Redefining learning in the digital era: Innovative tools shaping modern medical education

University of Chicago Division of the Biological Sciences Pritzker School of Medicine

Technology in graduate medical education: shifting the paradigm and advancing the field.

Council on Medical Student Education in Pediatrics

Increasing use of technology in medical education has caused concerns to medical teachers pertaining to the quality of digital learning environments. Thus, this review aimed to unearth the functional components of effective technology-enhanced learning environment in the undergraduate medical education context. The revised Arksey and O’Malley protocol was utilized that include identification of research question and relevant studies, selection of studies, data charting and collection, and collating, summarizing, and reporting results after consultation. We discovered nine components with 25 subcomponents of 74 functional elements found to be present in effective online learning environments. The nine components include cognitive enhancement, content curation, digital capability, technological usability, pedagogical practices, learner characteristics, learning facilitator, social representations, and institutional support. There is an interplay between these components, influencing each other in online learning platforms. A technology-enhanced learning in medical education (TELEMEd) model is proposed which can be used as a framework for evaluating online learning environment in medical education.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40670-023-01747-6.

Background: Medical education is integrating technology, including artificial intelligence, but ethical concerns remain. Objective: This study aims to enhance the role of ethics in medicine, focusing on the integration of human intelligence, particularly social and emotional intelligence, for ethical decision-making in medical education. Methods: The study uses a scoping review design to examine and explore key approaches to ethical considerations in using technology for medical education. Results: The data synthesis process identifies themes concerning behavior changes, technology acceptance, digital distraction, and AI mobile learning. Technology integration in medical education has led to significant advancements in assessment, learning, and professional development. Conclusions: Using Technology for Medical Education has enhanced learning outcomes, provided creative teaching methods, and increased resource access. The digitalization of medical education has led to the development of clinical skills and increased access to resources.

BackgroundLack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care. However, low and middle-income countries (LMIC) like Rwanda have struggled to implement medical education technologies adapted to local settings in medical practice and continuing education. Developing a user-centered mobile computing approach for medical and health education programs has potential to bring continuous medical education to doctors in rural and urban areas of Rwanda and influence patient care outcomes.ObjectiveThe aim of this study is to determine user requirements, currently available resources, and perspectives for potential medical education technologies in Rwanda.MethodsInformation baseline and needs assessments data collection were conducted in all 44 district hospitals (DHs) throughout Rwanda. The research team collected qualitative data through interviews with 16 general practitioners working across Rwanda and 97 self-administered online questionnaires for rural areas. Data were collected and analyzed to address two key questions: (1) what are the currently available tools for the use of mobile-based technology for medical education in Rwanda, and (2) what are user's requirements for the creation of a mobile medical education technology in Rwanda?ResultsGeneral practitioners from different hospitals highlighted that none of the available technologies avail local resources such as the Ministry of Health (MOH) clinical treatment guidelines. Considering the number of patients that doctors see in Rwanda, an average of 32 patients per day, there is need for a locally adapted mobile education app that utilizes specific Rwandan medical education resources. Based on our results, we propose a mobile medical education app that could provide many benefits such as rapid decision making with lower error rates, increasing the quality of data management and accessibility, and improving practice efficiency and knowledge. In areas where Internet access is limited, the proposed mobile medical education app would need to run on a mobile device without Internet access.ConclusionsA user-centered design approach was adopted, starting with a needs assessment with representative end users, which provided recommendations for the development of a mobile medical education app specific to Rwanda. Specific app features were identified through the needs assessment and it was evident that there will be future benefits to ongoing incorporation of user-centered design methods to better inform the software development and improve its usability. Results of the user-centered design reported here can inform other medical education technology developments in LMIC to ensure that technologies developed are usable by all stakeholders.

Background and Aims: Medical Education Technology has witnessed significant transformation over the years, largely influenced by advancements in technology. From traditional lecture-based teaching to the integration of multimedia tools and virtual simulations, the landscape of medical education has evolved to meet the needs of learners in an ever-changing healthcare environment. Objectives: To explore the evolution of Medical Education Technology, highlighting key milestones from the past, assessing the current state of technology integration in medical education, and envisioning future trends and challenges. Methods: A comprehensive review of the literature was conducted to examine the historical progression of Medical Education Technology. Results: The review revealed a notable evolution in Medical Education Technology, from early implementations of multimedia tools to the widespread adoption of online platforms and virtual simulations. Conclusions: Medical Education Technology has evolved significantly from past innovations to the present integration of virtual platforms. Looking ahead, future advancements promise to further revolutionise medical education, ensuring better preparation of healthcare professionals for the challenges of modern practice.

