In higher education, student clinicians, pharmacists and nurses are in need for active practice. Practice that helps acquire real-world clinical expertise and workplace experiences. The clinical workplace learning, however, is inherently challenging as the healthcare environment and, hence, the curricular emphasis are rapidly changing. The spreading opportunities of patient care from traditional hospitals to lesser controlled community and home care practices; the digitalized health knowledge and records; the increasingly significant cost-cutting and the humanistic and societal needs, while upholding patient safety and clinical benefits; have all dictated that clinical education needs to provide, in a short period of time, a boosted level of long-term learning that goes beyond simple knowledge, into the skills, values and behavioral needs of patient care. Such explosion in competencies, added to an explosion in available knowledge - with over 600,000 yearly medical articles in literature, creates an exceptional need for innovative education that is also technological, seeing a fast integrating technology into care systems and that younger health students are digital citizens and anticipating matching styles of education.
Common technologies in clinical education
Online-assisted learning is common, such as flipped classrooms and the online-activities. Mobile devices to access resources for learning and decision-making are now vital, especially with the recently announced heavy investments by the technology giants Apple and Google in healthcare applications. Patient simulations are extensively used as well, for various educational goals, and they are becoming more and more human. The social media is increasingly recognized as another important educational tool in clinical practices. This is used to share and develop knowledge, including via creating virtual communities of practice. Other forms of teaching technologies were also reported in literature as successful, such as digital games and the Google Glass, which were recently incorporated into medical curricula as essential teaching clinical tools.
Challenges of technology in clinical education
The challenges for universities in developing and implementing the kind of technologies described above in classes are, beyond the traditional challenges of added cost: the digital literacy and equity, integrating formal and informal learning, the very fast changing technology, or the risk of dependence, such as on mobiles. Special to the clinical education, challenges relate to the need for convinced and motivated faculty members. Reluctance by faculty members can be the result of three main concerns:
While the use of handheld devices increases practitioners’ access to resources, it may also reduce their connectivity with people or lead to what could be considered ‘unprofessional’. The use of such devices among patients and co-workers needs to be sensible and within what is perceived as good manners. Also, the fact that devices have cameras and recorders, including access to social media, promotes worries by faculty members about trust and confidentiality with students.
With the online-based activities, learning is more and more being steered by the student, with the educator being now more of a guide. In clinical education, many argue that self-learning about a clinical condition cannot substitute the magic of hearing about it from experienced faculty members and practitioners, who hands-on managed it. It is therefore common in schools of clinical education that the online activities are mostly to augment class activities or to replace parts of the learning activities, but not to substitute them completely. Significant is the concern that online activities can be limited against the need for the increasingly important inter-professional education in health disciplines.
Faculty members in medical colleges are relatively highly busy, especially if in research universities. Assistant professors are rewarded on their teaching, publications, and funds. Full professors are expected to increasingly also add university and community services. This is all added to being active practitioners in clinical settings. It is highly likely, therefore, that faculty members will not find or risk time to lead or implement new technologies into their classes.
Deans and academic administrators, therefore, need to push their colleges forward by inspiring faculty members and adjusting rewards to those who leap forward. In the College of Pharmacy at Qatar University, for example, a special Technology and Teaching Committee was organized. This initially worked to create an archive of teaching technologies, before it was expanded to facilitate the use of several non-didactic methods and technology tools, organize development sessions of recent technologies and methods, and conduct research to assess and share experiences about the use and outcomes of different technologies used, such as learning management systems and the virtual reality lab.
Overall, despite challenges, the traditional higher clinical education is being disrupted, and institutions are aggressively adjusting their curricula. While the value of this depends on content and drive, technology is surely not only altering how to administer medicine, but it is also altering how to learn it. This, nonetheless, is in infancy still, with the best utilization of the technology varying upon how it is combined with other learning approaches.