There’s a lot of anxiety among health professions educators right now as they try to move classes and entire courses online. They weren’t trained to do this, have little experience doing this, and many may not even want to do this. Hardly an inspiring thought. And I found myself agreeing with them. They didn’t sign up for this and most of them really do believe that a lot will be lost with the move online.
Thinking about this predicament (i.e. people who don’t think that “online” is the best way to teach health professionals, but who nonetheless must do it) made me wonder if reframing the question would change how they approach the problem. Instead of asking, “How do I move my course online?” what if we asked, “How can I help my less-experienced colleagues in their professional development?” Instead of focusing on building online classrooms, how about providing additional opportunities for CPD? Rather than focusing on moving content online, ask your less-experienced colleagues what the gaps are in their own learning. Don’t spend a lot of time trying to figure out how to control the assessment process but rather try to help our less-experienced colleagues to evaluate their own performance.
You may already have noticed that each of the above shifts the emphasis from you as a teacher having to control the process of students’ learning (environment, content, assessment, etc.), towards something that probably looks more like a dialogue. A conversation. You know, probably more like how you learn. No-one tells you what you need to focus on, or how far “behind” you are, or what you have to read. Maybe over the next few weeks and months we could reflect on how each of us learns best and provide our less-experienced colleagues (previously known as “our students”) with more authentic opportunities to develop as healthcare professionals.
Note: Thank you to Joost van Wijchen who first introduced me to the concept of “working with our less-experienced colleagues”, rather than “teaching to our students”, and who recently reminded me of this wonderful mental model.
In this wide-ranging conversation, Vanessa and I discuss her 25 years in health professions education and research. We look at the changes that have taken place in the domain over the past 5-10 years and how this has impacted the opportunities available for South African health professions educators in the early stages of their careers. We talk about developing the confidence to approach people you may want to work with, from the days when you had to be physically present at a conference workshop, to explore novel ways to connect with colleagues in a networked world. We discuss Vanessa’s role in establishing the Southern African FAIMER Regional Institute (SAFRI), as well as the African Journal of Health Professions Education (AJHPE) and what we might consider when presented with opportunities to drive change in the profession.
Vanessa has a National Excellence in Teaching and Learning Award from the Council of Higher Education and the Higher Education Learning and Teaching Association of South Africa (HELTASA), and holds a Teaching at University (TAU) fellowship from the Council for Higher Education of South Africa. She is a Deputy Editor at the journal Medical Education, and Associate Editor of Advances in Health Sciences Education. Vanessa was Professor and Chair of Clinical Medicine at the University of Cape Town from 2008-2018in health and is currently Honorary Professor of Medicine at UCT. She works as an educational consultant to the Colleges of Medicine of South Africa.
The challenges of real-world implementation alone mean that we probably will see little change to clinical practice from AI in the next 5 years. We should certainly see changes in 10 years, and there is a real prospect of massive change in 20 years. 
This means that students entering health professions education today are likely to begin seeing the impact of AI in clinical practice when they graduate, and very likely to see significant changes 3-5 into their practice after graduating. Regardless of what progress is made between now and then, the students we’re teaching today will certainly be practising in a clinical environment that is very different from the one we prepared them for.
Coiera offers the following suggestions for how clinical education should probably be adapted:
Include a solid foundation in the statistical and psychological science of clinical reasoning.
Develop models of shared decision-making that include patients’ intelligent agents as partners in the process.
Clinicians will have a greater role to play in patient safety as new risks emerge e.g. automation bias.
Clinicians must be active participants in the development of new models of care that will become possible with AI.
We should also recognise that there is still a lot that is unknown with respect to where, when and how these disruptions will occur. Coiera suggests that the best guesses we can make about predicting the changes that are likely to happen should probably focus on those aspects of practice that are routine because this is where AI research will focus. As educators, we should work with clinicians to identify those areas of clinical practice that are most likely to be disrupted by AI-based technologies and then determine how education needs to change in response.
The prospect of AI is a Rorschach blot upon which many transfer their technological dreams or anxieties.
Finally, it’s also useful to consider that we will see in AI our own hopes and fears and that these biases are likely to inform the way we think about the potential benefits and dangers of AI. For this reason, we should include as diverse a group as possible in the discussion of how this technology should be integrated into practice.
 The quote from the article is based on Amara’s Law: “We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run.”
Two weeks ago I presented some of my thoughts on the implications of AI and machine learning in clinical practice and health professions education at the 2018 SAAHE conference. Here are the slides I used (20 slides for 20 seconds each) with a very brief description of each slide. This presentation is based on a paper I submitted to OpenPhysio, called: “Artificial intelligence in clinical practice: Implications for physiotherapy education“.