BackgroundTechnology-enhanced learning (TEL) has become increasingly vital in global medical education, offering significant advantages in knowledge acquisition, communication, motivation, and student engagement. In Syria, a country facing prolonged crises, there is an urgent need to evaluate the integration of technology within medical education to address institutional limitations and support student learning.ObjectiveThe aim of this study is to evaluate the awareness, perceived challenges, and needs regarding the integration of technology in medical education from the perspectives of students and faculty at Syrian medical colleges.MethodsA cross-sectional survey was conducted during the 2023‐2024 academic year across Syrian universities. Stratified random sampling was used to recruit 500 medical students and 200 faculty members. Two tailored, self-administered questionnaires were used, covering motivation, perceived benefits, challenges, and suggestions for technology integration. Validity was assessed through expert review and pilot testing (n=30), and internal consistency was confirmed (Cronbach α=0.6‐0.7). Quantitative data were analyzed using descriptive statistics, t tests, ANOVA, and Kruskal-Wallis tests.ResultsAmong medical students, 94% (470\\500) agreed that integrating technology into medical education is essential, with similar agreement from 93.5% (187\\200) of faculty. No significant differences were found in student responses based on specialization (P=.32) or university type (P=.11). Likewise, faculty perspectives did not significantly differ by academic qualification or years of experience (P>.05). There were several perceived benefits; for instance, 93.2% (n=466) of students reported that technology kept them up to date with new developments, 88% stated it enhanced research skills, and 86.8% found TEL more enjoyable than traditional learning methods. Most respondents (95% n=475) said TEL created a flexible, interactive environment. Among faculty, 77% (n=154) agreed TEL improves clinical skill development. Respondents noted there were some challenges; specifically, 57% (n=285) of students cited poor internet service, 33% (n=165) noted the financial burden, and 82.2% (n=411) called for behavioral guidelines. Among faculty, 85.5% (n=171) cited lack of institutional support and 90% (n=180) emphasized the need for training. Both groups supported the development of communication platforms, curriculum revisions, and faculty development programs.ConclusionsThere is a strong consensus among Syrian medical students and faculty on the value and necessity of integrating technology in medical education. Despite infrastructure and administrative challenges, both groups recognize TEL as a powerful tool for improving clinical competencies, student motivation, and academic engagement. Institutional commitment, curricular reform, and tailored training are essential to achieving sustainable, effective technology integration.

Development of computer networks and introduction and application of new technologies in all aspects of human activity needs to be followed by universities in their transformation on how to approach scientific, research, and education teaching curricula. Development and increased use of distance learning (DL) over the past decade have clearly shown the potential and efficiency of information technology applied in education. Use of information technology in medical education is where medical informatics takes its place as important scientific discipline which ensures benefit from IT in teaching and learning process involved. Definition of telemedicine as "use of technologies based on health care delivered on distance" covers areas such as electronic health, tele-health (eHealth), telematics, but also tele-education. Web based medical education today is offered in different forms--from online lectures, online exams, web based continuous education programs, use of electronic libraries, online medical and scientific databases etc. Department of Medical Informatics of Medical Faculty of University of Sarajevo has taken many steps to introduce distance learning in medical curricula--from organising professional--scientific events (congresses, workshop etc), organizing first tele-exam at the faculty and among first at the university, to offering online lectures and online education material at the Department's website (www.unsa-medinfo.org). Distance learning in medical education, as well as telemedicine, significantly influence health care in general and are shaping the future model of medical practice. Basic computer and networks skills must be a part of all future medical curricula. The impact of technical equipment on patient-doctor relationship must be taken into account, and doctors have to be trained and prepared for diagnosing or consulting patients by use of IT. Telemedicine requires special approach in certain medical fields--tele-consultation, tele-surgery, tele-radiology and other specific telemedicine applications should be introduced to the curricula. Telemedicine and distance learning are best suited for medical education and doctor-to-doctor consultation--first contact between doctor and a patient should stay face-to-face when possible. In this paper, we present the results of the project Introduction and Implementation of Distance Learning at the Medical Faculty of University of Sarajevo and compare it with the following expected outcomes: development and integration of information technology in medical education; creation of flexible infrastructure which will enable access to e-learning to all students and teaching staff; improvement of digital literacy of academic population; ensuring high educational standards to students and teaching staff; helping medical staffto develop "life-long learning" approach in work and education.

