의학교육에서 변화하는 교육 테크놀로지 역할에 대한 준비(Acad Med, 2011)

의학교육에서 변화하는 교육 테크놀로지 역할에 대한 준비(Acad Med, 2011)

Preparing for the Changing Role of Instructional Technologies in Medical Education

Bernard R. Robin, PhD, Sara G. McNeil, EdD, David A. Cook, MD, MHPE, Kathryn L. Agarwal, MD, and Geeta R. Singhal, MD, MEd

고등교육기관이 진화하면서, 변화하는 트렌드에 따라서 급진적인 변화를 겪게 된다.

As institutions of higher education evolve, it is obvious that they, need to undergo radical changes to deal with the converging trends

 

Christensen이 Forum for the Future of Higher Education에서 지적한 바와 같이, 학교들이 교육내용의 전달에 대해서 다시 생각하고 다시 구조화할 때가 되었다. "이 리빌딩 작업을 위해서는 자신이 속한 과나 분과를 대표하지 않으면서, 현재의 조직 구조를 벗어나 생각할 수 있는 전문가 팀이 필요하다"

As Christensen1 notes in the Forum for the Future of Higher Education, schools must completely rethink and restructure the way they deliver educational content: “The rebuilding task demands a team comprising experts who don’t represent their departments or divisions and who can think outside the current organizational structure.”

미래 예측의 어려움

The Challenge in Predicting the Future

1936년 H.G. Wells는 "전 세계의 흩어지고 비효과적인 정신적 재산"을 위한 해결책으로 일반인을 위한 "World Encyclopaedia"라고 부르는 것을 제시했다. "World Encyclopaedia"는 각 분야의 권위자들이 집필assemble하며 (내용의) "집중, 명확, 종합"이 될 것이며, "전 세계를 정신적으로mentally 모아줄 것이다". Well이 말한 "World Encyclopaedia"는 2001년 Jimmy Wales와 Larry Sanger가 시작한 오늘날의 위키피디아와 매우 비슷하다.

In 1936, H.G. Wells3 suggested that the solution to “all the scattered and ineffective mental wealth of the world” was what he called a “World Encyclopaedia” for the common man. The World Encyclopaedia would be assembled by authorities in each subject area and would be “a concentration, a clarification, and a synthesis” designed to “hold the world together mentally.” Wells’ World Encyclopaedia sounds remarkably like today’s Wikipedia, a multilingual, Web-based, free-content encyclopedia project based on an editable, collaborative model begun in 2001 by Jimmy Wales and Larry Sanger.4

 

1945년 Vannevar Bush는 과학 커뮤니티의 연구결과를 관리하고 전파하는 것이 어렵다는 것을 느끼고 memex를 제안하였는데, 이것은 "개개인이 자신의 책/기록/커뮤니케이션 등을 저장하는 장치로서, 엄청나게 빠른 속도와 유연성으로 그 자료를 가지고 논의consult with 할 수 있게 해주는 장치"이다. 이 memex는 오늘날의 컴퓨터 또는 인터넷과 연결된 스마트폰과 매우 비슷하다.

In 1945, Vannevar Bush5 described the difficulty in managing and disseminating the results of research to the scientific community. He proposed the memex,a device in which “an individual stores all of his books, records, and communications, and which is mechanized so that it may be consulted with exceeding speed and flexibility.” The memex sounds surprisingly like today’s handheld computers and Internet- connected smartphones.

 

그러나 미래에 대한 예측이 늘 옳은 것은 아니다.

Yet not all predictions of the future are this accurate.

 

외과의사인 John Eric Erichsen는 1873년..."언제나 새로운 수술 필드fresh field가 있을 수는 없다...(후략)"이라고 했다

John Eric Erichsen,6 appointed Surgeon Extraordinary to Queen Victoria, stated in 1873: “There cannot always be fresh fields for conquest by the knife. There must be portions of the human frame that will ever remain sacred from its intrusion—at least, in the surgeon’s hand.”

