Like any extreme stress test, COVID-19 has exposed both the strengths and vulnerabilities of our healthcare system.
On the positive side, we quickly learned how to mitigate the virus following its first deadly wave. Morbidity rates have plummeted since the spring. Multiple vaccines, developed in record time, now promise to halt the virus altogether.
Yet for all the gains made in 2020, there is the grim fact that more than 1.5 million people have died to date. There’s also the realization that our healthcare system was ill-prepared to handle the burden of COVID-19.
So how might medical schools prepare future physicians so they are better equipped to handle the next pandemic? The answer, we believe, lies in a hybrid model that transcends traditional medical instruction to adopt new technologies that will make healthcare—and healthcare education—more agile, innovative, and responsive.
Digital content spaces and green screens
Consider this: In April 2020, telehealth claims in the U.S. increased by more than 8,000% from the previous year, according to medical claim tracker FAIR Health. Ten months from the onset of the pandemic, demand for telemedicine remains strong and isn’t expected to end with COVID-19. Training future caregivers on how best to use telehealth technology must be made a priority for medical and nursing schools.
Many medical education institutions are now incorporating digital content spaces into their facilities. These environments, which emulate TV studios (down to their green screen backdrops), offer one platform for practicing and teaching telemedicine.
Other solutions can be found in flexible training spaces like the Experiential Learning Laboratory at the University of South Florida Morsani College of Medicine. Designed like a black-box theater, the ELL can flex to provide large and small spaces and accommodate any type of technology. Spaces like these encourage future physicians to think beyond traditional approaches to care and experiment with new ways of diagnosing, treating and communicating with patients.
Health design ‘test kitchens’
Recent trends in medical education also make medical schools ideal platforms for the research and development of new technologies. At Thomas Jefferson University in Philadelphia, Dr. Bon Ku operates the college’s Health Design Lab, where students spend eight-month sessions developing new technologies. Working in conjunction with the product design studios and private industry, Jefferson students have leveraged the hybrid tech-education space to spin off new tools and solutions, including one device that protects patients from developing pressure ulcers and another that delivers medicine to the scalp.
“Medical schools need a safe space where students, physicians, patients, and others can co-design,” Ku told us. “I like to refer to these spaces as ‘test kitchens,’ where we can experiment, design, and create new healthcare recipes. We take a deep dive into understanding a healthcare problem, brainstorm solutions, create a functional prototype, and file for a patent.”
Like the ELL at University of South Florida, Ku’s test kitchen at Jefferson University helps future physicians become more comfortable with cutting-edge technology. While new innovations have greatly advanced the medical field over the past century, there is still a sense among many medical providers that technology—with all its whirring machinery, tangled cables, and plastic housing—interrupts the vital human connection required between caregiver and patient.
Best of both worlds: an in-person and virtual hybrid
Dr. Robert Wachter, chair of Internal Medicine at University of California, San Francisco, and author of the book “The Digital Doctor,” has long advocated for leveraging technology in medical education and care delivery. Yet, he warns virtual care and education cannot be a complete substitute, and that parts of both likely will need to remain in-person.
“Just as COVID-19 led to major shortcuts in the adoption curve for telemedicine, it did the same in virtual learning in medical schools,” says Wachter. Virtual learning allows medical schools to incorporate advanced visualizations, conduct online polls, and bring in great speakers from anywhere in the world, notes Wachter. On the flip side, the virtual experience is a poor substitute for a student trying to do clinical rotations and shouldn’t be used solely for convenience sake.
“I’m pretty sure we’ll still want to deliver bad news in person,” says Wachter. “But if it is more convenient for people to get care from home, or substantially cheaper, I think patients will demand virtual options and flock to providers that manage to offer a high-quality experience.”
Even before the coronavirus pandemic, USF Health had already integrated the Microsoft Teams virtual platform into its educational curriculum. Dr. Deborah DeWaay, associate dean of undergraduate medical education at the USF Morsani College of Medicine, says this lessened the impact of COVID-19.
For example, the school was able to seamlessly transition its clinical skills training with patient actors from an in-person to virtual format. Surprisingly, USF’s students tended to perform better in reasoning and diagnosis skills during the virtual simulations than they did during in-person medical simulations. However, DeWaay cautions that the virtual environment doesn’t support the full development of a future physician.
USF hasn’t had an opportunity yet to study why its students’ analytical skills improved in the virtual format, but the outcome has already led to change. The school now plans its future clinical skills training be a combination of in-person and virtual experiential models that “take advantage of both modes of learning.”
From nice-to-have to must-have
Within just a few short but historic weeks this spring, technology became the best and safest way for many caregivers to connect with patients—and for medical schools to connect with students. As COVID-19 has laid bare, technology is no longer simply a medical accessory. It’s a medical necessity. With a renewed focus on technology, our medical schools can ensure that future generations will receive the best, most accessible, and safest care possible—regardless of whatever crisis tomorrow brings.
Andrew M. Ibrahim, MD, MSc, is a surgeon and an assistant professor of surgery, architecture and urban planning at the University of Michigan. He also serves as chief medical officer for HOK’s healthcare practice. Randy Kray, AIA, is director of HOK’s science + technology practice with a focus on designing high-tech medical schools and research labs.