Technological Literacy as a Framework for Health Professions Education in the Digital Era.

With increasing use of information and communications technologies (ICTs) in health, and rapid technological changes, there is a pressing need to prepare current and future health professionals to use ICTs as an integral part of their practice. We propose the Technological Literacy Framework, which includes 3 interlinked elements-knowledge, capabilities, and critical thinking and decision making-as an overarching structure for organizing and designing competencies, learning objectives, and educational interventions for health professions education in the digital era. We provide examples of EHR and telehealth educational interventions and how they map to the framework.

Teaching and Evaluating the Virtual Physical Exam in Telemedicine.

With the rapid adoption of telemedicine since the COVID-19 pandemic, it has become imperative to teach and evaluate health professional trainees on skills important to conducting effective virtual visits. We developed a simulation-based workshop with (1) readings, (2) a lecture covering online communication and the virtual head and neck exam, (3) a telemedicine simulation with a standardized patient observed by faculty, (4) personalized feedback from faculty, and (5) a group debrief session. We created an evaluation rubric based on three of 20 Association of American Medical Colleges (AAMC) telemedicine competencies to assess learner performance during the simulations. Students (medical and physician assistant students; n = 50), and internal medicine residents (n = 20) completed this workshop in 2023. At least 90% of trainees across the two groups were rated as approaching entrustment or entrustable in each competency. This workshop is an example of a scalable telemedicine curriculum that can be used to teach and evaluate learners in the virtual physical exam across the training continuum.

When rules turn into tools: An activity theory-based perspective on implementation processes and unintended consequences.

The idea that actions of people, organizations or governments may lead to Unintended Consequences (UICs) is not new. In health, UICs have been reported as a result of various interventions including quality improvement initiatives, health information technology implementation, and knowledge translation, especially those involving translation of broad policies (evidence-based medicine and patient-centred care) or system level improvement into actionable items or tools. While some unintended consequences cannot be anticipated, others may be predictable. In this article, we present a model based on cultural historical activity theory, which may help policy-makers, health leaders, and researchers better anticipate UICs resulting from implementation of new programs or technologies and take action to address them or mitigate their risk of occurrence. We support this model using examples of UICs of implementing family centred care principles, electronic health records, and computerized templates for quality improvement in chronic disease management.