“Technology has made textbooks obsolete”
Technology has made textbooks obsolete. The aim of medical education is not to create robots who regurgitate facts learnt from textbooks, but rather to produce well-rounded clinicians who are able to diagnose, manage and care for patients. Medical knowledge is not static and, consequently, educational tools need to constantly evolve. The process of writing, publishing and distributing means that textbooks are quickly outdated and require updates. “Gray’s Anatomy for Students’ had its 4th edition in 2019 and 5th edition in 2023(1). In contrast, technology allows us to build upon strong foundations of knowledge which can be updated with innovation and medical advancements in real time.
Medical education has changed over the years, with more focus on patient-centred care and competency-based education, meaning trainees are required to show they are competent across a range of skills rather than a system whereby progression is time-based. Halstead’s model of ‘see one, do one, teach one’(2) has been a hallmark of medical education as it allows trainees to observe seniors perform a skill, perform the skill themselves and finally teach the skill to another, completing the learning cycle.
Paediatrics as a speciality is notoriously senior led and is currently finding difficulty in recruiting new trainees; in part because students and foundation doctors often had limited exposure to the speciality as despite benefiting from hands on experiences the stakes often feel that much higher when managing acutely unwell children(3).
Simulation is a rapidly evolving area of medical education(4), trainees both see one and do one in a safe setting without any risk to patient safety or ethical concerns(5). The list of recommended simulations by RCPCH include supraventricular tachycardia, raised intracranial pressure and upper airway obstruction(6).
In medical school, I was involved in a paediatric hi-fidelity simulation training session, the simulations ran were a first presentation of DKA, acute exacerbation of asthma and a child with non-accidental injury. The experience allowed me to think through how I would manage an acutely unwell child and practically apply the knowledge I had learnt without the worry that if I made a mistake a child could be placed at risk. The scenario on non-accidental injury allowed students to practice identifying a child at risk and the non-verbal communication and de-escalation techniques required to manage these sensitive situations that are essential to a career in paediatrics, a skill that cannot be learnt from reading a textbook.
The team running simulation asked for students’ opinions on a career in paediatrics, they found that students who engaged in simulation are more likely to consider a career in paediatrics as they can see themselves in the field. 58% of students considered a career in paediatrics prior to simulation and this was reinforced by the session. Of the 42% who had not considered paediatrics, 40% were more likely to consider paediatrics after simulation(7).
While there is still a place for textbooks, in the 21st century, new and innovative approaches to medical education should be celebrated and utilised to encourage the next generation of paediatricians.
References
1. Drake R, Vogly A, Mitchell A. ‘Grays Anatomy for Students 5th Edition’ Elsevier 2023
2. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004 Nov;11(11):1149-54. doi: 10.1197/j.aem.2004.08.003. PMID: 15528578.
3. Kahvo M, Whelan R, Vallabhaneni P. Why choose paediatrics? A scoping review of factors affecting the choice of paediatrics as a career. Eur J Pediatr. 2023 Jan;182(1):9-23. doi: 10.1007/s00431-022-04659-6. Epub 2022 Nov 1. PMID: 36316579.
4. Clerihew L, Rowney D, Ker Simulation in paediatric training Archives of Disease in Childhood - Education and Practice 2016;101:8-14.
5. Aggarwal R, Mytton OT, Derbrew M, et al Training and simulation for patient safety BMJ Quality & Safety 2010;19:i34-i43.
6. Royal College of Paediatrics and Child Health. ‘Simulation and technology enhanced learning (TEL) resources and scenarios’
7. Jeskins L, Beatty C, Layman S, et al 749 Does the delivery of undergraduate simulation increase future recruitment to paediatrics? Archives of Disease in Childhood 2023;108:A357.