Mobile technologies (including handheld and wearable devices) have the potential to enhance learning activities from basic medical undergraduate education through residency and beyond. In order to use these technologies successfully, medical educators need to be aware of the underpinning socio-theoretical concepts that influence their usage, the pre-clinical and clinical educational environment in which the educational activities occur, and the practical possibilities and limitations of their usage. This Guide builds upon the previous AMEE Guide to e-Learning in medical education by providing medical teachers with conceptual frameworks and practical examples of using mobile technologies in medical education. The goal is to help medical teachers to use these concepts and technologies at all levels of medical education to improve the education of medical and healthcare personnel, and ultimately contribute to improved patient healthcare. This Guide begins by reviewing some of the technological changes that have occurred in recent years, and then examines the theoretical basis (both social and educational) for understanding mobile technology usage. From there, the Guide progresses through a hierarchy of institutional, teacher and learner needs, identifying issues, problems and solutions for the effective use of mobile technology in medical education. This Guide ends with a brief look to the future.

Contents: H.S. Barrows, Foreword. Part I:The Evolution of Medical and Surgical Education. S. Abrahamson, Medical Education: The Testing of a Hypothesis. R.H. Moy, Medical Education in the 20th Century. C.E. Engel, Medical Education in Australia, Great Britain, and New Zealand in the 21st Century. A. Tekian, Teaching and Learning in Medicine and Surgery in the 21st Century: Challenges to the Developing World. Part II:The Art and Science of Medical Education. G. Regehr, K. Rajaratanam, Models of Learning: Implications for Teaching Students and Residents. D.A. DaRosa, A. Derossis, Applying Instructional Principles to the Design of Curriculum. G.L. Dunnington, Adapting Teaching to the Learning Environment. A.K. Sachdeva, Large Group Teaching. R.G. Tiberius, Small Group Teaching. E.E. Reynolds, J. Ende, Feedback for Medical Education. K.B. Williamson, Instructional Technology in Medical Education. L. Wilkerson, Curriculum Evaluation and Curriculum Change. D.E. Simpson, Medical Faculty as Teachers: Implications for Faculty Development. J.R. Folse, Medical Education as a Continuum. R.G. Bing-You, J.C. Edwards, Residents as Teachers. N. Bennett, Muddy Problems, Compassionate Care: Continuing Medical Education in the 21st Century. Part III:Major Curriculum Movements. Q. Mast-Cheney, Major Curriculum Movements. L. Arnold, K. Roberts, U.S. Medical Schools' Combined Degree Programs Leading to the MD and a Baccalaureate, Master's, or Other Doctoral Degree. L.C. Perkowski, Standardized Patients. J.A. Colliver, M.H. Swartz, Reliability and Validity Issues in Standardized Patient Assessment. R.K. Reznick, K. Rajaratanam, Performance-Based Assessment. L.J. Morrison, Clinical Practice Examinations. H.S. Barrows, Authentic Problem-Based Assessment. E.L. Loschen, Implementing Problem-Based Learning in Medical Education. Part IV:Challenges for Medical Education. M.E. Whitcomb, Effects of Changing Health Care Environment on Medical Education. G. D'Elia, E.J. Constance, Medical Education and the Physician Workforce. J.H. Shatzer, M.B. Anderson, Supporting Medical Education. W.A. Anderson, Funding and Financial Support for Research and Development in Medical Education.

Virtual reality (VR) technology has attracted great concern in computer science. As a cutting-edge computer simulation system, VR technology has undergone great development in scientific research, education and our daily life, etc. Herein, the development, characteristic, applications and potential limitations of VR technology was reviewed, especially, the applications of VR technology in medical science and professional education were highlighted. Moreover, a mini-research was carried out to study the teaching outcomes brought by VR technology from questionnaires. According to the results, it can be deduced that VR technology can solve the common problems in Chinese medical education.

