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Tech v Trust: scaling simulation for the 21C student

Tech v Trust: scaling simulation for 21st C students
Keynote for
4th International Conference on Medical Education Informatics (#MEI2021Conf)
Using technologies to support and enhance our student learning has been deemed a ‘wicked challenge’ by successive Educause ‘New Media Horizons’ reports, in their annual scanning of educational ‘futures’ environments. The challenge is not the technology, nor access to wide range of resources – the challenge is with us as educators stepping up and seeking to implement at scale. Healthcare students have had to overcome the restrictions and implications of Covid-19 with many of their clinical skills moving online, and with limited opportunities to engage with their clinical practice partners. But what are the factors we should be considering when creating authentic learning experiences for our students? Reimaging our teaching practice is a contested area, and this talk will set out some potential responses for building capacity and emphasises the significant ‘trust’ plays in taking our work forward.

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Tech v Trust: scaling simulation for the 21C student

  1. 1. Tech v Trust: scaling simulation for the 21C student Debbie Holley, Professor of Learning Innovation, Department of Nursing Sciences, BU find out more about our research: @debbieholley1 @N4LTH and #MEI2021Conf
  2. 2. Creating authentic learning experiences for our students
  3. 3. Why? A desire to create that 'best learning moment' The idea of best learning moments builds on the psychological concept of cognitive absorption, or ‘flow’, defined as deep involvement or immersion in an activity or task, often accompanied by feelings of enjoyment. People experience this mental state and these feelings when engaged in an activity that is appropriately challenging to their skill level, resulting in full concentration and focus. Best learning moments can result in deep learning and high levels of satisfaction, and they may also be particularly memorable. Enriching the learning environment for our students: Enriched realities extend what is possible in education and training and provide dynamic, new experiences that engage learners immediately. They also open up opportunities that are not available in the classroom, such as exploring places that would be difficult, dangerous or impossible to visit for a learner – the surface of Mars or the inside of a volcano, for example. With AR and VR, students can interact and work together, manipulating virtual objects and moving around the setting together... (OU Innovating pedagogies, 2021) Image credit: Anthony Canton (Unsplash)
  4. 4. How to engage our students ...offline, online and inbetween... • The JISC 'Student digital experience insights survey' was recently released, summarising the experiences of over 20,000 HE students at a range of 28 HE institutions. One surprising finding was that only 20% of students gain any 'real life' simulation experiences as part of their degree, and these tend to be in engineering design and healthcare. Link to JISC report: https://www.jisc.ac.uk/sites/default/files/student-dei-he- report-2020.pdf 360 video filming with our local trust partners and students
  5. 5. Quick definition And Mixed Reality too... Mixed reality Ref: Milgram, P. and Kishino, F., 1994. A taxonomy of mixed reality visual displays. IEICE TRANSACTIONS on Information and Systems, 77(12), pp.1321-1329.
  6. 6. The Topal review ... citizens, patients and families will have a pivotal role to play. Patient activism, such as #wearenotwaiting for patients with diabetes, exemplifies a growing trend in empowered patients demanding and taking greater control over their own care. Tackling digital exclusion while supporting the workforce to develop new skills and practices will be essential to ensure access and adoption across all socio-economic groups. Increased patient and public education programmes, as well as practical facilitation, will be needed to ensure that digital technologies do not increase health inequalities. pp24
  7. 7. Clearly not as simple as moving online.. but the main message is however we decide to move forward, trust is the key... The Topal Digital Medicine panel recommendation 1: "NHS online content should be a vital trusted source of health information and be resourced appropriately." (DM1)
  8. 8. Wellbeing for all "developing appropriate workforce skills and attitudes to empower patients and citizens to enhance their health and wellbeing through digital healthcare technologies" Topal pp40
  9. 9. Framing digital health and wellbeing: the EU context
  10. 10. The new EU Digcomp framework: digital health and wellbeing
  11. 11. EU project: looked at health • Worked with health visitors in the North-East of England • Their working patterns had changed – no longer say their colleagues to have the 'informal checking out' conversations. • What did they want from technology • A proxy for the 'trusted' other
  12. 12. https://labx.org/extreme-event/
  13. 13. VR Case Study: the deteriorating diabetic patient Research: • Randomised Control Trail (RCT) with 171 students • Significant learning gain when using VR • An inclusive learning tool • Quick and intuitive to use • VR made learning "more real" and engaging • Instant feedback and personalized learning • The students can repeat the exercise (distance learning) https://www.youtube.com/watch?v=AKpw1RbZ1hA
  14. 14. • Martian Attack: • Our paramedic team ran a simulation in our underground car park last month. • 3D 360-film clips created from the session captured scenarios, simulations and debrief, and are hosted on Panopto, and thus accessible by a range of technologies, from google cardboards, to OCULUS Quest Project lead: Adam Bancroft https://bournemouth.cloud.panopto.eu/Panopto/Pages/Viewer.aspx?id=d 91e4640-de42-45ee-beae-ad2f00cecebe
