‘Make sure to read up on this condition. Do you still use textbooks?’ This is a common question that  consultants ask medical students. The response is usually an explanation that students don’t use  textbooks anymore but instead various online resources. 

The evolution of medical education has accelerated due to the advancement of technology, pushed  further by COVID-19. In-person lectures, textbook reading and anatomy practicals have been replaced  with online lectures, online textbooks with question banks, online ‘practical’ sessions, and anatomy  mobile apps. Online lectures allow high-quality, consistent teaching to reach students in several  locations, reducing travel time and costs. Students can access lectures live or in their own time  including rewatching them when revising.1 

However, this creates a struggle for students with learning difficulties such as ADHD who may benefit  from timetabled in-person lectures. Participation and engagement become a challenge, due to the  hesitance of students to use the camera and chat functions and technical issues that can disrupt  learning. Students feel less supported as there are fewer opportunities to seek help from staff.2 

Effective learning involves active recall and spatial repetition for understanding and long-term  retention of information. MLA-style question banks such as PassMedicine offer categorised questions,  enabling students to regularly recall information they have learned so far using the high-yield online  textbook available and use the feedback to identify and fill gaps in their knowledge.3,4 These databases  can even use AI to tailor the question order, facilitating spatial repetition of key concepts. Multiple choice assessments have transitioned from paper to electronic systems, making online question banks  more useful as they more closely resemble summative examinations. 

Students now rely less on medical professionals and university resources for knowledge and more on  online resources which are updated regularly based on new guidelines and research. You can track  your understanding of each topic and compare your scores with other students in your university and  academic year. While useful, this can dishearten students when they are not achieving as well as  others. 

Online resources are used to master all aspects of patient interaction, from history-taking to clinical  procedures. Students can revisit websites, such as Geeky Medics which provide categorised videos,  detailed explanations, and OSCE-style checklists. Resources emulating clinical scenarios, such as  Capsule, provide high-quality cases useful for OSCE revision.5 However, these resources cannot replace  real-life clinical experience and may lead to students avoiding placements due to a false sense of  clinical competence. Almost all of these resources are accessible via a website and an app and include  offline modes if the internet is unavailable. Yearly subscriptions are offered at student-friendly prices,  making them more cost-efficient and convenient than textbooks. 

Nonetheless, adequate high-quality clinical exposure has remained paramount to health education.  The evolution lies in how clinical experience is supplemented and the resources used to consolidate  information learnt on placement. Medical education will undoubtedly continue to develop owing to  the advancement of mainstream technology, with new study options constantly emerging such as  emulating clinical scenarios using virtual reality and using AI to test knowledge.6

Andreas Stavrinou 


1. Stojan, J. et al. (2021) ‘Online learning developments in undergraduate medical education in  response to the COVID-19 pandemic: A Beme Systematic Review: Beme guide no. 69’, Medical  Teacher, 44(2), pp. 109–129. doi:10.1080/0142159x.2021.1992373. 

2. Bastos, R.A. et al. (2021) ‘Solutions, enablers and barriers to online learning in Clinical Medical  Education during the first year of the COVID-19 pandemic: A rapid review’, Medical Teacher,  44(2), pp. 187–195. doi:10.1080/0142159x.2021.1973979.  

3. Deng, F., Gluckstein, J.A. and Larsen, D.P. (2015) ‘Student-directed retrieval practice is a predictor  of medical licensing examination performance’, Perspectives on Medical Education, 4(6), pp. 308– 313. doi:10.1007/s40037-015-0220-x.  

4. Larsen, D.P., Butler, A.C. and Roediger III, H.L. (2008) ‘Test-enhanced learning in medical  education’, Medical Education, 42(10), pp. 959–966. doi:10.1111/j.1365-2923.2008.03124.x. 

5. Sadler, J. et al. (2020) ‘What is the impact of apps in medical education? A study of capsule, a case based learning app’, BMJ Simulation and Technology Enhanced Learning [Preprint].  doi:10.1136/bmjstel-2020-000593.  

6. Zhao, G. et al. (2021) ‘The comparison of teaching efficiency between virtual reality and traditional  education in Medical Education: A systematic review and meta-analysis’, Annals of Translational  Medicine, 9(3), pp. 252–252. doi:10.21037/atm-20-2785.

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