We are in a period of unprecedented disruptions – the COVID-19 pandemic has challenged our sense of normality. Lockdowns aimed at ‘flattening’ the curve impact our lives, including the delivery of medical education in WA.
Last year, lectures stopped, clinical placements and examinations were disrupted. Distress and anxiety percolated throughout medical schools, hospitals, general practices and postgraduate trainees. A drastic reduction in elective surgery and routine work limited customary hands-on clinical learning opportunities.
The switch to digital engagement models (e.g. telehealth, online learning) resulted in upskilling by clinicians to manage remote patient demands and focusing on the adoption of alternative working models but less time to teach in clinical placements and supervise trainees.
This year affords an opportunity to review and reconsider our previous ways of working. Online learning is not novel. However, with the COVID-19 pandemic, we rapidly moved towards exclusive online teaching, assessment delivery, clinical video teaching visits and examination delivery. Many students and trainees were able to return home (interstate) to be with their families, continuing to learn via live-streamed case studies and clinical discussions.
Studies show online learning allows us to break space and time boundaries. It improves collaborative and individualised learning effectiveness and is more convenient. An advantage is the ability for students to learn at their own pace and provide ‘caption’ texts for learners who may have learning difficulties (e.g. hearing impairment).
Extra time is available through online activities allowing students to think about concepts critically and gain a deeper understanding. Those who may shy away from asking questions in face-to-face lectures can digitally engage, which encourages active learning and participation.
The pandemic experience has also highlighted the importance of ‘community’ and ‘human interaction’ in medical education. A major drawback of online education felt by many students and trainees is disconnection from peers. Some feel daunted by the tech-savviness necessary for online study, technical platform failings and the blurred lines between our professional and personal lives.
Valid questions are emerging about the effectiveness of teaching ‘clinical reasoning’ and ‘clinical competence’ online. Case-based discussions (an effective clinical reasoning teaching approach) have been used to deliver curriculum. Nevertheless, student learning styles play a vital role to enable effective and impactful online delivery.
Certain aspects of medical education (e.g. clinical examinations, sharpening clinical acumen, procedural skills, interpersonal skills and communication style) are not easily substituted by online tools and methods.
The pandemic has prompted us to rapidly evolve blended learning – characterised by a combination of synchronous face-to-face teaching and online (asynchronous) education. This can have a positive effect on learning compared to the traditional methods. Academic results have shown it to be just as effective. Use of virtual patients enable trainees to gain clinical reasoning skills before their bedside learning and also has a positive impact on skills training and problem solving when direct patient contact is not possible.
Synchronous models of learning require the student and educator to be at the same place at the same time. Asynchronous models are not bound by time or place. Students can access the course/event at their convenience.
This pandemic has taught us that we can utilise a sophisticated model combining both online learning and real-time engagement (e.g. live chat questions in lectures or webinars, polling questions for small group teaching, synchronous conferencing techniques with small breakout rooms).
COVID-19 has only hastened this evolution in medical education. Harnessing the power of digital technology combined with face-to-face teaching is likely to be the effective learning model in medical education moving forward.
Author competing interests – nil