 

William Thomson 는 X-ray는 사기이다 라고 했다. Kanter의 경고를 따르자면, "미래를 예측하는 것은 점쟁이의 역할이며, 우리는 의학교육을 발전히키기 위해서 미래에 어떤 기회가 있을지 예측하는 것이 최선이고, 혹은 최악의 경우에는 세계가 우리를 남겨두고 발전해 나갈 수도 있다."

William Thomson (Lord Kelvin), an English physicist and inventor, stated in 1899 that “X-rays will prove to be a hoax.”7 Acknowledging Kanter’s8 caution that predicting the future is best left to fortune tellers, we need to do our best to predict future opportunities to improve medical education, or worse, be left behind as the world moves on without us.

우리에게는 두 가지 중요한 과제가 남았다. 하나는 변화를 충분히 일찍 수용하여 결과에 영향을 미치는 것이고, 둘째는 변화를 활용하여 교육을 향상시키는 것이다.

We face two important tasks: first, to adapt to change early enough to influence outcomes; and second, to harness change to enhance education.

의학교육에 영향을 주고 있는 변화 트렌드

Converging Trends in Technology That Are Affecting Medical Education

 

1. 새로운 정보의 폭발

Trend 1: The explosion of new information

전 세계의 지식의 총체는 엄청난 속도로 빠르게 증가하고 있다. 1800년에서 1900년이 되면서 두 배가 되었으나, 1940년에는 20년이면 두 배가 되었고, Cornall은 2015년이 되면 35일마다 두 배가 될 것이라고 예상했다

The rate of growth of the world’s collective body of knowledge has been accelerating at an extraordinary pace. The world’s body of knowledge doubled between 1800 and 1900, by 1940 the doubling rate was every 20 years,9 and Cornall10 has postulated that by 2015, the body of knowledge in the world will double every 35 days.

2. 모든 정보의 디지털화

Trend 2: The digitization of all information

Google Health 는 모든 사람들이 자신의 의무기록, 처방 등을 모으고, 이 데이터를 가족이나 의사나 다른 사람들과 온라인으로 공유할 수 있다.

Google Health (https://www.google.com/health) now allows people who create an account to collect their medical records, prescriptions, and other health data and share them with family members, health care practitioners, and others online.

이것은 한 가지 사례일 뿐이며, 이러한 hyperconnectivity는 의학교육자들과 의료정책에 광범위한 사회적/개인적/윤리적 이슈에 관한 심각한 질문을 던지며, 이 질문은 사용자/부모/정책개발자/교육자들에게 tension을 일으킬 것이다.

Yet this growth of hyperconnectivity to the Internet and the Web prompts medical educators and policy makers to ask serious questions about a broad range of social, personal, and ethical issues that will almost certainly provoke tension among users, parents, policy makers, and educators.

파괴적 테크놀로지의 중요한 특징 중 하나는 권력이 (중앙화된 사전에 결정된 사용/통제가 아니라) 사용자 개인에게 넘어간다는 것이다.

One of the significant characteristics of disruptive technologies is that they turn the power over to the user rather than maintaining centralized, predetermined use/control.

예컨대, 디지털카메라가 값싸고 쉽게 사용할 수 있는 물건이 되면서 이제 누구나 '사진가'가 되었다. 

inexpensive, easy-to-use digital cameras allow anyone to be a “photographer.”

학습자가 방대한 양의 디지털 정보에 접근가능하게 되면서, 이 정보센터의 파괴적 영향력을 활용하는 교육자만이 성공할 수 있게 되었다. Bonk는 "(교육)기관들은 지식을 생성하고/서포트하고/전파하고/소비하는 방식에 대한 새로운 기전을 만들어야 할 것이다"라고 했다.

As learners gain access to and control over increasing amounts of digital information, successful educators must take advantage of the disruptive effects this information creates. In Bonk’s14 view, “institutions will need to create new mechanisms for the way knowledge is created, supported, disseminated, and consumed.”

3. 새로운 세대의 학습자

Trend 3: New generations of learners

오늘날 대부분의 의학교육자들은 세 가지 카테고리로 구분된다.

Most medical educators today fall into one of three categories: “digital immigrants,” “digital settlers,” or “traditionalists.”

