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Academic Medicine In Conversation:

Health Professions Education – What is the future of education with no borders?

Co-facilitators:

Associate Professor Chow Wan Cheng
Group Director, Academic Medicine, SingHealth
Senior Associate Dean, Academic Medicine, Duke-NUS Medical School

Associate Professor Nigel Tan
Neuroscience Academic Clinical Programme
Group Director, Education (Undergraduate), SingHealth
Senior Consultant, Department of Neurology, National Neuroscience Institute


Panellists:

Associate Professor Ong Thun How
Academic Vice Chair, Education, Medicine Academic Clinical Programme
Director of Education, SingHealth Duke-NUS Sleep Centre
Senior Consultant, Respiratory & Critical Care Medicine, Singapore General Hospital

Associate Professor Tan Hak Koon
Academic Chair, Obstetrics & Gynaecology Academic Clinical Programme
Designated Institutional Official, SingHealth Residency
Chairman and Senior Consultant, Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital

Associate Professor Yeo Khung Keong
Academic Vice Chair, Training & Education, Research EXCO, Cardiovascular Sciences Academic Clinical Programme
Deputy Group Chief Medical Informatics Officer (Research), SingHealth
Senior Consultant, Department of Cardiology, National Heart Centre Singapore

Ms Sabrina Koh
Campus Director, Sengkang Health
SingHealth Duke-NUS Institute of Medical Simulation
Deputy Chair, College of Clinical Nursing, SingHealth Academy
Deputy Director, Nursing, Sengkang Health

Professor Fernando Bello
Associate Dean, Technology Enhanced Learning and Innovation, Office of Education, Duke-NUS Medical School

Mastering Health Professional Education in a Global Pandemic


Educators from the SingHealth Duke-NUS Academic Medical Centre (AMC) discussed optimising education delivery amidst the onset of COVID-19, working creatively around social distancing measures with digital professionalism and framework agility.

  • How technology can help in medical education when social distancing is a must.
  • Equipping present and future generations for the VUCA world.
  • Mindset and tools for a crisis-ready future of healthcare professionals.


The third session of Academic Medicine In Conversation addressed the future landscape of borderless education for medical and healthcare professionals.

While lectures and exams were being cancelled globally, educators at SingHealth Duke-NUS AMC were pivoting to support health professions education.

Associate Professor Ong Thun How described the details of running virtual exams successfully despite heavy logistical challenges. "Conducting a high-stakes OSCE in a COVID-19 environment" was detailed in a paper that garnered 13,000 views when published.

Assoc Prof Ong's example was one of many. The acceleration of virtual education and telemedicine was a demonstration of agility, an alignment of teaching and training towards united efforts in digital literacy, alongside identification of "true essentials" in healthcare thrusted with a pandemic.


Sustaining healthcare education with innovation

As manpower issues persisted, many nurses were receiving training in actual COVID-19 sites. Seeking a balance between risk-taking and student safety, Ms Sabrina Koh underscored the importance of moving fast with teaching ideas and resource development "because we never know that it may be the next best thing to help us through a crisis".

Driven under this context, Ms Koh had begun co-developing an augmented reality (AR) training tool for automated external defibrillator (AED) application with NUS Mechanical Engineering students.

Professor Fernando Bello echoed Ms Koh's direction and stressed for a research movement to transpose training of procedural skills to simulation-based learning.

He proposed that collaborations between engineers, clinicians, and educators can hasten tools research and development, while accurately addressing present gaps in the education of healthcare professionals.

Moving beyond lessons delivery, Prof Bello raised that Academic Medicine's future should focus on improving education engagement and interactivity. To accomplish these, he highlighted the necessity for achieving digital literacy and a coordinated integration of technology usage across the AMC.


Entering a "VUCA" world

Session co-facilitator Associate Professor Chow Wan Cheng introduced the concept of "VUCA" (volatile, uncertain, complex, and ambiguous) running parallel to timely technology use.

Associate Professor Nigel Tan followed to explain that VUCA environment was here to stay and will be a major element in healthcare academic development.

He detailed that learning adaptive responses from failure will be the new normal, alongside the need for explicit frameworks to cope with change. Such experiential learning and guided reflections will provide support for a robust future in VUCA situations.

Sharing further on coping in a crisis, Associate Professor Tan Hak Koon described that the pandemic had touched every aspect of the residency system: Residents, administrators, and faculty, but that "people are coming back to this as a learning experience".

Administrators had learnt to conduct teachings differently and residents had stepped up to the experiential learning opportunity, volunteering to join the healthcare frontlines as COVID-19 unfolded.

"If there was one thing that have come up with COVID-19, it would be that it had shown us how adaptable and resilient we can be as a person and as a system," Assoc Prof Tan said.


Staying the course

Even with AMC moving rapidly to develop a wider strategy for technology-enhanced learning, health professions educators were acutely aware that virtual education cannot make up for physical aspects of medicine.

The pandemic onset had driven many to re-examine how healthcare was being taught and learnt. In response, Associate Professor Yeo Khung Keong emphasised the importance of having a good mentor to help one "not lose sight of the core principles that guide [our] work".

He reminded how it was ever more vital to have someone to check in with for clear feedback, to embody a "can-do" mentality to model after, and to impart the readiness to explore.

No matter the times, serving and connecting with patients are constant as the enduring core of the healthcare system, and Assoc Prof Ong believed that the message was clear.

"By carrying on with teachings and examinations, it sent a signal to students that despite everything, your job was to come and learn and your job is to (care for) patients," she said. "I thought that was quite powerful."

"To build trust, we need to be able to connect meaningfully no matter which medium we use," Assoc Prof Tan said in closing. "It really starts with empathetic listening. That should be our foundation of digital professionalism, to connect with the patient at the end of the line."

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