The current education climate and the impact of technology on education
Could you tell me a bit about how your medical education solutions work?
The medical and nursing solutions that we have address two fundamental issues that students have: information overload: the vast amount of information that medical students need to absorb, and the need to understand their own learning: what do they know, what don’t they know, how much more work do they need to do to fully understand a topic. These are the problems that our solutions address, which is how I prefer to think about it, rather than how they work. What is it that the solutions do for students?
Why are global education initiatives like this so important in the current climate?
I interpret the current climate to essentially mean that in the next 30 years the aging population will grow and the number of people available to manage that aging population will decline, so there will be a resource problem. There is also the problem that people are living longer, and as they are living longer, they are developing multiple overlapping illnesses, and those require different treatments. Historically a person would suffer from one illness, whereas now a person may suffer from three different illnesses simultaneously which creates a different set of problems for doctors. Finally, I think that patients are emerging from being objects of treatment to a partner in treatment, and therefore doctors are having to learn how to work with patients rather than on patients. In this climate, global educational initiatives are helpful in that it is possible to reach more people, more cost-effectively, it is possible to tailor information to the specific needs of specific countries and patient groups, in a way that physical textbooks were less well-suited to. Through simulation and through interactive learning materials you can bring students closer to the clinical experience sooner, and to the decision making that they need to make.
Half the students who took place during Elsevier Hacks, a 2017 medical education event which took place in Helsinki alongside the 2017 Annual Medical Education in Europe Conference (AMEE), wanted to solve the problem of classroom to clinic anxiety. Digital technology seems very well-suited to that ‘at the point of care’, ‘at the point of need’ tool in a way that you can’t carry a suitcase of all your favourite textbooks around and flick through them to find the answer.
Do you think tech has helped form a learn-anywhere culture and what impact does this have on learners/citizens?
The mobile phone is now the ubiquitous device and is hugely powerful and connected. There’s a lot of talk about being able to ‘offload learning onto the device’. I think we should be careful about that, because it’s hard educationally to tease out the impact of knowing those things - those things being the architecture of your understanding - and the impact that has. I have a suspicion that that time spent on task, on memorisation, creates other associated knowledge. You still need to learn the material in order to understand the answers. Technology can provide you with the answers, but it cannot replace the knowledge you gain from time spent studying.
How is tech addressing cultural boundaries in learning and what results are you seeing?
I think there are two answers for this question: one for medical education for doctors, and one for nursing. What we find when talking to medical students around the world, is that their goals and aspirations are remarkably similar. Medical students around the world are very much the same. The notion of cultural difference is less applicable, it doesn’t stand out as much. Clearly there are cultural differences between patients that doctors need to respect, but the doctors themselves tend to be very similar. As doctors engage more with patients as partners, understanding the cultural difference of their patients is important, but the cultural difference in their learning is less obvious.
Nursing, however, is very different. The cultural status of nurses varies widely around the world. In many Western countries becoming a nurse is an aspirational, socially mobile career choice and is held in high regard. People have huge respect for nurses. But in other cultures that isn’t the case; nursing doesn’t have the same status, and therefore the education that is associated with it aligns with the cultural status of the people being taught, regardless of the value of the task.
We believe there is a global medical education culture, it’s less clear that there’s a global nursing culture.
What does a truly global education look like?
I do believe global medical education is possible, I think it’s a matter of sensitivity and degree. There is a common core of medical practice, medical conditions, patient concerns, people are afraid of illness around the world, people want the best things for their loved ones. All of those things are the same around the world, and so the world into which doctors go is very similar. There are differences, but undoubtably a doctor standing by the bedside of someone terminally ill, wherever they are in the world, is participating in the same set of emotions and skills and they’re bringing their skills to bear in the same way. Because that is the end point, the education that enables that person to do the best thing, has to have very similar elements. I don’t think an Indian doctor standing behind someone’s bed is materially different in what they’re trying to do for that patient than a Chinese doctor, or a doctor from Bulgaria: they’re all trying to do the same thing, and therefore their education is providing them tools to do that.
Can it even exist?
Yes, and it should exist. There is a body of evidence about medical practice and best results, and all patients around the world deserve to be served by those best practices.
eProduct Director, Education EMEALAAP, Elsevier
David has spent the last sixteen years in e-product development and management in the higher education sector. Prior to working at Elsevier, David managed the Mastering platform, an innovative adaptive higher education science learning and assessment platform.
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