By Vjekoslav Hlede, PhD

This column aims to provide insight and practical information on the impact of e-learning on CME/CPD and the latest trends in technology available to enhance the online learning experience.

Technology-Enhanced CPD After 1.5 Years of the COVID-19 Crisis: Where are We Now?

Necessity is the mother of innovation

It has been 1.5 years since coronavirus disease 2019 (COVID-19) was recognized in China, and over a year since the first American COVID case was reported on January 20, 2020. It has been a time of crisis, changes, and innovation—especially in technology-enhanced CPD.

Twenty-three centuries ago, Plato wrote that invention is fueled by our need (Plato & Scharffenberger, 2005). "Necessity is the mother of invention" is a contemporary proverb rooted in the same thought.

The COVID-19 crisis is an example of such an emerging, innovation-generating need. We had to innovate how we commute, socialize, heal—and yes, we had to (re)invent how we learn. The CPD we know today is different than the CPD from 2 years ago. 

When the epidemic is over, we may go back to many old practices. Still, we will have a shared understanding that there are valid alternatives to face-to-face learning, and multiple ways to enhance the traditional learning formats with technology. We will be (more) familiar with different pedagogies we can use, and aware of the value technology-enhanced social learning and autonomous networked learning can deliver.

Many changes have been developing during the last decade or two. Therefore, we have had plenty of materials to use for innovations. The crisis has accelerated these changes. More importantly, it has catalyzed us, the people. We, as learners, CPD providers, and faculty, have gotten comfortable with technology-enhanced pedagogies. We have become accustomed to optimizing technology-enhanced CPD or finding innovative ways to address the limitations of technology.

One great example of an innovative way to address commonly mentioned limitations of technology-enhanced meetings was the SACME Annual Meeting session "What Connects Us: Meet Our Young Co-Workers (i.e., your kids)." During that session, conference participants joined with their kids, creating a unique, memorable, social, and friendly atmosphere. Imagine that—a chance to meet your peers and their kids, hear kids' perspectives on parents working from home, and see toddlers attempting to use keyboards. How awesome is that?! That kind of social interaction is not possible during traditional face-to-face meetings. Therefore, while replicating the rich, friendly atmosphere from live annual meetings in an online context can be a challenging task, there are a wealth of opportunities to innovate in adding meaningful social interaction to online meetings. 

For CPD providers, technological change is a big task that requires additional resources and new know-how. So, providers may be hesitant to take further steps in that direction. On the other hand, learners find it easier to say: "Yes, that is the way to go. "

For example, Swiatek et al. (2021) surveyed 902 spine surgeons from 91 countries and seven continents, and found that virtual medicine practices are being adopted very rapidly and that surgeons love them. Online education platforms have become the primary sources for spine education and physician-to-physician communication. In the same manner, telehealth, which was "once considered technologically cumbersome, financially unproductive, and difficult from a medico-legal perspective, has now become part of clinical spine surgery" (p. 9). Surgeons are happy with that direction.

Improved access to CME/CPD and access to high-profile experts in CME/CPD conference programming are additional benefits. It may be hard to expect busy, well-known experts to be ready to spend two or more days traveling (time, cost of travel and accommodation) to deliver one presentation at your conference. Yet, if they can join the conference from the comfort of their own office, they will be more prone to say, "Yes, I will be happy to present." For example, the SACME 2021 virtual annual meeting highlights were the sessions delivered by a few globally recognized experts. That is a benefit we cannot afford during purely face-to-face live meetings.

Kisilevsky et al. (2021) report that the COVID crisis has helped us improve collaboration between various CME/CPD stakeholders and has increased access to CME/CPD. Improved access to high-quality resources benefits all learners, especially those from groups that have traditionally had limited access to CME/CPD events (participants from remote areas, those with limited funding, or women with young kids, for example). Furthermore, virtual CME/CPD may be an equalizer that helps us reduce the gender gap in medicine. Virtual CME/CPD provides an opportunity for female faculty to increase involvement in CME/CPD. That is, as Kisilevsky et al. (2021) explain, an important step toward an equal gender balance on journal editorial boards and women being better represented as primary authors in peer-reviewed journals.

