The origins of medical education are strongly linked to a didactic style of teaching. A tutor stands before a room of students and instructs them in the form of a lecture which is reinforced through the reading of textbooks.
This form of learning is slowly being removed and replaced by curriculums aimed at more interactive, student lead learning. This movement lead to the development of small group sessions, with self-directed teaching such as problem based learning (PBL) and case based learning (CBL), originating in the late 1960s1. These styles have been shown to develop knowledge better than traditionally structured courses2 and are preferred by both staff and students in comparison to didactic teaching 3. These methods are now core elements of 12 UK medical schools.4
The development of interactive learning methods has coincided with a greater implementation of student selected components (SSC); SSCs have been a mandatory part of medical school curriculums since 2003.5
Medical education is therefore shifting towards an adaptive curriculum in which ‘the system conforms to the learner rather than the learner conforming to the system’ 6. This will allow students to work at an individualized pace which challenges them in areas they excel, while providing support in the fields they find harder. Technology has an essential role to play in this.
One such technology I have had the opportunity of using myself is virtual reality (VR) simulation. Simulation is a great learning tool, allowing individuals to learn management of patients in active and engaging way, without any risk of harm to patients. VR simulation has many advantages over traditional simulation whilst having no difference in quality of learning7. VR simulation doesn’t require a trainer to run the sessions, meaning it can be run by students on their own in their home . It also doesn’t have the limiting factor of a small number of mannequins restricting opportunities, with VR headsets being easily available and not nearly as expensive, it is possible to equip a whole student body with headsets. The current limiting factor is the cost of the simulation software but this, with time, will hopefully be reduced.
Looking to the future I believe we will see VR simulation and AI technology play a large part in medical education. AI will present students with certain resources from a large online pool to teach them a topic. Their understanding will then be tested with use of a question bank and VR simulation, which the student will be able to undertake using their own laptop and headset given by the institution teaching them. The AI algorithm will identify, based on questions answered incorrectly and steps missed or incorrect actions taken in the VR simulation, which areas the student is struggling with. It will then present new resources tailored around these areas of limited knowledge to help support the student. This would create an entirely unique curriculum for each student, ensuring they reach the required knowledge base while moving at a pace most suitable for them.
References
1. Servant-Miklos VFC, (2019) ’Fifty years on: A Retrospective on the World’s First Problem-based Learning Programme at McMasters University Medical School’ Health Professions Education Volume 5 (Issue 1,March 2019, pages 3-12) Available at: https://www-sciencedirect-com.uea.idm.oclc.org/science/article/pii/S2452301118300592
2. Thistlethwaite JE, Davies D and Ekeocha S, et al. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME guide (No. 23. Med Teach. 2012;34:e421–44)
3. George T, Carey RAB and Abraham OC, et al. Trainee doctors in medicine prefer case-based learning compared to didactic teaching. Journal of Family Medicine and Primary Care (2020 Feb; 9(2): 580–584) Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113923/#:~:text=Seminars%20and%20lectures%20continue%20to,does%20not%20promote%20deep%20learning.
4.BMA (01/09/2001)Courses at medical school Available at: https://www.bma.org.uk/advice-and-support/studying-medicine/becoming-a-doctor/courses-at-medical-school
5. GMC (2009) Tomorrow’s Doctors Available at: http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009_domain5.asp
6. Salerno-Kennedy R and O’Flynn S, (2010) Medical Education: The State of the Art Publisher: Nova Science Publishers Inc
7. Abulfaraj M, Jeffers J, Tackett S, Chang T. Virtual Reality vs. High-Fidelity Mannequin-Based Simulation: A Pilot Randomized Trial Evaluating Learner Performance. Cureus [Internet]. 2021 [cited 13/09/2023];. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432415/