Without a doubt, medical sciences have a significant effect on our lives. The medical sciences aid in the diagnosis and treatment of diseases and ailments. According to studies, the majority of students utilized conventional instructional methods in their practical classroom. Virtual reality is one of the immersive technologies that aid the learning process by reducing cognitive load. According to Mayer's 12 Multimedia Principles, the learning process is enhanced when multimedia elements such as visuals audio are combined. This study presented the design and development of a VR anatomy medical classroom by employing cognitive load theory and determining the acceptability of virtual reality technology for the medical sciences. The combination of the ADDIE model and 12 Mayer's Principle of Multimedia improved the learning method and research framework for the use of VR-based technologies in medical sciences education. Utilizing a modified version of the Technology Acceptance Model (TAM), the VMedTAAM is used to determine the acceptance of technology in medical education. The result will serve as a guide for future VR developers to improve the design of immersive technology in this area.

To the Editor.—We read with interest the review by Koch et al1 on medical education in pathology, which outlined strategies for undergraduate and graduate curricula based on 5 educational paradigms: cognitive load, competency-based learning, boot camps, peer-assisted learning, and the flipped classroom. As junior doctors and novice educators, we have benefited from and leveraged on many of these strategies, including peer-assisted learning and the flipped classroom approach. However, we believe that current circumstances, namely the diminishing status of pathology in medical student curricula and the rise of technology in medical education, demand novel strategies. To this end, we propose 2 suggestions for consideration.First, we propose that pathologists be engaged more widely in preclinical medical education, in particular during cadaveric dissection or anatomy teaching sessions. These sessions are traditionally run by anatomists, and in recent years, surgeons, who have the experience and expertise to emphasize particular areas of surgical importance in the dissection hall.2 In a similar vein, we propose that pathologists could also play a role in the dissection hall and anatomy teaching. Integration of pathology into the dissection hall has been suggested before,3 although the focus has been on the mere identification of pathologies, such as pulmonary tuberculosis or a colonic tumor. We believe that in addition to the identification of pathologies, a surgical pathologist would have an opportunity at this instance to discuss how such a specimen may be handled and processed in the laboratory and its clinical implications (eg, diagnosis, staging, and prognostication of malignancy). This would help medical students connect the dots on the role of pathology in the wider clinical setting and potentially inspire interested students to consider pathology as a career.Second, we suggest the development and incorporation of augmented reality (AR) or virtual reality (VR) tools for specimen grossing in postgraduate pathology training. VR has been used in a wide variety of surgical disciplines, such as neurosurgery,4 to overcome the steep learning curve and improve understanding of complex anatomy. Similarly, grossing is a crucial part of pathology training, which requires trainees to learn how to handle myriad specimens, including en bloc specimens.1 The use of technology in this regard is encouraging in that it allows the initial cognitive load to be spread out over several sessions in a safe simulated environment. Other postulated benefits of AR and VR that may be applicable to pathology include enhancing trainees' ability to learn, synthesize, and incorporate knowledge and ideas through virtual, augmented, and even mixed reality tools remotely, especially crucial in the current worldwide COVID-19 pandemic.5 It is high time for digital education to be used in pathology education to allow trainees the opportunity to practice even in the event of isolation notice or deployment to the pandemic's frontlines.While these suggestions are promising in theory, we concede that further study is required, and we hope that future research can investigate their utility in achieving learning outcomes and in increasing interest in the field of pathology.

The ASIC [adaptation, standardisation, integration and compliance] framework was developed to set the standard for the use of innovations and technologies in medical education. There is a need to develop frameworks and reference guides for educational technologies [EdTechs] and innovations, noting that EdTechs are becoming increasingly important to the delivery of medical education. The ASIC framework as previously published presents four major tenets including: adaptation, standardisation, integration and compliance. The operational matrix is now developed and presented in this article. Each tenet of the ASIC framework has key requirements or questions that the user of an EdTech or educational innovation should address. Each question represents a key requirement to be satisfied by the user of the EdTech to satisfy the ASIC tenets. Each question is also equally weighted as every other one. The matrix has 12 key questions, representing 12 key requirements. The results measurement can either be a fraction of 12 or a percentage. As a requirement, the minimum score under each category is 2 out of 3; ideally, optimisation of an educational innovation or technology requires that all boxes are checked in the affirmative. However, a minimum of 2 out of 3 in every category would indicate a minimum score or threshold. This effort is in line with previous and ongoing efforts to ensure that educational technologies and innovation that are deployed to deliver medical education are adapted for optimal performance, standardised for the use of training, integrated into the medical education delivery system, and compliant with professional, institutional, and regulatory standards.