The New Era of Healthcare in the Digital Age: Medical School Curricula

The rapid change in how medicine is being conducted in clinical practice is largely driven by the introduction of new healthcare technologies as well as their implementation since the pandemic. [1,2] This has consequently had an impact on the way medical education is delivered, making it imperative to prepare the incoming workforce to integrate digital technologies into daily practice.3 Incorporating digital competencies into the curriculum such as medico-legal and ethical aspects of using these technologies in addition to how to use them in a clinical setting is very important.4

Already, there have been numerous advances in healthcare technologies that have the capacity to revolutionize the way medical school content is taught. For example, just a few years ago, a UK teaching surgeon, Dr Shafi Ahmed, livestreamed an operation using Snapchat spectacles; these are sunglasses that have an integrated small camera, enabling the wearer to record what they are seeing.5 He had performed a routine hernia repair, and clips from the procedure were posted to Snapchat, a digital platform. The surgeon expressed his rationale, explaining his interest in using cutting-edge and relatively low-cost technology to teach people globally, reaching areas that do not have the same high standard in medical education. 

There has also been considerable research conducted on the use of virtual patients (VPs)  in medical school, and has already been implemented in some medical schools.  Research has shown that VPs provide an opportunity for students to engage in clinical content and improve clinical reasoning.6 A study conducted in the UK aimed to assess the overall opinions of 2nd year graduate-entry medical students on the use of VPs.7 Many were optimistic due to the impression of feeling like a doctor looking after a real patient. Results also indicated that more than half of the participants completed over 75% of the VP content, suggesting they are a useful learning aid.7 However, there are still limitations to their use such as how to optimize the creation of VP cases so that they are interactive and deliver course content effectively.

Telemedicine is rapidly becoming a component of healthcare delivery, yet not many medical schools offer training to students on its use before entering the workforce.8 A study in the US implemented a telemedicine OSCE (TeleOSCE) simulation to allow medical students to practice this type of patient interaction.[9] The students were asked to address a case of a patient with depression in a medically underserved area. Upon completion, they received immediate feedback and then evaluated their experience using a survey. Overall, the feedback was positive, with the overall quality of the experience being rated 7.59 out of 10.9 The use of TeleOSCE provides students exposure to the concepts of telehealth, to evaluate clinical and diagnostic reasoning skills of remote and rural learners, as well as to engage with remote and rural faculty wanting to teach. There are still limitations related to its successful implementation, such as cost and the fact that some learners and faculty may find it hard to adapt to the usage of technology.[9] 

It is evident that the introduction of healthcare technologies has already prompted for its implementation into the medical school curricula. As more and more research emerges evaluating their use and how their use can be optimized in a teaching setting, digital healthcare technologies training will be without a doubt a component of medical school curricula everywhere. 

References:

1. Machleid F, Kaczmarczyk R, Johann D, Balčiūnas J, Atienza-Carbonell B, von Maltzahn F, et al. Perceptions of digital health education among European Medical Students: Mixed Methods Survey. Journal of Medical Internet Research. 2020;22(8). 
2. Wood EA, Ange BL, Miller DD. Are we ready to integrate artificial intelligence literacy into medical school curriculum: Students and Faculty Survey. Journal of Medical Education and Curricular Development. 2021;8:238212052110240. 
3. Foadi N, Koop C, Mikuteit M, Paulmann V, Steffens S, Behrends M. Defining learning outcomes as a prerequisite of implementing a longitudinal and transdisciplinary curriculum with regard to digital competencies at Hannover Medical School. Journal of Medical Education and Curricular Development. 2021;8:238212052110283. 
4. Zainal H, Xin X, Thumboo J, Fong KY. Medical School Curriculum in the digital age: Perspectives of Clinical Educators and Teachers. BMC Medical Education. 2022;22(1). 
5. Snapchat spectacles worn by UK surgeon while operating [Internet]. BBC News. BBC; 2016 [cited 2023Mar19]. Available from: https://www.bbc.com/news/technology-38314539 
6. Poulton T, Conradi E, Kavia S, Round J, Hilton S. The replacement of ‘paper’ cases by interactive online virtual patients in problem-based learning. Medical Teacher. 2009;31(8):752–8. 
7. Dale MacLaine T, Juengst C, Harris D, Fenn C, Gabathuler H, Davies S. The (future) doctor will see you now: Piloting a longitudinal virtual patient in medical education, simulating general practice. Medical Teacher. 2020;43(4):472–4. 
8. Nesbitt TS, Dharmar M, Katz-Bell J, Hartvigsen G, Marcin JP. Telehealth at UC Davis—a 20-Year experience. Telemedicine and e-Health. 2013;19(5):357–62. 
9. The Children’s Hospital of Philadelphia. Premature rupture of membranes (prom)/preterm premature rupture of membranes (PPROM) [Internet]. Children’s Hospital of Philadelphia. The Children’s Hospital of Philadelphia; 2014 [cited 2023Mar14]. Available from: https://www.chop.edu/conditions-diseases/premature-rupture-membranes-prompreterm-premature-rupture-membranes-pprom#:~:text=A%20significant%20risk%20of%20PPROM,dangerous%20for%20mother%20and%20baby.