Accessing New Technologies for Teaching and Intervention

Abstract

As clinicians we often argue that our effectiveness is enhanced by the interpersonal interactions and the direct contact that we have with clients and students. However, changes in the world economy and the social climate are placing stresses on health care and education, which require new approaches for delivery of service. Increasing numbers of elderly and infirm individuals have insufficient direct access to rehabilitation facilities or clinicians. In addition, there is a lack of funding for training new clinicians at universities, and it remains difficult to find faculty committed to teaching aspiring clinicians. All these factors impede public access to rehabilitation services. Despite the current limitations in funding and recruitment, current and future generations of students are increasingly comfortable in developing personal relationships through technology-supported social interactions. It is likely that this approach to interpersonal communication will transfer into the health care domain. The past decade has witnessed numerous exciting developments in technology that can be applied to rehabilitation in both clinical practice and teaching. A number of different therapeutic technologies are already available for use in clinics and classrooms, but the value of these programs is not always well defined. One of the main concerns is whether there is any value added by having these technological services conveyed from a distance. Clinicians and educators use a combination of verbal, visual, and physical interactions to deliver their content. Delivering equivalent interactions via technology presents significant obstacles; however, it also presents numerous opportunities to enhance the quality, consistency, and documentation of delivery2 New rehabilitation technologies may provide more responsive treatment tools or augment the educational process; however, the scarcity of education about technological advancements5 and apprehensions by clinicians related to the role of technology in the treatment delivery process puts us at risk of losing the benefit of an essential partnering between clinicians and technology developers. The rapid rise of technology is pushing the market place,4 and it is essential that rehabilitation specialists oversee the quality and validity of these new applications before they reach the consumer.3 In order to determine the importance and best applications of technology, we need to thoughtfully consider whether it is best that the technology replicate the actions of a therapist/teacher, or whether technology should be used to assist or augment these actions. 2 In our own area of interest, that of applying virtual reality to rehabilitation,1,4 we are often faced with having to justify our technological approach to research and treatment. Concerning the application of virtual reality, the question most often asked is why we do not just employ the same techniques in the physical world. The answer to this question is that technology offers great potential for enhancing and perpetuating our treatment outcomes. For example, virtual reality permits the user to interact with a multidimensional and multisensory environment in real time. It provides an opportunity for patients/clients to engage in challenging but safe, ecologically valid environments while maintaining the clinician's control over stimulus delivery and measurement. Virtual reality offers the opportunity to provide both standardized and individualized interventions while monitoring the resulting behaviors.6 Finally, by using virtual reality, interventions can be provided within a functional, purposeful, and motivating context that can be readily graded and documented. Although we might be able to provide some of these features with various traditional approaches to treatment and education, we argue that employing the new technology provides access to all of these attributes in a more efficient and effective fashion. …