It’s important, but not important enough: eHealth as a curriculum priority in medical education in Australia

Abstract

Information and communications technology has become central to the way in which health services are provided. Technology-enabled services in healthcare are often described as eHealth, or more recently, digital health. Practitioners may require new knowledge, skills and competencies to make best use of eHealth, and while universities may be a logical place to provide such education and training, a study in 2012 found that the workforce was not being adequately educated to achieve competence to work with eHealth. We revisited eHealth education and training in Australian universities with a focus on medical schools; we aimed to explore the progress of eHealth in the Australian medical curriculum. We conducted a national interview study and interpretative phenomenological analysis with participants from all 19 medical schools in Australia; two themes emerged: (i) consensus on the importance of eHealth to current and future clinical practice; (ii) there are other priorities, and no strong drivers for change. Systemic problems inhibit the inclusion of eHealth in medical education: the curriculum is described as ‘crowded’ and with competing demands, and because accrediting bodies do not expect eHealth competence in medical graduates, there is no external pressure for its inclusion. Unless and until accrediting bodies recognise and expect competence in eHealth, it is unlikely that it will enter the curriculum; consequently the future workforce will remain unprepared.

Understanding Medical Students’ Attitudes Toward Learning eHealth: Questionnaire Study

“…Therefore, education about eHealth for those involved, in this case the undergraduate students, can lessen the barriers previously mentioned and help to create a workforce that is open and able to use eHealth in their daily practice. Many universities do not have dedicated eHealth training in the current curriculum, adding to the resistance to change [ 17 , 18 ]. Universities and their executives are aware that eHealth training is important, but due to the already overcrowded curricula with competing interests, implementation is lacking [ 18 ].…”

“…A recent assessment of medical curricula in Sweden showed that only one university had concrete plans about implementing eHealth into their medical curriculum [ 17 ]. Another trial in Australia showed that none of the universities had established an eHealth program [ 18 ]. In addition, the European Health Parliament found that current health professionals do not feel adequately trained in eHealth and found that formal eHealth training is lacking from an early stage in the training of medical professionals [ 19 ].…”

“…In addition, the European Health Parliament found that current health professionals do not feel adequately trained in eHealth and found that formal eHealth training is lacking from an early stage in the training of medical professionals [ 19 ]. Universities and their executives are aware of the lack of formal eHealth education, but the medical curriculum is already crowded and priorities are given to other subjects [ 18 ].…”

We still need the clinic; patient perceptions on doctor‐in‐training delivered telehealth versus in‐person consultation

“…To address these issues, the institution of telehealth services have been recommended by the World Health Organization across primary health and specialist services in an effort to minimize the discrepancy in healthcare opportunities faced by rural patients . Continuous advancements in technology and improved internet connectivity have allowed for the digitization of services to push past the archaic boundaries of strictly in‐person, health facility delivered care models …”

“…Those who are not willing to engage often list a major barrier to the uptake of telehealth as the increased time per consultation when compared with in‐person appointments . Improvement in telehealth skills for delivery is paramount, yet despite this, Australian medical education systems have failed to adopt telehealth education into their curriculums citing competing topics of equal importance . The DIT involved in these consultations was 3 years post‐graduation and had received no formal education, either in university or prior to commencing teleconsultations.…”