nocioni, & Piccolo, 2012). For students who are not well versed in advanced computer technologies, such as those who reside in developing areas, introductory lessons at the preparatory level using commonly known programs, such as the basic functions of Microsoft Excel, can serve as a transition and/or review of computer assisted learning, while building and reinforcing computer skills before delving into complicated medical simulations (Singh, Siddiqui, Singh & Singh, 2010). Also of importance for those in developing areas lies in the fact that introducing more people to communication technology is paramount to advancing health care and overall social well-being, as “relevant medical education through telecommunication is perhaps related to increasing social welfare and the development of new health services” (Wang, 2008, p. 190). Information and communication technologies can help potential students recognize whether or not they are suited for a career as a medical professional by engaging young learners with interactive materials that can help them understand and appreciate the skills required to pursue their chosen profession (Tang, Maroothynaden & Kneebone, 2013). Also pertinent for post-secondary institutions is that utilizing information and communication technologies can allow colleges and universities to increase their intake of qualified candidates because instructors take on more of a facilitator role, as opposed to acting as providers of information (Nagunwa & Lwoga, 2012). With regards to continuing education, those in the medical field are lifelong learners and new communication technologies are allowing established physicians to create and maintain a database of current best practices in medicine, eliminating the likelihood of continuing antiquated methods (Manning & DeBakey, 2001).

Obstacles

In some underserved and rural areas, places that would benefit the most from information and communication technologies, high speed internet and other requirements to access the new learning resources are not readily available (Amarsaikhan, Lkhagvasuren, Oyun & Batchuluun, 2007). Another drawback to using new technologies in these rural areas is the possibility for students to become isolated or experience feelings of separation and withdrawal from their peer group because of an increased amount of virtual instruction (Palmer & Dodson, 2011). Sometimes, a simulated situation does not accurately reflect what would take place in a real hospital setting where patients do not always follow directions or experience unexpected changes in their condition (Chen, Cheng, Weng, Chen & Lin, 2009). Unlike a seasoned instructor, computer applications do not take prior knowledge into account and questioning techniques may be lacking to assess the learner’s genuine understanding of the scenario (Ng, Hall, Maier & Armstrong, 2002). Many instructors in the medical education field do not have a formal background in education and therefore appropriate methods of delivering this new content developed around information and communication technologies may not evolve as quickly as the material itself (Olson, Mata & Koszalka, 2013). Some trainers can only demonstrate or teach using the same methods that they were taught and believe correcting conventional, paper based assignments is easier than learning how to assess the results of a new computer application (Curry, 2010). As such, faculty members who are early adopters of technology embrace these new methods while more traditional instructors exhibit reluctance to use a new approach, creating an inconsistency in education depending upon the individual teacher’s preference for technology (Zayim, Yildirim & Saka, 2006).

Works cited

Amarsaikhan, D., Lkhagvasuren, T., Oyun, S., & Batchuluun, B. (2007). Online medical diagnosis and training in rural Mongolia. Distance Education, 28(2), 195-211.

Chen, L., Yuh-Ming Cheng, Sheng-Feng, W., Yong-Guo, C., & Chyi-Her Lin. (2009). Applications of a time sequence mechanism in the simulation cases of a web-based medical problem-based learning system. Journal of Educational Technology & Society, 12(1), 149-161.

Consorti, F., Mancuso, R., Nocioni, M., & Piccolo, A. (2012). Efficacy of virtual patients in medical education: A meta-analysis of randomized studies. Computers & Education, 59(3), 1001-1008.

Curran, V. R., Hoekman, T., Gulliver, W., Landells, I., & Hatcher, L. (2000). Web‐based continuing medical education (II): Evaluation study of computer‐mediated continuing medical education. Journal of Continuing Education in the Health Professions, 20(2), 106-119.

Curry, D. G. (2010). Selection and implementation of a simulated electronic medical record (EMR) in a nursing skills lab. Journal of Educational Technology Systems, 39(2), 213-218.

Curtis, M. T., DiazGranados, D., & Feldman, M. (2012). Judicious use of simulation technology in continuing medical education. Journal of Continuing Education in the Health Professions, 32(4), 255-260.

John, N. W. (2007). The impact of Web3D technologies on medical education and training. Computers & Education, 49(1), 19-31.

Nagunwa, T., & Lwoga, E. (2012). Developing eLearning technologies to implement competency based medical education: Experiences from Muhimbili University of Health and Allied Sciences. International Journal of Education and Development using Information and Communication Technology, 8(3), 7-21.

Ng, M. H., Hall, W., Maier, P., & Armstrong, R. (2002). The application and evaluation of adaptive hypermedia techniques in web-based medical education. Research in Learning Technology, 10(3).

Olson, B., Mata, M. & Koszalka, T.A. (2013). Implementing an online curriculum for medical education: Examining the critical factors for success. International Journal on E-Learning,12(2), 197-208.

Palmer, R., & Dodson, L. (2011). Distance learning in the cloud: Using 3G enabled mobile computing to support rural medical education. Journal of the Research Center for Educational Technology, 7(1), 106-116.

Singh, G., Siddiqui, K., Singh, M., & Singh, S. (2010). Modeling Mendel's Laws on Inheritance in Computational Biology and Medical Sciences. Journal of Educational Technology Systems, 39(1), 31-46.

Tang, J. J., Maroothynaden, J., & Kneebone, R. (2013). The role of medical simulation technologies for outreach activities in secondary school education: A workshop for prospective medical students. British Journal of Educational Technology, 44(5), E120-E126.

Wang, F. (2008). Valuation of online continuing medical education and telemedicine in Taiwan. Journal of Educational Technology & Society, 11(4), 190-198.

Zayim, N., Yildirim, S., & Saka, O. (2006). Technology adoption of medical faculty in teaching: Differentiating factors in adopter categories. Journal of Educational Technology & Society, 9(2).