Embedding mHealth into undergraduate medical education

Introduction
The gap between current undergraduate medical curriculum and eHealth and clinical informatics in health care contexts has been clearly identified in the literature. eHealth requires a fundamental change to the design and delivery of the medical curriculum to ameliorate forecasted shortages in the digital medical workforce. Yet a mismatch between the current undergraduate medical education curriculum and practice reality have not been satisfactorily addressed. This work describes outcomes from the delivery of an innovative eHealth informatics elective, which was designed to embed health informatics, a disruptive pedagogical concern, into undergraduate medical education.

Method
This single case study uses an action research approach to draw on the process of progressive problem solving that improves educational approaches to eHealth informatics in undergraduate medical education settings. The study shares key aspects of our learning with others involved in eHealth training to support similar informatics innovations for consideration in the future design of undergraduate medical curriculum.

Results
We analyze lessons learned from the design and delivery of a creative eHealth elective for first year medical undergraduate students at Monash University (Australia). We needed to overcome seven key challenges “on the run” to help prepare the students for digital practice horizons. Firstly, a lack of suitable funding and resources hampered elective design. Medical students enrolling in the elective were overwhelming male and lacked techno-savvy in the context of medical practice and learning. Medical students were unaware of the risks, benefits and security threats relating to the application of eHealth systems in practice. Only a very limited number of academic staff possessed the specific skills required to achieve informatics learning outcomes. Specific skills training were required for most students enrolled in the elective. Finally, we needed to ensure the transparency of medical and eHealth informatics jargon to support student learning.

Discussion
The design and delivery of this elective allowed the education content around serious computer games and applications for eHealth to be embedded into the medical pedagogy. Direct and collegiate support was a critical element in the successful development of the program. The program did not require additional space in an already busy curriculum. Student feedback suggested gender imbalances in the class may have been addressed by improved communication. The evidence also indicates noteworthy mismatches between the perceptions of course designers and the expectations and skill level of students. Academic staff required robust eHealth informatics, information privacy, and security teaching skills to lead the elective. In addition, significant resource constraints became apparent requiring flexibility and the capacity to modify the program during delivery. Nonetheless the elective provided a space for students to reflect upon their own learning in eHealth informatics. Experience in design and delivery of this elective has informed content for knowledge management, which is a core component of the current undergraduate medicine curriculum at our institution.