As the academic year concludes, digital learning professionals start horizon scanning, looking for social, economic and political trends that might impact teaching and learning, and emerging learning technologies and practices. This article is a snapshot of digital medical education in three key areas: blended, online and simulated learning. The arguments are that medical education is now inevitably digital and the sector is at a state of deep strategic change.
A good example of this change is the NHS Long Term Workforce Plan, which, although not new, outlines strategic commitments for the next fifteen years. By extending education beyond the "traditional classroom" (NHS England, 2023), expanding and improving blended, online, and simulated learning, the goals are to enhance efficiency, improve learning experiences, develop digital capabilities, address training inequality, and ensure high-quality, safe care (NHS England, 2023). Ambitious goals.
Reading “the traditional classroom” here as mainly as credit bearing programmes, taking place face-to-face on campus, these commitments align with interesting changes in digital learning. For instance, UK university enrolments in online learning courses increased by nearly a third from 2019/20 to 2021/22, with almost 10% of UK-based students being online learners in 2021/22 (HESA, 2023). Additionally, 28% of postgraduate students in Health and Medicine were online learners in 21/22 (HESA, 2023).
While these changes in learning modality are impressive, they refer to the provision of distance education, a well-established part of digital learning. As a contrast, Dr. Jo Elliott’s summary of Dr. Jo Blannin’s DeCOP presentation explores a more cutting-edge innovation: the integration of AI in simulated learning experiences.
Much is happening in digital medical education. The sections below will delve into developments in the sector and showcase some of the work being done at the Faculty of Medicine and Dentistry.
One of the most notable aspects of Sue Beckingham’s model above is that it emphasises the aspect of choice (Beckingham et al., 2022), more so than the axes of location (online and campus) and time (synchronous and asynchronous) that traditionally inform definitions of blended learning.
There is growing adoption of blended learning approaches across the sector (Walker et al., 2022). Articles by Neil Mosley and Dave White, when read alongside the NHS report, indicate a profound need for strategic reflection, focused on blended learning as a strategic commitment. Currently, many blended learning approaches, despite being widespread, often lack clear goals, leading to confusion and reduced effectiveness. Since the pandemic, the sector has been trying to address profound social, economic, and cultural changes that affect both HEIs and students through blended approaches. The current work in IHSE, supported by Health Education England, to develop a blended learning medical degree, is a good example of how blended approaches can be introduced into courses that have traditionally emphasised in-person learning.
There are two strong drivers for change in blended learning practice today, and they might lead to a greater mix of modalities in the long term. The first is a greater demand by students for flexible and convenient learning modalities (Educause, 2023), with the demand being shaped by socioeconomic conditions and the way students choose and commit to learn; think attendance, for example. The second is the way Higher Education providers (or the “educator” in Sue Beckingham’s model above) choose to integrate digital learning approaches with their on-campus provision as an answer to changing conditions, student demand, financial and social goals.
It is exciting to see the ongoing curriculum revision work done at IHSE and the Institute of Dentistry, highlighting the collaborative nature of the work done in these revisions – between academic, professional service staff and students – and the commitment to digital learning. An article by Dr Amitha Ranauta about the work being done at IoD can be read here.
There is a growing use of virtual and augmented reality technology in healthcare education, both at FMD and across the sector.This trend is not surprising, as immersive learning environments such as VR and AR offer ideal settings for practical, high-stakes training without risk. For instance, medical students can perform virtual surgeries and explore human anatomy in 3D, gaining experience without ethical concerns or irreversible consequences (Kyaw et al., 2019). Such technologies might enhance engagement and retention by making learning interactive and sensory-rich, leading to better knowledge acquisition and problem-solving skills (Radianti et al., 2020). However, this adoption is not without challenges, such as high costs, technical complexity, lack of research and a scalable implementation model (Radianti et al., 2020).We highlight some of the exciting work being done by the Digital Education Studio, at the Institute of Dentistry and the Institute of Health Sciences Education to explore and integrate the use of VR/AR, covering the development of clinical skills, scenario-based learning, virtual OSCE sessions, and others can be read about here.
The growth in online learning provision and enrolment mentioned in the introduction is not without its challenges, such as an increase in competition between providers and the complexity of creating high quality learning experiences. The sector is at a point of growth where greater maturity and experience are to be expected in the next few years.There are two interesting updates at FMD related to online learning. The first is the recent creation of the Queen Mary International Clinical Academy. QMICA will be dedicated to clinical postgraduate education for international students, offering flexible programs and serving as a central hub for specialised clinical learning opportunities and a community of practice.As part of the Digital Education Studio’s CARE Agenda, FMD is also launching three new online learning programmes and one short course in the next academic year; more information is available here.
Digital medical education is at an interesting point, where experience from years of blended approaches, remote provision, greater demand, and more resources (Walker et al., 2022) are available to meet also greater opportunities and challenges. Where the sector and FMD might go can be learned by looking at some of the examples shared here.
Bailey, R., Weiner, S., House, T., & Mena, J., 2023. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. [online] Available at: https://doi.org/10.1097/SIH.0000000000000747 [Accessed 24 May 2024].Beckingham, S., Beggs, R., Hinton, D., Varga-Atkins, T. and Watson, D. (2022) Modes of learning: a practice guide. Edited by Kay Hack. Advance HE. Available at: https://www.advance-he.ac.uk/knowledge-hub/beyond-flexible-learning-practice-guide (Accessed: 24 May 2024).Digital Education Studio, 2024. The impact of digital education on student engagement and learning. [online] Available at: https://www.qmul.ac.uk/digital-education-studio/news-events/de24/april/digital-education-story3/ [Accessed 24 May 2024].Educause (2023) 2023 Horizon Report: Teaching and Learning Edition. Available at: https://library.educause.edu/-/media/files/library/2023/4/2023hrteachinglearning.pdf (Accessed: 24 May 2024).HESA (2023) 'Higher Education Student Data: 2021/22'. Available at: https://www.hesa.ac.uk/news/31-01-2023/higher-education-student-data-202122 (Accessed: 24 May 2024).NHS England, 2023. NHS Long Term Workforce Plan. [online] Available at: https://www.england.nhs.uk/long-term-workforce-plan/ [Accessed 24 May 2024].Walker, R., Jenkins, M., Voce, J., Gibson, A., and Jenkins, P. (2022) 2022 UCISA Survey of Technology Enhanced Learning in Higher Education. Available at: https://www.researchgate.net/publication/365532798_2022_UCISA_Survey_of_Technology_Enhanced_Learning_in_Higher_Education (Accessed: 24 May 2024).Jensen, L., & Konradsen, F. (2018). A review of the use of virtual reality head-mounted displays in education and training. Education and Information Technologies, 23(4), 1515-1529.
Kyaw, B. M., Saxena, N., Posadzki, P., Vseteckova, J., Nikolaou, C. K., George, P. P., ... & Car, L. T. (2019). Virtual reality for health professions education: Systematic review and meta-analysis by the digital health education collaboration. Journal of Medical Internet Research, 21(1), e12959.
Radianti, J., Majchrzak, T. A., Fromm, J., & Wohlgenannt, I. (2020). A systematic review of immersive virtual reality applications for higher education: Design elements, lessons learned, and research agenda. Computers & Education, 147, 103778.