• "디지털 이주자": Prensky가 만든 용어로서, 공식교육을 받는 기간에는 컴퓨터를 접하지 못했다가 그 이후에 테크놀로지를 활용하게 된 집단. 대부분은 디지털 테크놀로지를 사용하나 약간의 "사투리with an accent"가 있다.
  “Digital immigrants,” a term coined by Prensky,15 describes those who learned to use technology after finishing a formal education without continuous access to computers. Most of these people now use digital technologies, but they do so “with an accent,” typical of someone who learned a new language as an adult.

• "디지털 정착자": Palfrey and Gasser는 이들을 "디지털 세상에서 태어나지는 않았으나" "디지털 세상에서 살아가는" 사람들이라고 묘사했다. 이들은 많은 테크놀로지에 익숙하고, 이들의 "사투리"는 "디지털 이주자"의 그것보다는 덜 심하다. 
  A smaller number of adults, including many educators and health care professionals, are “digital settlers,” described by Palfrey and Gasser16 as those who were not “born digital” but who “live digital” nonetheless. These adults feel comfortable using many technologies for professional and personal productivity, and their accent is decidedly less pronounced than that of their digital immigrant cousins.

• "전통주의자": 테크놀로지 없이 태어났으며, 교육 방법으로 테크놀로지를 수용하지 않음
  Another group, the “traditionalists,” grew up without technology and have not embraced it as a core part of their teaching.

 

"디지털 네이티브": Norris and Soloway는 교육이 혁신적 교육 전략을 집중적으로 활용하여 Prensky가 "디지털 네이티브"라고 말한 집단의 학생을 참여시킬 수 있어야 한다고 주장하였다. 이 세대가 의과대학에 들어오면서 세 가지 중요한 질문이 등장했다.
Educators such as Norris and Soloway17 suggest that change in educational practices should focus on innovative instructional strategies to reach and engage those students whom Prensky described as “digital natives.” As this generation of learners reaches medical schools, there are three important questions to consider:

• 어떤 유형의 학습자인가? What type of learners will these “digital natives” be?

• 이들은 교육 구조에 어떤 변화를 가져올 것인가? What changes will they precipitate in the way education is structured?

• 의학교육자들은 어떻게 이 학생들의 기대를 다룰 것인가? How will medical educators deal with these students’ growing expectations to integrate new technologies in the curriculum?

4. 새로운 교육 테크놀로지의 등장

Trend 4: The emergence of new instructional technologies

의학교육자들의 과제는 새로운 테크놀로지를 화교적으로 활용하여 보다 협력적인 학습과 개별화된 학습으로 만들고, 새로운 세대의 학습자를 inspire할 수 있는 경험을 만드는 것이다. Bonk는 테크놀로지의 새로운 시대를 "언제든 누구에게서든 무엇이든 배울 수 있는 시대(Anyone can now learn anything from anyone at anytime)"라고 했다.

The task for medical educators is to use these new technologies effectively to transform learning into a more collaborative, personalized, and empowering experience that can inspire a new generation of learners. Bonk14 captures the essence of this new age of technology tools for education by stating, “Anyone can now learn anything from anyone at anytime.”

디지털 비디오 클립은 거의 모든 주제를 다루고 있으며, 방대한 시청자가 능동적으로 비디오 평가에 창며하고, 비디오에 대한 반응을 올린다. 여기서 중요한 것은 사용자가 단순히 수동적 관람자가 아니라, 능동적으로 새로운 형태의 커뮤니케이션과 표현에 참여한다는 것이다.

Digital video clips on almost any topic can command a sizeable audience that also actively participates in the rating of the videos and the posting of video responses.18 The significance of this is that these users are not just passive viewers; many of them are actively engaged in a new form of communication and expression.

Web 2.0은 새로운 온라인 도구와 리소스를 말하는 것으로, 다양한 SNS, 가상환경, 위키, 블로그, 팟캐스트 등을 말한다.

Web 2.0, a term used to describe an evolving set of online tools and resources, includes a wide variety of social networking sites, virtual environments, wikis, blogs, and podcasts.20

웹을 글로벌한 서포트 그룹으로서 가능하게 하는 프로젝트에는 Patients Like Me21와 같은 것이 있다.

