“If we teach today’s students as we taught yesterday’s, we rob them of tomorrow.”  John Dewey1

Medical education has fundamentally been transformed with the advent and evolution of technology and more innovative forms of learning. Textbooks, once considered the cornerstone of medical education, have less relevance and use in this era of technological advance.2 In this essay, I will argue that technology has made textbooks obsolete.

Interactivity, engagement and targeted learning

The use of technology in medical education has revolutionized the way we learn. Mobile assisted devices which can be used in patient care settings, gamification and computer assisted learning enable students to take control of their own education and can provide an interface for detailed personalised feedback.2,3

Moreover, Evidence based medicine underpins key guidelines, procedures and models of training. It is the cutting-edge research that is being published online and championed on various social media channels by experts which inform medical education and practice of today.4

Traditional textbooks have several drawbacks; they quickly become outdated, can be highly expensive and therefore inaccessible. Detailed examination of one surgical textbook by Tez, Yildiz (2017)5 revealed outdated and contradictory information which led them to question the reliability of medical textbooks. However, there is an argument for the “online “textbook which can be reviewed and revised. Nevertheless, a plethora of resources at the fingertips and a customised tailored experience are benefits textbooks cannot offer.2,5

Memorisation and rote learning cannot suffice and in the face of a rapidly evolving and complex healthcare landscape more innovative, experiential and problem based learning solutions are required as a solution. This cannot be achieved through the traditional medical textbook. Simulation and virtual reality (VR) are amongst the new advancements which have a large body of evidence supporting their use.3,6 Medical procedures and scenarios which otherwise would be inaccessible can be experienced and enacted in a safe and controlled environment.6

Platforms such as Geeky Medics, with guides and tools such as AI-powered simulated patients, have been prolific and gained a global following and reputation of providing quality resources. Lessons, lectures and tutorials seem incomplete without the use of quizzes such as Kahoot! and Menti; cited as the “new dimension” in medical education.7 They can be effective in being a dynamic resource to increase participation, engagement and target learning aims and objectives. Moreover, Spaced repetition flashcards such as Anki have been found to be associated with higher exam scores.8

Crisis necessitating change

A radical shift away from conventional educational methods was brought about by the COVID-19 Pandemic.  Platforms such as Microsoft Teams, and Zoom allowed healthcare professionals and students to connect in a simple and affordable way. Active participation, and real time collaboration meant learning was not disrupted. It was often said “COVID acted like a time machine: it brought 2030 to 2020” in a matter of months. It highlighted the need to embed novel and innovative technologies in to medical education.3,4

As a student and learner, I have benefited greatly from the benefits of newer technologies and novel teaching methods. Anatomy was taught through wet dissection however detailed videos were created of each class with step-by-step methods and tutorials to enable us to prepare. This real-world visualisation and interactivity enabled me to gain a greater understanding of complex topics in a manner which I would not have been able to though 2D images in a textbook. 

For my MRES Master of Research I worked with the NIHR Global Health Research Group in Surgical Technologies-Sierra Leone. We pioneered, designed and set up an online registry at the Masanga Medical Research Unit to document and capture cases of Buruli Ulcer. We trialled the use of novel Wound Imaging Software to Aid the Diagnosis of Neglected Tropical Diseases (NTDs) in this rural setting.9

The project was an international effort where we worked in collaboration with organisations such as WHO and FIND (Foundation for Innovative New Diagnostics). I had the opportunity to work with partners from across SL and Europe; maximising and thinking of solutions on how we best work effectively together in partnership (training up staff from grassroots to conduct ethical research in resource scare settings amongst other clinical activities to help develop novel point-of-care rapid diagnostic tests). This would not have been possible without the use of modern technology highlighting the prowess of such innovation and  tools. 

In conclusion, the pace of changes in the medical field is relentless. The rise of more innovative forms of learning have made the traditional textbooks increasingly redundant and no longer the primary source of information for students. Online resources, VR and the use of AI have been revolutionary in providing a more engaging and interactive learning experience.6Technological innovation is going to keep transforming healthcare and to prepare our future clinicians, it is crucial medical education continues to evolve and embrace technology and innovative forms of learning.

References

1. A quote by John Dewey Goodreads. Available at: https://www.goodreads.com/quotes/833916-if-we-teach-today-s-students-as-we-taught-yesterday-s-we (Accessed: 01 November 2023). 

2. Guze PA. Using Technology to Meet the Challenges of Medical Education. Trans Am Clin Climatol Assoc. 2015;126:260-70. PMID: 26330687; PMCID: PMC4530721.

3. Goh PS and Sandars J. A vision of the use of technology in medical education after the COVID-19 pandemic [version 1]. MedEdPublish 2020, 9:49 (https://doi.org/10.15694/mep.2020.000049.1)

4. Jeffries PR, Bushardt RL, DuBose-Morris R, Hood C, Kardong-Edgren S, Pintz C, Posey L, Sikka N. The Role of Technology in Health Professions Education During the COVID-19 Pandemic. Acad Med. 2022 Mar 1;97(3S):S104-S109. doi: 10.1097/ACM.0000000000004523. PMID: 34789662; PMCID: PMC8855755.

5. Tez M, Yildiz B. How Reliable Are Medical Textbooks? J Grad Med Educ. 2017 Aug;9(4):550. doi: 10.4300/JGME-D-17-00209.1. PMID: 28824784; PMCID: PMC5559266.

6. Pottle J. Virtual reality and the transformation of medical education. Future Healthc J. 2019 Oct;6(3):181-185. doi: 10.7861/fhj.2019-0036. PMID: 31660522; PMCID: PMC6798020.

7. Dengri C, Gill A, Chopra J, Dengri C, Koritala T, Khedr A, Korsapati AR, Adhikari R, Jain S, Zec S, Chand M, Kashyap R, Pattan V, Khan SA, Jain NK. A Review of the Quiz, as a New Dimension in Medical Education. Cureus. 2021 Oct 18;13(10):e18854. doi: 10.7759/cureus.18854. PMID: 34804707; PMCID: PMC8597672.

8. Gilbert, M.M., Frommeyer, T.C., Brittain, G.V. et al. A Cohort Study Assessing the Impact of Anki as a Spaced Repetition Tool on Academic Performance in Medical School. Med.Sci.Educ. 33, 955–962 (2023). https://doi.org/10.1007/s40670-023-01826-8

9. Please HR, Vas Nunes JH, Patel R, Pluschke G, Tholley M, Ruf MT, Bolton W, Scott JA, Grobusch MP, Bolkan HA, Brown JM, Jayne DG. Chronic wounds in Sierra Leone: Searching for Buruli ulcer, a NTD caused by Mycobacterium ulcerans, at Masanga Hospital. PLoS Negl Trop Dis. 2021 Oct 13;15(10):e0009862. doi: 10.1371/journal.pntd.0009862. PMID: 34644298; PMCID: PMC8544828.

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