Written by Andy Smith, MTM publisher.
When looked at from an education, training, assessment and simulation point of view, 2018 was an interesting year in healthcare when some of the answers to the upcoming demographic challenges—including lack of staff, increasing long-term care demand and a different student profile—began to crystallize and perhaps really bite those in the industry.
The AR/VR scene continues to intrigue with new companies staffed by bright young engineers and backed by VC money popping up at all events across the year. Their enthusiasm and positivity was wonderful to see and those of us with a few years of healthcare ‘action’ behind us certainly hope that survives after their early collisions with healthcare professionals.
AI will undoubtedly help erase the errors made in increasingly (and necessarily) rushed diagnoses and also will support and enhance the treatment decisions for complex conditions. The issue here is can we crunch the data quickly enough—a problem for all data-rich industries that are dependent on computing power—as well as the collection of the correct data? AI might also be used to enhance the ‘virtual experience and judgement’ of students, perhaps allowing them to avoid the errors and uncertainties of recent rookies. Could the dangerous month after graduation become a thing of the past?
Data mining, feeding from the workplace to training and education centers, helps them better represent actuality and teach to the need, and should form a virtuous loop that could show all around improvement in outcomes from both a patient-safety and an economic perspective. However, we wonder how many teaching organizations will actually create that virtuous loop.
Students could find themselves assessed on entry to the next stage of their career/training with a purpose-built education and training course that is designed to take into account their strengths and weaknesses. This ‘adaptive learning,’ or individualized training is currently used by some institutions and can be applied as long as the students have been properly assessed through the learning process and not just processed by their ability to pay.
Sixty-year-old’s have (mostly) stopped throwing their hands in the air when the subject of the millennial student is raised and have accepted that we simply have to manage things and move on. Their digital strengths and their likely dexterity with various machine interfaces, plus their confidence in technology may make them THE robotic and minimally invasive surgeons of the future. Their interpersonal skills, the appalling language of many and their lack of leadership ability have been identified as real issues, but then nurses have grown used to dealing with verbal abuse from patients and senior staff.
Simulation, from the computer-based and manikin perspectives, continues to improve in fidelity. Although industry itself probably saw few signs of real advance in that theirs is still a low-volume business. In other words, the demand is frequently for almost bespoke solutions in low-volumes rather than standardized products and techniques that can be manufactured and delivered in large quantities. That will not change until healthcare itself changes and that seems to be as distant as ever. There are some not-for-profit organizations that have designated serious solutions for their members and some have even mandated their use.
At the same time the simulation buyer is becoming more discerning, mostly having been caught out first time around, they are now aware of the fidelity cost issue, the need for a maintenance budget, the need for well-trained techs and the need for of all the devices they buy to work together. Many still seem to base their buying decision on the ‘shiny new’ thing, rather than buying to fit the training need.
Which brings us to the myriad events everyone in healthcare attends at huge costs, each year. If these events are to remain a recognized source of education, then we remain in trouble as an industry. At best they may expose practitioners to the latest research, although 59 percent of that research is likely going to prove incorrect, the value is dubious. Scrap CMEs and replace them with a properly structured and evaluated training, annually. Mandate this training and make it free of charge and a part of the working day, i.e. pay the attendees as normal or provide insurance cost breaks.
An interesting comment from an extremely well-qualified physician seemed to capture the issue with healthcare. During a briefing on a wonderful new initiative late this year, he paused and commented, “At one time, and for many years, we accepted that 15 percent of patients undergoing (procedure x) would suffer from an infection. We simply accepted it. Until we decided not to accept it any longer, then we fixed it and now the infection rate is under 1 percent.”
Increasing numbers of healthcare providers are saying ‘we can fix it (healthcare) and we can fix it quickly, it can be done’. However, it evidently won’t be done until enough clinicians and other leaders decide it needs to be done and decide to do it. Adopting a real culture of safety is one very potent answer. That means changing the approach to the healthcare enterprise where everything within the systems and all its processes must be scrutinized and improved.