Educational Technology is Changing Education of Health Professionals

Jonathan Daitch, Associate Provost for Online Education, Western University of Health Sciences and Jonathan Labovitz, DPM, FACFAS, CHCQM, Associate Dean, Clinical Education and Graduate Placement Professor, College of Podiatric Medicine at Western University of Health Sciences

Jonathan Daitch, Associate Provost for Online Education, Western University of Health Sciences and Jonathan Labovitz, DPM, FACFAS, CHCQM, Associate Dean, Clinical Education and Graduate Placement Professor, College of Podiatric Medicine at Western University of Health Sciences

1. How has the Education Technology landscape evolved over the years and what are the advantages of this evolution?

Educational technology has evolved from using established technology in education to developing technology designed for education. This distinction allows us to focus on the student as our customer to improve the student experience and improve the quality of the education as we concurrently give faculty multiple pedagogical options.

At Western University of Health Sciences College of Podiatric Medicine, we developed the Virtual Doctor’s Office (computerized standardized patients) and a virtual reality operating room to give students real-world experiences of increasing complexity in a safe environment. Contrary to the traditional lecture-based approach, these developments provide our faculty the opportunity to train podiatric medical students in medical and surgical management using real patient scenarios with attributes like gamification to enhance student engagement. In addition, this style of education moves medical education to a more objective, competency-based system, which can dramatically advance technical skills without exposing patients to the undue risks of being treated by inexperienced health professional students. Several studies demonstrate multiple types of simulation in advanced medical training improve outcomes with fewer medical errors.

We have also developed behavioral competencies within the clinical scenarios. For example, in our Virtual Doctor’s Office, we vary the race and ethnicity of the provider and the patient roles, and the patient’s goals, expectations, and cultural and/or religious beliefs are incorporated into clinical cases. Several scenarios involve socio-economic considerations, such as insurance restrictions and the legal ramifications of the care that students provide. This allows us to embed significant public health concerns into the content and assessment process, such as structural competencies, social disparities in health, and various behaviors.

One of the greatest benefits of this pedagogy is that the technology platform tracks every decision the student makes throughout the patient scenario. This allows faculty to hold group sessions to discuss each case while knowing where students deviated from medical care best practices. Teaching students clinical reasoning skills is at the foundation of medical education, yet we typically rely on indirectly teaching and assessing this critical process while observing student interactions with patients and through preceptor-student discussions. Tracking each decision in the order they occur, gives faculty a way to diagnose errors in clinical judgment in a safe environment.

In the future, I can see multiple types of simulation environments, from hands-on training to computer-based standardized patients to augmented and virtual reality, as we begin longitudinally assessing medical knowledge and skills, from the medical student to the practicing healthcare provider.

2. What are some of the considerations for developing new Education Technology solutions?

New education technology solutions require a partnership between subject matter experts (SMEs), who often are university faculty, and e-learning developers specializing in multimedia creation, game design, and computer programming. The development process requires an extensive period of discovery, during which faculty/SMEs must gain a general understanding of the process of building technology solutions, and during which developers need to obtain a basic understanding of the intended instruction or activity progression. Faculty is not expected to become programmers, and technology developers do not need deep knowledge of the underlying principles of the content. However, a basic mutual understanding is critical to the success of an e-learning technology project.

When embarking on a project of this nature, project sponsors must consider faculty availability. Oftentimes, the educational technology development process becomes a major time commitment and health education faculty are typically stretched thin with teaching, research, and clinical practice commitments. Their input includes: (1) defining the initial project scope and design blueprinting, (2) providing instructional and assessment content, (3) guiding technology designers during product development, and (4) testing, quality control, and feedback. Faculty will be pressed to spend substantial time on the project, usually on a tight timeline meant to contain costs associated with external creative and technical consultants.

Developing new educational technology solutions frequently involves substantial resources. Firstly, contractually, faculty might be due additional compensation for their time. Secondly, if a university has a full-time e-learning development team, the cost of new technology solutions might already be budgeted. Otherwise, there is likely a hefty price tag with utilizing freelance developers and technology vendors. And thirdly, there might be a need for immediate or long-term investment in hardware, software, or online services. It is therefore critical that the return on investment be considered prior to embark on an educational technology solution. This return might not be directly financial, but rather, an indirect gain such as improved student outcomes, enhancement of the learning experience, and reputation-building for the institution. Of course, all of these can indirectly lead to a financial return. Whatever the benefits are determined to be, college leadership should stand behind the commitment.

3. What are some challenges plaguing the Education Technology landscape and how can they is effectively mitigated?

The greatest challenge in healthcare educational technology remains the development of the technology itself. Therefore, as an example, we rely on electronic health records (EHR) designed for patient care, not for the medical student learning patient care or learning how to document patient encounters. The complexity of some EHR platforms and other technologies poses the same challenges making the faculty role more important, complex, and challenging than it needs to be. The simplest way to mitigate this obstacle involves faculty leading the charge. Instead of relying on established technology, faculty need to identify the need to educate students in a way that gets to the heart of their thought process, clinical reasoning, and decision-making to ensure that they understand and can apply the fundamentals to complex situations.

While an obvious and simple correction, it is wrought with challenges that plague all technological developments. The lack of resources needs to be addressed. For health education technology advancements to continue, we must commit to dedicated faculty time for collaboration with programmers and devote the necessary financial resources to ensure the completion of the project.

Summary

The educational technology advancements are changing how we educate health care professionals, and it will continue to be a positive change in the future if we strive to develop technology that maximizes patient safety and quality of care while optimizing the educational environment. This is best achieved using simulators that are developed for medical education, and not for healthcare delivery or other industries, and then simply applied to education. Innovative simulations will encourage critical thinking and multifaceted decision-making that prepares healthcare students to face similar scenarios in their professional careers.

Data collection and reporting of an individual student and cohort performance within these simulations will help faculty pinpoint areas of instruction, student understanding, or technology design requiring refinement. Thus, we create a continuous performance improvement cycle enhancing student outcomes and producing better prepared and more confident healthcare professionals.