A project that enables using the Web as a global support group illustrates one of the disruptive effects of these new types of resources. Patients Like Me21

여러 Web 2.0 도구 뿐 아니라, Hi-Fi 시뮬레이터나 가상환자 등도 불과 몇 년 전만 해도 상상조차 못했던 새로운 학습경험을 제공해줄 수 있다.

In addition to the many Web 2.0 tools, new technologies such as high-fidelity simulators and virtual patients can provide new learning experiences that were unimaginable just a few years ago.

5. 점점 더 빨라지는 변화속도

Trend 5: Accelerating change

마이크로소프트는 2008년 'Being Human: Human–Computer Interaction in the Year 2020'에서 다음 10년간 개개인은 수천대의 컴퓨터, 즉 사실상 자신이 착용하고 있는 모든 것과 상호작용하게 될 것이다라고 했음

A 2008 report from Microsoft, Being Human: Human–Computer Interaction in the Year 2020,24 predicts that within the next decade, individuals will interact with thousands of computers as virtually every piece of equipment we use,

Gaudin는 2020년에는 키보드와 마우스가 더 이상 필요없어질 것이라 했음

Gaudin25 postulated that by 2020, the keyboard and mouse will no longer be needed to control a computer.

권고

Recommendations

권고 1: 테크놀로지를 활용하여 학습을 서포트하라

Recommendation 1: Use technology to support learning

교수는 (테크놀로지가 없었다면) 불가능했었을 경험을 학습자에게 제공하고 그러한 경험을 지원하여야 한다. 테크놀로지는 면대면 경험의 대체제가 아니라 그것의 보완제이다.

Faculty should use technology to provide and support experiences for learners that are not otherwise possible—not as a replacement for face-to-face experiences but as a supplement to them.

 

종종, 가장 효과적인 교육 디자인은 전통적인 것과 테크놀로지-강화 방법을 함께 사용하는combination 것이다. 그렇다면 질문은 "테크놀로지를 활용해야 하는가"가 아니라 "언제 어떻게 테크놀로지를 활용해야 하는가"이다.

Often, the most effective instructional designs involve a combination of traditional and technology-enhanced methods. The question, then, is not whether we should use technology to support education, but when and how to employ these technologies.

 

권고 2: 기본에 충실하라

Recommendation 2: Focus on fundamentals

테크놀로지가 빠르게 진화하면서 교수들은 (특정 테크놀로지가 아니라) 교수학습의 기본원칙에 더 충실해야 한다.

Because technologies evolve rapidly, faculty members should focus on fundamental principles of teaching and learning rather than specific technologies in isolation.

"테크놀로지"는 교육자들이 필요에 따라 적절한 도구를 선택하여 사용할 수 있는 도구상자의 역할을 해야 한다.

“Technology” thus assumes its appropriate role as a toolbox fromwhich educators may select the appropriate tool (or combination of tools), depending on the needs at hand.

 

권고 3: 다양한 리소스를 활용하라

Recommendation 3: Allocate a variety of resources

의과대학은 교육 테크놀로지의 적절한 활용을 지원하기 위하여 다양한 리소스를 할당해야 한다.

Medical schools should allocate a variety of resources to support the appropriate use of instructional technologies.

이러한 리소스에는.. 

Such resources might include

• 교육 디자이너 instructional designers with expertise in various technologies,

• 적절한 시간 adequate time for faculty to learn and create curricular materials enhanced with technology, and

• 적합한 소프트웨어와 하드웨어 suitable software and hardware.

 

교수들은 내용전문가가 되어야 하나, 꼭 기술전문가가 되어야 하는 것은 아니다.

Faculty members should be content experts, but they do not necessarily need to be technology experts.

권고 4: 교수들이 새로운 테크놀로지를 도입하는 것을 지원하고 인정하라

Recommendation 4: Support and recognize faculty as they adopt new technologies

대부분의 의과대학은 교수들이 새로운 테크놀로지를 도입하도록 서포트해야한다.

Medical schools should support faculty members as they adopt new technologies.

Ruiz 등은 "e-learning을 위해서는 전통적인 교수활동을 넘어서는 교수의 역량을 필요로 한다"라고 지적했다. 새로운 교육방식을 도입하기 위해서는 과목 개발에 대한 연구비grant 뿐 아니라 새로운 테크놀로지를 배울 시간이 필요하다.

