Health Education: Digital helps, but we must still learn from real-life scenarios

Dr Kunal Patel 03 Apr 2019
The drawings depicted have been created on behalf of the authors, and copyright has been paid and written permission to use it in a medical journal has also been given by the artist. (Ferreiro Iglesias Studio SL, Igualada, Barcelona)

As a health worker, engaging with real people and real examples of disease is an essential component of learning throughout your career. Sadly, we are seeing less use of essentials such as anatomy education via the use of real cadavers due to numerous reasons such as cost and the availability of donors. In the meantime, digital tools can help, but as the name suggests, ‘tools’ are there to assist and not replace, and until we get the balance right and expose students and qualified health workers to more real-world cases, we have to find the right balance between digital and reality.

Case Study - Video display versus a real theatrical performance.

Studies continue to examine digital tools and the role they play in medical education. One such study was recently published examining how we present clinical cases, ‘live’ type v virtual cases. Ultimately, a blended approach is essential, yet the findings of this study were still a read worth bookmarking. María José Robles and her co-authors at the Geriatric Department Consorcio Parc de Salut Mar de Barcelona compared knowledge attainment via the type of case study method. Basically, they compared looking at a video display versus a real theatrical performance.

Using a teaching seminar model, case studies based on delirium were presented to 131 students, who were split into two groups. A scene was then simulated live in the classroom as a theatrical performance for the scene group while the case was projected on a wall screen for the video group, after which open questions on the case were asked and discussed (debriefing). The figure below, (courtesy of BMC Medical Education), shows the two scenarios:

a. The pre-recorded scene was displayed on a screen wall using the usual projector that was already installed in the classroom.
b. The image that shows the live simulation in the centre of the classroom surrounded by the students

Knowledge after the scenarios was assessed, improved in both groups. Those using the ‘scene’ case study had higher scores than those who used the ‘video’ case study on both delirium knowledge but also their subjective learning perception.


This data shows that video cases/presentations do work well yet, ‘live’ study that involves either real patients or actors in simulated scenarios, provides an authenticity that can never be truly replicated digitally. Therefore, when we consider how we learn during a course but also while we practice, real scenarios are still the most effective, yet, they should be supported by digital tools such as video.

When I was a student and recently in clinics and postgraduate courses, I have been exposed to patients or actors as part of my learning, as they have done so in this study. Learners have to have a base that covers all grounds, digital and reality because as they progress their patients won’t be a line of code or an anonymous entry on a data sheet, they will always be human beings.