Integrating Technologies in Teaching Medicine by Eric L. Osborn

Because of the risks often involved within the medical profession, medical education and training must provide experiences that bring confidence and proficiency in carrying out necessary procedures.  Although numerous technologies are currently involved in medical education and training, great strides are being made to further improve the education and training within the medical field.

Technology can greatly aide performance and instruction within the medical field, where the concept of “learning by doing” carries too much risk.  While problem-based learning offers a good beginning for medical education, the nature of the positions these students will hold demands that technologies be developed, improved and utilized.  Technologies currently being improved in the field will bring detailed change in medical education and training because of the sophistication of the technologies.  Existing technologies being improved include: Web-based teaching, and real-time automated tools, including virtual reality and high-fidelity simulation programs.  Using these technologies will enable students to learn by seeing detailed demonstrations and participating in virtual reality simulations, so that when they actually “do” the procedure on a patient, they have a higher level of proficiency, thus lowering the risks.  This approach becomes particularly important with rare procedures, where these procedures can be completed over again and again in a virtual reality, despite the unavailability to perform the “real” procedure.  (Vozenilek et al., 2004)

As simulations and virtual reality technology improve, medical students, residents, and other trainees will be able to complete very realistic procedures over and over again, possibly gaining great proficiency, before ever attempting the procedure on a real patient.  Improving these processes should improve medical training and bring better results on the job.  While great strides have been made in medical technologies and medical training technologies, there is a need for continual improvement, especially in virtual reality.  Much of the current virtual reality currently in use utilizes computerize models, where even microscopic views are available.  In addition, students can perform a full surgery using tools connected to a virtual reality program.

The following video provides a good example of how virtual reality can aid in medical training:

The use of virtual reality in the medical field goes beyond education and training.  Virtual reality can also be used to treat phobias and numerous mental health issues, including bulimia (Gian, et al., 2013) and post-traumatic stress disorder, which bring a different side to this medical technology.  It can be used for physicians to practice a difficult surgery beforehand or help the process with image-guided surgery (Szekely and Satava, 1999).  Neurosurgeons especially benefit from virtual reality training and practice, where little room for error exists (Chan et al., 2013).  Virtual reality can also aide in remote diagnosis for patients in remote areas or to help with specialty areas (Szekely and Satava, 1999).  The more realistic the various aspects of virtual reality become, the better the training experiences.  For example, the way tools behave in a virtual reality situation should be as close as possible to how they would behave in a real procedure.

Current simulation programs can imitate real-life situations quite accurately.  Clinical problem-solving can also be used when using simulations, with computerized mannequins that can imitate numerous emergency situations.  Simulations can also include aspects of virtual reality.  The following video gives a helpful overview of simulation technologies currently in use:

Simulation-based medical education with deliberate practice has been found to bring better training results when compared to traditional clinical practices (McGaghie, et al., 2011, Singer, et al., 2012, Cook, et al., 2011).  For example, one study found that first-year medical students trained with simulations performed significantly better than third-year medical students trained without simulations on clinical care competency (Singer, et al., 2012).  Another study found that simulation-based medical education show significant improvements in knowledge, skills, and behaviors, while showing moderate improvements in patient-related outcomes (Cook, et al., 2011).  Thus, the use of technology in medical education appears to bring a better overall situation in the medical field.  As technologies for medical simulations improve, these positive affects may increase.

The technologies being used are quite impressive in their own right; however, possible advances in this field are many and can greatly improve education and training abilities.  As an instructor or a student in the medical field, being open to using new technologies in the classroom or in clinical experiences will likely bring better outcomes for student abilities.  

Resources

Chan, S, Conti, F, Salisbury, K, Blevins, N (2013). Virtual reality simulation in neurosurgery: Technologies and evolution. Neurosurgery: 72 (p A154-A164).

Cook, DA, et al. (2011). Technology-enhanced simulation for health professionals education: A systematic review and meta-analysis. Journal of the American Medical Association: 306(9).

Gian, LC, et. al (2013). Virtual reality for enhancing the cognitive behavioral treatment of obesity with binge eating disorder: Randomized controlled study with one-year follow-up. Journal of Medical Internet Research. 15(6): e113.