  15. 15. There is always a BUT... Image credit: green chameleon on Unsplash
  16. 16. Digital poverty “Without broadband we struggle to teach our children, order food and medicines, work or search for a job. Citizens Advice (2020) found that during the first lockdown, certain groups, including people with children, disabled people, people from Black, Asian or ethnic minority backgrounds, those who were shielding and young people were particularly struggling with their broadband bill An NUS survey (2020) reported BAME students, disabled students and lower socio-economic homes more severely impacted Image Credit: Fusion Medical Animation
  17. 17. Typical image: happy families using 'tech' • Working-age adults (16-64s) in DE households are more than four times as likely as those in non- DE households to not use the internet (13% vs. 3%), showing that differences in non-use of the internet are driven both by age and by socio-economic group. (Online Nation Ofcom report 2020)
  18. 18. Office for Students: Digital poverty report 2020 52% of students report their learning impacted by slow or reliable internet connection 8% severely 71 per cent reported lack of access to a quiet study space, with 22 per cent ‘severely’ impacted 56 per cent said they lacked access to appropriate online course materials, with 9 per cent ‘severely’ impacted 18 per cent were impacted by lack of access to a computer, laptop or tablet – 4 per cent said they were ‘severely’ impacted. 4% of students do not use the internet
  19. 19. The challenge of Scale:
  20. 20. Scaling technologies – what are the barriers?
  21. 21. Scaling Innovation • Bridging the missing middle: a design based approach to scaling Spread Depth Shift Sustainability Evolution Scaling up is achieved by diffusion of the innovation to large numbers of users. Requires modifications to retain effectiveness while reducing the resources and expertise required. Getting to scale produces deep and consequential changes in practice. Requires evaluation and research to understand and enhance the causes of effectiveness. Ownership of the innovation is assumed by users, who deepen and sustain the innovation via adaptation. Requires moving beyond “brand” to support users as co-evaluators, co- designers, and co-scalers. Sustaining scaled growth means maintaining these changes in practice over substantial periods of time. Requires robust design to enable adapting to negative shifts in context. The innovation as revised by its adapters is influential in reshaping the thinking of its designers. Requires learning from users’ adaptations about how to rethink the innovation’s model. Strengths Weaknesses Scan QR code to link to Scaling paper
  22. 22. Summary: health trends – how will you respond? • Broader adoption of artificial intelligence (AI) and machine learning in population health​ • Virtual reality and augmented reality as routine treatment for pain control after surgery and as an adjunct for chronic pain control​ • Wearables and implantable health devices to enable more routine detection of chronic conditions and monitor treatment effectiveness​ • Increased use and impact of digital therapeutics to enhance medical adherence and as an alternative to traditional treatments, such as diabetes prevention programs and other models relating to preventing or mitigating the impact of chronic conditions​ • Broader use of voice recognition and intelligent assistants to reduce clinical burden​ Image credit and report: Prof Kevin Warwick, professor of cybernetics at Reading University and the microchip in his arm https://www.telegraph.co.uk/news/science/science-news/10888828/Captain-Cyborg-the- man-behind-the-controversial-Turing-Test-claims.html
  23. 23. References and resources: Scaling: • Coburn, C (2003). Rethinking Scale: Moving beyond numbers to deep and lasting change. Educational Researcher 32, 6 (3-12) available online http://vocserve.berkeley.edu/faculty/CECoburn/coburnscale.pdf • Dede, C (2007). Scaling Up: Evolving Innovations beyond Ideal Settings to Challenging Contexts of Practice, available online: http://www.collegechangeseverything.org/dotAsset/d352af01-fb00-43c3-a956- 6a2f092a7c67.pdf Augmented reality: • Holley D., Hobbs M. (2019) Augmented Reality for Education. In: Peters M., Heraud R. (eds) Encyclopedia of Educational Innovation. Springer, Singapore https://doi.org/10.1007/978-981-13-2262-4 Online ISBN 978-981-13-2262-4 • Virtual reality • Singleton, H PhD (unplished) https://microsites.bournemouth.ac.uk/flie/2019/02/01/what-did-mental- health-nursing-students-think-of-vr-deteriorating-patient/Thanks to daden limited for the creation of the resources! • Heidi and Janet video of using VR for Nursing diabetes: • https://www.youtube.com/watch?v=AKpw1RbZ1hA • Prof Liz Falconer talking about Virtual Avebury: • https://www.youtube.com/watch?v=LVNIQMqIU6g
  24. 24. References • Beetham, H. (2015) Revisiting digital capability for 2015. http://digitalcapability.JISCinvolve.org/wp/2015/06/11/revisiting-digital- capability-for-2015/ • EU Learning Layers http://results.learning-layers.eu/ • European Commission (2014). Measuring Digital Skills across the EU: EU wide indicators of Digital Competence • Heath Education England: The Topal review (2019) preparing the healthcare workforce to deliver the digital future https://topol.hee.nhs.uk/ • Health Foundation: Securing a positive health care technology legacy from Covid – 19 https://www.health.org.uk/publications/long-reads/securing-a- positive-health-care-technology-legacy-from-covid-19 • Milgram, P. and Kishino, F., 1994. A taxonomy of mixed reality visual displays. IEICE TRANSACTIONS on Information and Systems, 77(12), pp.1321-1329.

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