Digital Education in Neurology

As digital transformation of healthcare is proceeding we need to enhance our medical education especially in Neurology Digtially!

Introduction

  • The era of radical digital transformation is upon healthcare and has brought about Healthcare 4.0.
  • Most activities have transitioned from physical to virtual space in the pandemic. This forced change has led to an ever-lasting cultural shift where people prefer to work remotely and have healthcare and education delivered virtually.
  • The medical community needs to prepare for a generation of mobile-first students, ceaselessly connected to the internet and constantly bombarded with information.
  • Virtual healthcare is poised to become a quarter-trillion dollar industry, with neurology and psychiatry at the forefront of care delivery claims.

Digital Transformation of Industry, Healthcare and Education (4.0)

  • Industry 4.0 denotes a world where control and decision-making are decentralized, wherein various systems are integrated to achieve hyper-connectivity.
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Healthcare 4.0 will also be a similarly hyperconnected, decentralized system.
  • Innovative technologies create a better healthcare experience by placing the individual patient at the center of point-of-care.
  • The FDA approving autonomous artificial intelligence-based devices for diagnostics and new virtual reality-based therapies for chronic pain and Irritable Bowel Syndrome represent a significant paradigm shift in the delivery of healthcare.
  • Medical education needs to evolve to meet the changing needs of our new virtual world.
  • An exponential increase in knowledge and the rise of disruptive technologies are making traditional medical education obsolete.
  • Medical graduates are "digital natives", who have access to a wealth of information at any given moment, a "knowledge cloud."
  • A shift to meta-learning and "knowledge management" is imperative, as students need to be taught to discern between practical, verified and inauthentic information.
    • Figure 1 : Evolution of Medical Education

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Medical Education 4.0: New Tenets

  • For clinical neurology to keep up with the time and to produce competent digital neurologists, we have to prepare medical students for a cyber-physical, virtual new world.
  • The authors propose that medical education must adhere to the following tenets:
    • Hybrid : Blended learning, combining technology with traditional classroom setup
    • Mobile First : Resources need to be designed from the ground up and have a mobile interface
    • Mixed Reality : Sources should be created to be integrated into multimedia and mixed reality applications
    • Open Access : Decentralization and democratization of knowledge, remote access is crucial to combat misinformation, and open access is critical, especially in resource limited countries.
    • Collaborative + Peer-Reviewed : Peer-reviewed by experts, authentic curation resultant of collaboration that is open to scrutiny.
    • Up-To-Date : Regularly updates and monitored resources.
    • Intelligence : Intelligent, Just-in-Time Learning. Constantly connected and continually evolving system.
    • Game-Based Learning : Application of game playing elements (point scoring, rules of play etc.) encourage user engagement, team building.
    • Global : Need to accommodate for different learning styles, cultural and language preferences.
    • Figure 2 : Tenets of Medical Education 4.0

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Advances in Medical Education beyond traditional institutions

  • Wikidoc : "an open-source website that allows an international community of healthcare professionals to add and edit medical content in a process termed co-creation.”
    • Wikidoc reduces the chances of any factual errors occurring by being open access.
    • Emerging and evolving topics are addressed very quickly, and they keep on evolving, with newer information added as the topic matures.
    • The comment section on Wikidoc serves as a great place for voicing opinions and exchanging views, hence creating an interactive space.
  • Neurologypocketbook.com : an "Applied, Concise, Practical, Up-to-date, Mobile-friendly & Open-Access Pocketbook of Neurology and related clinical specialties.”
    • runs on a modern software-as-a-service platform called Notion.
    • preserves the Wiki model of collaboration but adds the authenticity of peer-review
    • Google Meet meetings are held monthly, and a Discord server is set up to enhance communication between authors and faculty.
    • Students do not just learn neurology but advanced digital tools alongside clinical education.
    • The vision of NeurologyPocketbook is beyond medical education and will include health education, where patient education material both in print and video-based format will be collaboratively made.
  • Evolution of MOOCs in Medicine - Mini-Fellowships
    • MOOCs provided a great opportunity to deliver information-dense lectures to students.
    • Students can replay lectures as many times as needed. Online lectures are much more interactive, e.g., online quizzes, and can help medical students practice their clinical information numerous times and increase their understanding.
    • MOOCs have democratized education in areas where there is a lack of neurologists in the wake of an aging population, especially in the developing world, as they have a dual burden of disease, e.g., cholera, vascular dementia etc.
    • One such early example was the Mini-Fellowship in Movement Disorders launched at the University of Nebraska Medical Center (UNMC) in 2017 as a 6-months long online fellowship, spearheaded by Dr. Danish Bhatti
      • This is "a program intended to enhance Movement Disorders (MD) training for General Neurologists, Psychiatrists, Physiatrists (PM&R), and Primary Care Providers to improve their skills in Movement Disorders.”
      • The program was initiated to fill the vacuum of untrained neurologists in under-developed countries like Pakistan cost-effectively and has since turned into a project of informational exchange between America and the rest of the world.
      • The fellowship uses virtual learning, online modules, and informative feedback through clinical case discussions and has successfully graduated 81 Physicians (mostly neurologists) from 13 different countries.

Further Reading

  • Blobel B. Application of Industry 4.0 Concept to Health Care. IOS Press; 2020:23.
  • Witze A. Universities will never be the same after the coronavirus crisis. Nature. 2020;582(7811):162-165.
  • Prensky M. H. sapiens digital: From digital immigrants and digital natives to digital wisdom. Innovate: journal of online education. 2009;5(3)
  • Friedman CP, Donaldson KM, Vantsevich AV. Educating medical students in the era of ubiquitous information. Medical teacher. 2016;38(5):504-509.

Bibliography

  1. Blobel B. Application of Industry 4.0 Concept to Health Care. IOS Press; 2020:23.
  1. Oleg Bestsennyy GG, Alex Harris, and Jennifer Rost. Telehealth: A quarter-trillion-dollar post-COVID-19 reality? McKinsey & Company. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality
  1. FDA permits marketing of artificial intelligence-based device to detect certain diabetes-related eye problems. U.S Food and Drug Adminstration https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-artificial-intelligence-based-device-detect-certain-diabetes-related-eye
  1. metaMe Health Receives FDA Clearance for Regulora®, the First FDA-authorized Treatment Specifically for Abdominal Pain Due to Irritable Bowel Syndrome (IBS). metaME Health. https://www.metamehealth.com/press/metame-health-receives-fda-clearance-for-regulora-the-first-fda-authorized-treatment-specifically-for-abdominal-pain-due-to-irritable-bowel-syndrome-ibs
  1. Shah D. By The Numbers: MOOCs in 2021. The Report. https://www.classcentral.com/report/mooc-stats-2021/