So, what will happen after the epidemic is over?

Based on previous technology adoption cycles among healthcare professionals—smartphone adoption, for example—it is fair to say the genie is out of the bottle. There is no way back. Physicians are very busy, highly trained, and well-regulated professionals, sharply focused on patients' health. Therefore, they do not have time to play with emerging technologies. On the other hand, if there is proof that a mature technology can help us improve patient care, and appropriate policies and regulations are in place, clinicians will adopt it very quickly. We can recall that clinicians were not early adopters of smartphones. There were many concerns about how a smartphone could negatively impact healthcare practices (Gill et al., 2012). And then, during the first few years of the last decade, that changed fast (Putzer & Park, 2012).

Now when we know the direction and the quite permanent nature of recent changes, we may ask ourselves, are there additional opportunities and gaps? The scoping review by Daniel et al. (2021) on developments in medical education in response to the COVID-19 pandemic reveals that there was quite a lot of research focused on pivoting to online learning, simulation, and assessment. On the other hand, they found only two articles focused on faculty development. Faculty skilled in supporting and leading engaging technology-enhanced CPD are critical for effective technology-enhanced CPD. Therefore, faculty development seems to be a gap and opportunity that requires additional attention.

The COVID-19 crisis has initiated many changes and innovations. Though the crisis is coming to an end, many of those changes and innovations are here to stay. We can use them to fuel new innovations and new improvements. The necessity in the near future will not be to react to the epidemic; the necessity will be to continue improving. While we do so, Kitto (2021) convincingly explains, our focus should not be on technology, but on how to use the technology to deliver human-centered improvements to the increasingly complex socio-technical systems we live in.

Vjekoslav Hlede, PhD is a Senior Learning Management Specialist with the American Society of Anesthesiologists, Chicago. 

References

Daniel, M., Gordon, M., Patricio, M., Hider, A., Pawlik, C., Bhagdev, R., Ahmad, S., Alston, S., Park, S., Pawlikowska, T., Rees, E., Doyle, A. J., Pammi, M., Thammasitboon, S., Haas, M., Peterson, W., Lew, M., Khamees, D., Spadafore, M., Clarke, N., & Stojan, J. (2021). An update on developments in medical education in response to the COVID-19 pandemic: A BEME scoping review: BEME Guide No. 64. Med Teach, 43(3), 253-271. https://doi.org/10.1080/0142159x.2020.1864310

Gill, P. S., Kamath, A., & Gill, T. S. (2012). Distraction: an assessment of smartphone usage in health care work settings. Risk management and healthcare policy, 5, 105-114. https://doi.org/10.2147/RMHP.S34813

Kisilevsky, E., Margolin, E., & Kohly, R. P. (2021). Access, an unintended consequence of virtual continuing medical education during COVID-19: a department's experience at the University of Toronto. Canadian Journal of Ophthalmology, 56(1), e18-e19. https://doi.org/10.1016/j.jcjo.2020.10.002

Kitto, S. (2021). The Importance of Proactive and Strategic Technology-Enhanced Continuing Professional Development. Journal of Continuing Education in the Health Professions, 41(1), 3-4. https://doi.org/10.1097/ceh.0000000000000343

Plato, & Scharffenberger, E. W. (2005). Republic (B. Jowett, Trans.). Barnes & Noble, Incorporated. https://books.google.hr/books?id=9FLdTCiaI_MC

Putzer, G. J., & Park, Y. (2012). Are physicians likely to adopt emerging mobile technologies? Attitudes and innovation factors affecting smartphone use in the Southeastern United States. Perspectives in Health Information Management/AHIMA, American Health Information Management Association, 9(Spring).

Swiatek, P. R., Weiner, J. A., Johnson, D. J., Louie, P. K., McCarthy, M. H., Harada, G. K., Germscheid, N., Cheung, J. P. Y., Neva, M. H., El-Sharkawi, M., Valacco, M., Sciubba, D. M., Chutkan, N. B., An, H. S., & Samartzis, D. (2021). COVID-19 and the rise of virtual medicine in spine surgery: a worldwide study. European Spine Journal. https://doi.org/10.1007/s00586-020-06714-y