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      A vision of the use of technology in medical education after the COVID-19 pandemic

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      a , 1 , , 2
      MedEdPublish
      F1000 Research Limited
      technology, medical education, transformative change, coronavirus, COVID-19

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          Abstract

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          Medical education across the world has experienced a major disruptive change as a consequence of the COVID-19 pandemic and technology has been rapidly and innovatively used to maintain teaching and learning. The future of medical education is uncertain after the pandemic resolves but several potential future scenarios are discussed to inform current decision-making about the future provision of teaching and learning. The use of emergent technology for education, such as artificial intelligence for adaptive learning and virtual reality, are highly likely to be essential components of the transformative change and the future of medical education. The benefits and challenges of the use of technology in medical education are discussed with the intention of informing all providers on how the changes after the pandemic can have a positive impact on both educators and students across the world.

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          COVID-19 and medical education

          The coronavirus disease 2019 (COVID-19) outbreak has rapidly transitioned into a worldwide pandemic. This development has had serious implications for public institutions and raises particular questions for medical schools. Frequent rotations between departments and hospitals make medical students potential vectors for COVID-19. Equally, as trainee doctors we stand to learn a tremendous amount and can contribute to the care of patients. More immediate concerns among medical students centre on the impact of COVID-19 on medical education. A substantial number of medical students are in the process of preparing for or undertaking assessments that require clinical exposure. The effect of COVID-19 on medical education could therefore be considerable. Several teaching hospitals in the UK have reported cases of COVID-19, with some hospitals suspending medical and observership students from attending clinical attachments. This suspension might extend to more hospitals as the COVID-19 pandemic continues to develop, which could lead to clinical medical students receiving reduced exposure in specific specialties, causing a detrimental effect to exam performance and competency as foundation year 1 doctors. The situation is more complex for some final year medical students who are in the process of sitting their final assessments. Some medical schools have reduced clinical exposure in the weeks coming up to their final exams to reduce the risk of contracting the virus. Many electives could also be cancelled because of the global prevalence of COVID-19. This situation would not only cause financial losses for students, but also lead to a missed opportunity of working in a health-care system outside of the UK. At this stage, it is difficult to predict what will happen, and most medical schools are following advice from Public Health England to determine how to proceed. Despite widespread panic and uncertainty, the medical community must ask itself what history has taught us about medical education during pandemics. To answer this question, we reflect on the effects of severe acute respiratory syndrome (SARS) on medical education in China at the turn of the century. 1 Some Chinese medical schools officially cancelled formal teaching on wards and their exams were delayed, hindering the education of medical students in the face of the newly emerging epidemic. 1 Similarly, in Canada, the impact of the SARS restrictions led to the cessation of clinical clerkships and electives for students for up to 6 weeks. 2 The Canadian national residency match felt the effect of these limitations, particularly because electives are one of the most crucial factors determining allocation. 1 Despite the challenges posed by the SARS epidemic, several resourceful initiatives were implemented, leading to progress in medical education. In one Chinese medical school, online problem-based learning techniques were implemented to complete the curricula; these methods proved incredibly popular, to the extent that they were applied in subsequent years. These impressive feats illuminate how even in times of distress, solace can always be found. We are waiting to see what ingenuities for medical education will emerge in the face of the COVID-19 pandemic. This online publication has been corrected. The corrected version first appeared at thelancet.com/infection on March 27, 2020.
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            Applications and Challenges of Implementing Artificial Intelligence in Medical Education: Integrative Review

            Background Since the advent of artificial intelligence (AI) in 1955, the applications of AI have increased over the years within a rapidly changing digital landscape where public expectations are on the rise, fed by social media, industry leaders, and medical practitioners. However, there has been little interest in AI in medical education until the last two decades, with only a recent increase in the number of publications and citations in the field. To our knowledge, thus far, a limited number of articles have discussed or reviewed the current use of AI in medical education. Objective This study aims to review the current applications of AI in medical education as well as the challenges of implementing AI in medical education. Methods Medline (Ovid), EBSCOhost Education Resources Information Center (ERIC) and Education Source, and Web of Science were searched with explicit inclusion and exclusion criteria. Full text of the selected articles was analyzed using the Extension of Technology Acceptance Model and the Diffusions of Innovations theory. Data were subsequently pooled together and analyzed quantitatively. Results A total of 37 articles were identified. Three primary uses of AI in medical education were identified: learning support (n=32), assessment of students’ learning (n=4), and curriculum review (n=1). The main reasons for use of AI are its ability to provide feedback and a guided learning pathway and to decrease costs. Subgroup analysis revealed that medical undergraduates are the primary target audience for AI use. In addition, 34 articles described the challenges of AI implementation in medical education; two main reasons were identified: difficulty in assessing the effectiveness of AI in medical education and technical challenges while developing AI applications. Conclusions The primary use of AI in medical education was for learning support mainly due to its ability to provide individualized feedback. Little emphasis was placed on curriculum review and assessment of students’ learning due to the lack of digitalization and sensitive nature of examinations, respectively. Big data manipulation also warrants the need to ensure data integrity. Methodological improvements are required to increase AI adoption by addressing the technical difficulties of creating an AI application and using novel methods to assess the effectiveness of AI. To better integrate AI into the medical profession, measures should be taken to introduce AI into the medical school curriculum for medical professionals to better understand AI algorithms and maximize its use.
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              Twelve tips for the effective use of videos in medical education.

              Videos can promote learning by either complementing classroom activities, or in self-paced online learning modules. Despite the wide availability of online videos in medicine, it can be a challenge for many educators to decide when videos should be used, how to best use videos, and whether to use existing videos or produce their own. We outline 12 tips based on a review of best practices in curriculum design, current research in multimedia learning and our experience in producing and using educational videos. The 12 tips review the advantages of using videos in medical education, present requirements for teachers and students, discuss how to integrate video into a teaching programme, and describe technical requirements when producing one's own videos. The 12 tips can help medical educators use videos more effectively to promote student engagement and learning.
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                Author and article information

                Journal
                MedEdPublish (2016)
                MedEdPublish (2016)
                MedEdPublish
                F1000 Research Limited (London, UK )
                2312-7996
                26 March 2020
                2020
                : 9
                : 49
                Affiliations
                [1 ]National University of Singapore
                [2 ]Edge Hill University Medical School
                [1 ]Ain Shams University Faculty of Medicine
                [1 ]Swansea University
                [1 ]American International Medical University
                [1 ]The First Affiliated Hospital of Sun Yat-sen University
                [1 ]BMJ
                [1 ]SRM UNIVERSITY,RAMAPURAM,CHENNAI.
                [1 ]AMEE
                [1 ]Leeds Institute of Medical Education
                Author notes
                Article
                10.15694/mep.2020.000049.1
                10697445
                38058893
                4b501000-5d1e-4a7c-951a-1ba9fb61041e
                Copyright: © 2020 Goh PS and Sandars J

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                technology,medical education,transformative change,coronavirus,covid-19

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