Ruiz et al35 note that “e-learning requires faculty competencies that go beyond traditional instructional activities.” Course development grants as well as adequate time to learn new technologies are necessary if faculty members are to adopt new ways of teaching.

권고 5: 협력을 장려하라

Recommendation 5: Foster collaboration

National organizations should provide funding and leadership to enhance a national/global infrastructure to foster collaboration to develop and share resources as well as discuss instructional ideas in medical education.

• HEAL Several online resources provide ideas for how this online community can be structured. For example, the Health Education Assets Library (HEAL), developed in conjunction with members of the International Association of Medical Science Educators, is a digital repository that “allows medical educators to discover, download, and reuse over 22,000 medical education resources.”36 HEAL gives medical educators access to a wide range of multimedia resources that can support health care education.

• MedEdPORTAL MedEdPORTAL, a free, peer-reviewed publication service and repository for health-related teaching materials, assessment tools, and faculty development resources, is an example of an excellent online publication service designed to help educators publish and share teaching materials.37,38 The structure of MedEdPORTAL differs slightly from HEAL in that it typically publishes more complete, stand-alone resources such as tutorials, virtual patients, simulation cases, lab guides, videos, podcasts, and assessment tools.36

• BioMedExperts “BioMedExperts” is not a repository of resources but, rather, an online community that generates expert profiles by analyzing PubMed publications. It then connects researchers with similar expertise and interests to create professional networks and support collaboration and interdisciplinary research.39

미래는 이미 와 있다

The Future Is Here

비록 우리가 미래를 확실하게 예측하지는 못하지만 한 가지는 확실하다: 우리는 테크놀로지를 수용하고, 테크놀로지에 적용하고, 테크놀로지를 활용하여(embrace, adapt to, and harness) 현재와 미래 의료전문직의 요구에 부응해야 한다.

Although we cannot predict the future with certainty, one thing is clear: We must embrace, adapt to, and harness technology in order to meet the needs of present and future health professionals.

2 Baylor College of Medicine. Faculty Development Conference: A 2020 Vision of Faculty Development Across the Medical Education Continuum; February 26–27, 2010; Houston, Tex. http://www.bcm.edu/ fac-ed/index.cfm?pmid 15709. Accessed December 8, 2010.

---

Acad Med. 2011 Apr;86(4):435-9. doi: 10.1097/ACM.0b013e31820dbee4.

Preparing for the changing role of instructional technologies in medical education.

Robin BR1, McNeil SG, Cook DA, Agarwal KL, Singhal GR.

Author information

• 1Department of Curriculum and Instruction, and director, Master's of Education in Teaching Program With an Emphasis in the Health Sciences, College of Education, University of Houston, Houston, Texas 77204-5027, USA. brobin@uh.edu

Abstract

As part of an international faculty development conference in February 2010, a working group of medical educators and physicians discussed thechanging role of instructional technologies and made recommendations for supporting faculty in using these technologies in medical education. The resulting discussion highlighted ways technology is transforming the entire process of medical education and identified several converging trends that have implications for how medical educators might prepare for the next decade. These trends include the explosion of new information; all information, including both health knowledge and medical records, becoming digital; a new generation of learners; the emergence of new instructional technologies; and the accelerating rate of change, especially related to technology. The working group developed five recommendations that academic health leaders and policy makers may use as a starting point for dealing with the instructional technology challenges facing medical education over the next decade. These recommendations are (1) using technology to provide/support experiences for learners that are not otherwise possible-not as a replacement for, but as a supplement to, face-to-face experiences, (2) focusing on fundamental principles of teaching and learning rather than learning specific technologies in isolation, (3) allocating a variety of resources to support the appropriate use of instructional technologies, (4) supporting faculty members as they adopt new technologies, and (5) providing funding and leadership to enhance electronic infrastructure to facilitate sharing of resources and instructional ideas.

© by the Association of American Medical Colleges.

Comment in

• More about technology-enhanced learning in medical education. [Acad Med. 2012]

PMID:

 

21346506

 

[PubMed - indexed for MEDLINE]