McGaghie, WC, Issenberg, SB, Cohen, ER, Barsuk, JH, Wayne, DB (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine: 86(6): 706-711.

Singer, BD, Corbridge, TC, Schroedl, CJ, Wilcox, JE, Cohen, ER, McGaghie, WC, Wayne, DB (2012). First-year residents outperform third-year residents after simulation-based education in critical care medicine. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: 8(2): 67-71.

Szekely, G and Satava, RM (1999). Virtual reality in medicine. British Medical Journal. 319 (7220): 1305.
Vozenilek, J, Huff, JS, Reznek, M, Gordon, JA (2004). See one, do one, teach one: Advanced technology in medical education. ACAD Emergency Medicine. 11 (11).
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6 comments

  1. I agree that virtual reality is very important to the medical field. You present some really great examples on how virtual reality technology is used in the medical field. Instructors and students as well as trainers and trainees need to be up to date on the latest technology and how to use it. There are also many other technical innovations that help out the medical field. The internet helps connect those in the medical field to the latest research as well as to others for advice and even consultation. How do you think technology will keep improving in the medical field in the future? Do you think that those in the medical field will need instruction from time to time to update them on how to use the current technology? What do you feel is the most important innovation? I like how you include videos and photos as examples.

  2. I agree that simulations have huge potential in education. However, I had an interesting experience with my current job. We are supposed to be developing online course for energy certificates and degrees. These are largely hands-on jobs – climbing utility poles, connecting wires, turning valves, etc. While simulations for some of these exist (not sure about climbing poles), the faculty are pretty adamant that connecting virtual wires isn’t the same as real hands on practice. I’m wondering, if it’s good enough for heart surgeons, shouldn’t it be good enough for utility technicians? Maybe the simulations are not real enough. The connecting wires ones seem like drawing lines rather than actual virtual reality. Should it matter? Their contention was that the connection between the virtual and the real wasn’t being made when students use simulations. In other words, with the tactile feel removed, the learning was more theoretical. Maybe they have a point. In the medical field a lot of the simulation is still real hands on. Similar to working on real power equipment but in a lab situation.

    1. It sounds like there is a difference in the simulations here. It looks like the health care workers are using simulations that will help them develop muscle/body memory for handling surgical implements as they connect with other matter. The skill should transfer to all other types of matter. However, the energy worker students don’t seem to be developing muscle/body memory for splicing and handling wires while being distracted by safety concerns, balance issues, or weather conditions. Although drawing wires will probably translate into improved visualization, problem-solving, and design skills, the simulation only helps students develop tactile knowlege of a pencil and paper, not wires and the environmental effects of movement on the job. In other words, the energy students are developing good muscle memory for drawing, which will not translate as effectively. Does this make sense or am I misinterpreting the description? (Sorry–my coherence is probably suffering here because I’m finding it difficult to edit my response within this box thingy.)

      1. That’s pretty much it. Actually, the energy students do develop this muscle memory when they work on the mock equipment in labs. In essence, this is exactly what the medial students do. What doesn’t seem to be working is computer-mediated simulations – mouse and keyboard type stuff. Which begs the question if these types of programs can ever be online. Even a hybrid model might have students at school and in labs 80% of the time.

    2. One of the biggest aspects of using virtual reality and simulations in medical training is continuing research to continually increase the realism, including tactile perceptions. There is yet a long way to go in this area, of course. I agree that real experiences have to come in eventually, but if virtual reality and simulations can decrease risks and improve knowledge and performance, it seems to be worth it. I am certain that simulation and virtual reality won’t have a place in every field, but the research thus far shows benefits in the medical field.

      I have a friend who assists in operations, and he showed me a leg skeleton simulation they use to show them where to cut. I observed that the leg was too light and that it didn’t feel like a bone would feel. He replied that he found it helped, not to give a real experience, but to allow him to know where to cut in a semi-realistic simulation. So, although he still needed to have a real experience after having this simulation, the simulation aided him in being more successful in the real situation. This was really interesting to me, especially after this post, because I never thought about a case study for something like this.

      1. There is definitely value to simulations. I suspect flight simulations have been used maybe longer than anything else. Better to crash a virtual plane or maim a virtual patient.

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