Tag Archives: technology

Some reflections on medical education at the end of a plague year


A year ago I was in the UK.  Some years the cycles repeat themselves like ecclesiastical dates or  “terms” in the academic year but, sometimes, something happens and nothing is ever quite the same again.  I’m sure the daffodils are flowering again in Finsbury Park but medical practice and education are still in a state of flux.

This post was part written at the end of August and, like many things in this year of Covid, it got postponed.  August was an upside-down month for me.  My usual August for the last few years has involved attending the Edinburgh Fringe Festival (where my daughter performs) followed later by an event with a different vibe – the AMEE conference somewhere in Europe.  So, there I was with no presentation to prepare, saving money by registering online and hoping the technology worked.  I saw a few interesting sessions and came across some relevant online posters when browsing but the vibe was certainly different.  A few months later saw me having to change a 1.5 hour workshop at another European conference into a 45 minute presentation.  Not sure if anyone saw it.

I was indeed fortunate to continue being involved with writing and delivering some online modules for a Certificate in Clinical Teaching and Supervision during the year and I was able to do that from home.  Currently these can be found at https://bit.ly/3detS5S  and the twitter link is ModulesInClinicalTeaching @GPCertModules  The last module was on e-learning and teaching.  Later in the year we started some online live webinars – so a few new skills acquired!  Those deadlines provided some structure.   In fact the third Zoom online, on the topic of Feedback, is happening on March 9th (more information at gpcertificate@newcastle.edu.au).

In between, I read a lot, ensured I did more daily walks than usual and set myself some drawing projects.

What is happening to education and training in the glow of corona?  I guess the answer to that is not yet complete, it’s not the same in every country and probably will continue to change, depending on what is happening in each country regarding Covid-19 (and now the vaccinations).

This year has revealed (in Australia) the significance and extent of casualisation in Universities.  One might speculate in what ways this influences the quality of education, training and the morale of teachers and researchers.  It’s an issue that won’t go away but may eventually become unquestioned and something to just “live with” (as some say), but perhaps it warrants a few minutes’ thought.  Moving from face-to-face to online is different from moving distance learning to online.  At many levels the effect of the virus has been unequal and the enormous work of changing courses to online at short notice also fell unequally.  Of course, let’s not forget that more workers in the arts sector also lost their jobs and, for some, their careers in one fell swoop.

We all knew that we were moving slowly toward more online and less personal contact but this suddenly accelerated and I reflected on educational aspects of that in my last post in May.  It’s had its challenges but it’s also been interesting.  There will no doubt be lots of presentations at next year’s medical education conferences about what worked and what didn’t.  As educators we are hopefully moving from getting it done, to doing it well (but what are we measuring?)  There are lots of “tech” things happening and that provides opportunities to some.

We changed our ways of engaging and communicating and some words and phrases got used a lot more frequently or developed different meanings: zooming, you’re muted, podcasts, WhatsApp it, virtual conferencing, breakout rooms, asynchronous webinars etc.

Other training organisations were already losing funding in many instances, and is it possible that online training may be seen as a panacea, not just to the viral context but to the economic context?  However, it is not often acknowledged that to do online “well” is not necessarily cheaper.

Will education be changed for good (or for the better)?  Will we reassess the place of interaction and the interpersonal in health professional education – but also in the area of health care generally?

I have no answers to any of this but I confidently predict some interesting PhDs and books in the coming years.

Going viral: some lockdown thoughts on e-learning

And apologies for the overused pun in the title. When I recently returned from the UK it seemed like there wasn’t much to say on medical education at the moment.  Suddenly life and death issues were raising their heads instead.  At the time Covid-19 started to flare up I was on my way to the UK to help out with grandkids.  This suddenly became more complicated.  With family there involved at the scary front line of the NHS and the numbers predicted to rise, it suddenly began to dominate our thoughts even further.  So much so that we were persuaded to return to Australia ten days early in the expectation that things would be better here for someone in a relatively high-risk category.  The weekend we left, the reported deaths in the UK numbered 10 and within a month were in the thousands.  The rest is history – still in the making.

When we got back – to self-isolation – I noted GPs getting themselves organised for the predicted onslaught with discussions about sourcing protective equipment and changing over to telephone or video consultations.  Within not too long a time the government gave this their imprimatur when they came up with a medicare item number for telephone consultations.  Suddenly they were “a thing”.   Meanwhile my university colleagues (in all faculties) were suddenly under the pump to change everything over to “online” in an incredibly short time frame as rules for social distancing, group gatherings and working-from-home came into effect.  I will not be attending AMEE in Glasgow this year, sadly.

Just now we all have a very volatile work and social situation which is very different from country to country and with negative economic implications still developing world-wide.

Meanwhile I was still working on the (already online) CPD modules for the Certificate in Clinical Teaching and Supervision (general practice) for which most modules had been uploaded on Open Blackboard.  All my social interactions turned into Zoom get-togethers.  As the weeks progressed and the country’s response seemed to have worked (as I write) in holding Covid numbers down, some GP colleagues actually noted practices being quieter as patients stayed away – no doubt a temporary hiatus as other presentations can no longer be deferred.  But there is talk about General Practice itself having changed for the future and who knows for the tertiary education sector. So, it was suggested we add a tenth module on “e-learning” (instead of leaving it as a parenthesis in some previous modules).

Thus, I have been pondering and reading the (not very extensive and not always very current) literature around the topic and here is my current, unfinished list of thoughts and queries which I’m sure will start being addressed by the next generation of educators

  • When we have sessions on “consultation skills” in the future we will have to have one also on the subset of “telephone consultation skills” and “video consultation skills”.
  • When we think about presentation skills and running small groups we may be adding in “Zoom Skills”.
  • We are well versed in some important pedagogical skills for medical education but how are these being put into practice in the online environment?
  • The move to “online” had been already happening – often with the managerial impetus of cost efficiency rather than educational value – but suddenly it has accelerated and become all pervasive and we are not all necessarily up to speed. There is little spare time to acquire the skills and management need to consider their responsibilities in this regard.
  • On the other hand, it will no longer be OK to be proud of being an eccentric Luddite, not knowing how to switch your computer on, how to download an app or the name of the latest social platform used by your students. The gap between teacher and student may widen.
  • Many of us subscribed to a view that education is emphatically interpersonal. How does that stand up now?  Previously we had perhaps turned to Blended Learning to make up in some areas for the growing lack of interaction in others.
  • On the other hand, let’s face it, not all lecturers related to their students, even in the “good old days”. So, let’s not idealise it and let’s move on to how we can interact in the brave new world.
  • A more generic Covid related educational issue that has come up (to which my husband alerted me) is the whole issue of health messaging to populations (with evidence from different countries, or even states, with different systems, cultures and politics) and by extension communicating with and educating of patients.
  • It will be nice to have some evaluation of what is actually effective in the new environment, not forgetting to research the actual experiences and wellbeing of learners and teachers.
  • Online learning is an interesting area where we need to apply some basic and long-standing principles with which we are very familiar to what is a very changed environment – a constantly changing context of tools, resources, platforms, apps, connectivity etc
  • A bigger challenge may lie in the previously expanding area of work-based learning especially in the community. This will be particularly in question for undergraduate health professional students, depending on what happens re Covid-19 in the near future with its implications for safety.
  • There are exciting ways to utilise technology to enhance education but this is likely to still be constrained by bureaucracy
  • Meanwhile we also need to not fall into the trap of being driven completely by the technology where we only value what can be measured in the newly constricted context or where any innovation is responded to with a “computer says no”.

I’m sure we will all think of a few more points over the coming days and months.