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The Evolution Of Medical Training In Dermatology And The Impact Of Technology

Discussion in 'Hospital' started by The Good Doctor, Sep 7, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    In nearly every field, ongoing education is warranted, if not explicitly required. Be it the informal transfer of knowledge between colleagues, or a more formalized process like recertification, nearly every profession mandates some form of maintenance of knowledge and skills. However, there are few professions that produce information at the volume and pace of health care. Indeed, since ancient times when early Greek and Egyptian texts provided documentation of new findings, treatments, and theories, medical education has continued to evolve. Now, the doubling time of medical information is a staggering 73 days. As a result, it has become nearly impossible for those in medicine to learn everything they need to know, let alone keep up with this veritable firehose of information. The answer may lie–at least in part–with technology.

    Modern medical education and the incorporation of technology

    In addition to the rapid pace at which new knowledge becomes available, there are several other issues that can impede medical education. One hurdle is that there are fundamental differences between performing well in a classroom setting and actually dealing with real-life patients and colleagues. Clinicians, especially those that are somewhat new to the field, often feel intimidated when first taking on a patient-facing position as a seemingly endless variety of challenges, nuances, and caveats become manifest, quite unlike the neat and tidy presentations within a clinical vignette. This is against the backdrop of a medical education system that has remained relatively stagnant for several decades. It is only recently, especially in light of the COVID-19 pandemic, that organizations have been forced to adapt.

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    Today’s health care providers are much different from the ones that entered the field 50 years ago. In their daily lives, they have constant interactions with technology and access to myriad resources at their fingertips. Because they are used to more engaging, short-burst experiences, they may be more receptive to alternative kinds of education — sitting in a lecture hall for hours on end is far less appealing than watching quick, informational videos or participating in interactive training. Although the medical field has been somewhat resistant to change for many years, the COVID-19 pandemic has proved that e-learning and remote engagement can be just as effective as conventional training.

    Another issue with traditional medical training is that it can skew significantly toward certain specialties and neglect others. Take dermatology, for example. In one survey study of 65 dermatology residency programs and 10 medical schools without dermatology residency programs, half of the responding institutions required 10 or fewer hours of dermatology instruction and eight percent required no dermatology instruction whatsoever. Only 10 percent of schools required a clinical dermatology rotation of any kind. However, despite the limited exposure in medical school, many primary care physicians treat patients with skin issues. In one of the seminal papers on the topic, researchers found that more than 20 percent of visits in a pediatric clinic featured either a skin complaint or finding. With more flexible, accessible training methods, instructors can cover more focus areas and students can engage with learning materials about the topics that are most interesting to them in their free time.

    The next frontier in medical education

    In his exhilarating book A Thousand Brains, Jeff Hawkins quipped: “A model is the embodiment of knowledge.” Since today’s learners increasingly prefer to receive information in an interactive, fast-paced format, video games are uniquely positioned to be the next frontier in medical education. More than simple “gamification”, which can focus on using crude techniques to increase engagement through features like point-scoring and leaderboards, medically-focused video games present players with problems, then give them the opportunity to experiment and rework their strategies to explore potential solutions and outcomes. These aspects of game design can actually encourage users to develop mental models of complex systems, and high-fidelity graphics can be especially useful in visually-focused specialties like dermatology. It is very likely that developing such models, as Hawkins has suggested, will result in better and deeper understanding of the concepts involved.

    During COVID, the medical training system had to adapt because people couldn’t meet in person and even those that could didn’t have access to patients or facilities in the same capacity. However, the explosion of remote training tools that became available make this hybrid training method as good in many ways, and perhaps even preferable to one that consists mainly of in-person lectures. In fact, some medical schools have suggested that all preclinical classes should be available exclusively online by 2025. As a result, schools and other stakeholder organizations should examine alternative methods of medical training and can use this opportunity to embrace new technologies in order to effectively and efficiently educate trainees. It may be time to abandon the old ways and fully embrace the advantages virtual training environments, including video games, have to offer.

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