Presented by Vanessa Carter from an e-Patient perspective at Stanford University Medicine X | Ed 2017
A Twitter chat was held on the 31st of January with various stakeholders to discuss openly. A public transcript can be viewed on Symplur. Thank you to all the participants who contributed to the research.
An abstract article from an e-Patient perspective about closing the medical education gaps in South Africa using the web and other digital resources.
The shortage of Medical Education facilities in developing countries like South Africa has had major repercussions on the local and global economy. In a recent 2014 article, it was reported that there were more than 36 000 applications for the 1 770 places available for first-year students in South Africa’s eight medical schools. For many, it has been disappointing that they were not getting the opportunity to study, despite ticking all the boxes. A growing population and lack of investment have been a portion of the contributing criteria. To worsen the crisis, students at some Universities across South Africa are protesting violently for free education, such as in the #FeesMustFall campaign because of the heavy burden of poverty and high fees.
Often, we stereotype medical education to a university earned PhD degree, a doctor, a nurse, a specialist, a professor, but as this WHO article emphasises, “A well-functioning health system working in harmony is built on having trained and motivated health workers, a well-maintained infrastructure,
and a reliable supply of medicines and technologies, backed by adequate funding, strong health plans and evidence-based policies”.
An all-inclusive, Universal HealthCare (UHC) workforce consists of every stakeholder whose predominant activities are aimed at enhancing a healthy population. They include doctors, specialists, nurses, caregivers, pharmacists, laboratory technicians, social workers, patient advocates — management and support workers such as financial officers, cooks, drivers and cleaners. Pressing global health concerns like infectious disease cannot be managed without a well-trained and comprehensive interdisciplinary team. Precision medicine is also not possible without this collaborative synergy. Imagine this; a top surgeon performs a clinical procedure on a patient, but the cleanliness of the theatre lets him down and causes an infection. Could it have been prevented if we focused on empowering cleaning workers with a more comprehensive medical education?
Digital Solutions and Closing Gaps in Medical Education
Infrastructure and connectivity issues in South Africa are being addressed as part of the Sustainable Development Goals. How would you reimagine medical education if it was accessible with the right tools, like smartphones and connectivity?
Navigating the Health System
Navigating the health system is key to Sustainable e-Health. A central, geographic healthcare social network could be developed which acts as an entry point to find resources like Online Communities, MOOCs, Live Lectures, Thought Leaders, News about Emerging Technology, Disease Control Information, Policy News, Events and more. The user-interface (UI) of the platform should be simple as well as visual to optimise navigation and improve participation, particularly bearing in mind that not every user will be an avid internet user.
Live lectures could be filmed in virtual reality to improve the learner’s experience. Collaborating with organisations like Doctors without Borders (MSF) or rural clinics like Zithulele might provide diverse opportunities for e-Interns to gain Real World Experience (RWE) which could count towards their PhD degree. This is especially beneficial to our global refugee issues and provides a volunteer resolution for these organisations who are facing dire shortages for qualified helping hands. Live surgery recordings like those performed in the recent #VRinOR could also be made more accessible to African medical students.
Medical certificates could be offered to regular citizens who want a qualification as a community health worker to make a difference with diseases like TB & AIDS, women are prominent candidates to achieve this. As part of their virtual health qualification, they should receive equipment like an iPad to capture data from each patient they consult and be able to share animations to educate them about self-care and adherence. Perhaps they should even have the opportunity to earn incentives for submitting complete data to a National Health Database and for showing progress towards achieving healthy outcomes.
Digital solutions are adaptable by design, therefore they can enable learners to choose a preferred language and address other barriers like literacy, disability, culture and religion. Online communities can be used to separate different demographic learners like medical students, nurses, spiritual healers, volunteers, caregivers, pharmacists, patient advocates and community workers. Data from these collective conversations could be useful to identifying issues to adapt education curriculums in real-time. No health worker should be excluded, in terms of HCPs, patients should have the freedom to choose their type of health provider whether they are traditional or modern.
By including patient communities on a single platform, learners have access to narratives which patients choose to share as case studies to further research or seek answers. Medical mystery cases could benefit the most from this online practice if it reaches the right networks. Some existing websites use medical crowdsourcing to review difficult cases, a good example of this is DefinitiveDX. Students and lecturers could also review these mystery cases in private portals as part of training. Patients could also apply for academic research projects which are distributed by the medical education community.
This is a fraction of what can be done using online technology, there are multiple ways that a digital health geographic platform could benefit medical education in South Africa, however, it will depend heavily on active user feedback, open idea sharing, collaboration and participation to progressively adapt the design and improve functionality so that it serves the health sector productively.
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