Digitalization is an integral part of the modern world, and health care is no exception. In fact, it heralds a new age in the delivery of medical care, and one of the most important places in this regard belongs to online education. eHealth, or electronic health, is broadly defined by the World Health Organization as “the use of information and communication technologies (ICT) for health” with the aim of improving the health care framework (World Health Organization 2019).
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In other words, this is an umbrella term, which covers the ways of effective use and implementation of ICT in the context of delivering medical care to the population. Consequently, the concept of eHealth education implies the training setting, designed to provide opportunities for health care specialists to enhance their digital competencies and performance. In particular, eHealth education is of paramount importance for continuous training of health care workers in order to be able to tackle the professional challenges of the 21st century.
In recent years, costs for the delivery of medical care have increased dramatically. According to the World Health Organization, about 40% of all health costs are wasted due to inefficient use and inappropriate allocation (World Health Organization 2019). In fact, scholars have estimated a global medical staff shortage of as much as 18 million by 2030 (Car et al. 2019, e12913). This tendency is highly alarming since it jeopardizes “the achievement of universal health coverage” (Car et al. 2019, e12913), that is, equal access to high-quality health services for everyone.
Currently, the systems of health care worldwide face a range of unresolved issues. These include the high cost of education, demographic shifts, and time shortage to follow the newest advances in health care technologies. Moreover, there are persistent inequalities in health and life expectancy both between and within states, as well as increased numbers of aging and obese population (World Health Organization 2019). In this context, eHealth is considered as one of the potential ways to address these urgent issues.
Likewise, medical education all over the world faces a wide range of challenges, including rigid medical curricula and the need for a more collaborative and patient-centered focus. In particular, ongoing medical training needs a continuous review and upgrading. This will equip health professionals with skills and competencies that are essential in the modern, fast-paced world and render them competitive in the employment market. Continuing professional development is a crucial constituent of any health care career since medical science and clinical practice are constantly changing and updating fields of knowledge.
Therefore, it is highly important for physicians to undertake training lifelong in order to maintain and develop their professional competencies and skills. Continuous medical training is essential for health care professionals in order to ensure maintaining of medical knowledge and skills, as well as regular updating and upgrading of professional competencies. Therefore, medical education of the 21st century must integrate the synergic principles of multifunctionality, multi-competency, and multi-expertise in order to meet the demands of the present-day society, which currently undergoes dramatic changes and rapid advances.
As a matter of fact, eHealth is particularly relevant nowadays. In particular, Waseh et al. (2019) identify such tendencies as health care workforce shortage and its unequal distribution, which can be addressed by implementing online education in the ongoing training programs of health care professionals. eHealth provides numerous opportunities for continuous professional development. These include massive open online courses intended for trainees from across the globe, virtual patient technology based on interactive simulations of clinical cases, mobile digital education, and many others (Car et al., 2019).
Scholars contend that “the current health care landscape in the United States presents ideal conditions” for eHealth spread (Waseh et al. 2019, e12515). Hence, eHealth is gradually becoming widely accepted as a key factor for enhancing the quality of public health service on a global basis. Thus, the concept of eHealth and digital literacy becomes the priority of ongoing training in health care.
eHealth education reduces the loss of time and costs, thus ensuring higher productivity. Perrin et al. (2019, 2) remark that eHealth ensures “the cost-effective and secure use of information and communication technologies (ICTs) for health and health-related fields.” The concept of eHealth embraces “a range of knowledge, skills, and behaviors to appropriately and effectively engage individuals in activities related to digital information and technologies” (World Health Organization 2016). eHealth possesses a wide variety of undeniable benefits, providing health care professionals with an opportunity to get an education, such as refresher courses, at a suitable time, from any spot of the Earth, and using any device.
Hence, eHealth training can provide a wide variety of opportunities for health professionals to develop job-specific competencies in the use of ICT. However, one should bear in mind that, apart from mastering technical skills and focusing on technology as such, it is equally essential to develop an “understanding of how these skills could be applied to professional health contexts” (Wentink et al., 2019, 6).
It is necessary to emphasize eHealth does not imply only technology as such; it rather focuses upon providing access to information, cooperation between people, effective data exchange, and its ultimate objective is mutual professional perfection of all stakeholders. That is to say, eHealth education is health care career development should be “a combination of software training and training in how to use the technology in daily work” (Varsi et al. 2019, e14255).
In other words, successful career development in health care needs a profound comprehension of eHealth’s practical purposes and confident application of the possibilities it can offer, rather than a formal ICT training course.
eHealth education contributes to overall digital competency and ICT awareness of the population. It also promotes the development of such relevant skills as evidence-based reasoning and action-oriented management. Furthermore, eHealth education can strengthen the health care capacity in low- and middle-income countries via reducing costs of undergraduate education provided to health professionals through online access to e-learning. Thanks to eHealth, health professionals can obtain the required training, enhance their educational portfolio and ultimately improve the quality of health care delivered for their populations.
For instance, the People’s Open Access Education Initiative (Peoples-uni) provides training modules for master’s levels. The Peoples-uni program “seeks to ensure inclusive and quality education for all and promote lifelong learning by 2030” (Sridharan et al., 2018, 2). Sridharan et al. (2018, 13) studied the impact of Peoples-uni across 31 countries and found that it had positive impacts on its graduates since “the online nature of the program provides the possibilities of scale and reach.” In other words, eHealth has a substantial impact on career development in health care since it can ensure and promote master’s degree programs and continuous professional development for people from third world countries via e-learning. eHealth technologies provide a wide range of possibilities for “train the trainers” courses in health care, which is particularly relevant for those with a previous occupational background.
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eHealth has a significant impact on the knowledge, competencies, and skills of health care professionals, as well as their career paths in both developing and developed countries. For instance, evidence-based massive open online courses (MOOCs) are effective tools to share clinical findings worldwide and to keep health care professionals well-informed as to the new treatment guidelines and protocols. Albrechtsen et al. (2017) found that internet-based courses served as a potent resource for advanced training of health care professionals. In particular, eHealth expanded the respondents’ professional network. Over 90% of respondents reported that they had obtained knowledge to be used further in their professional life. Moreover, the participants informed that they had significantly developed their job-related skills (Albrechtsen et al., 2017).
Hence, online learning is particularly relevant for continuing education since it enables graduates to update their knowledge and skills in order to keep with recent developments in the field of health care, which undergoes persistent changes. Due to ICT and online applications, health professionals from third-world countries have an opportunity to access information, develop their competencies, and eventually contribute to the advance of health care services in their settings.
Expanding the eHealth network ensures the availability and accessibility of medical information to vulnerable population groups. For example, in the survey by Sridharan et al. (2018, 6), 57% of respondents stated that “they would not have been able to get a Master in Public Health without attending Peoples-uni.” Furthermore, 41% had been given a salary increase or a new position as a result of their eHealth education.
Overall, 85% of respondents reported a certain practical impact of online education on their career development. Education via such tools as Peoples-uni provides an effective background for discussions at forums, completion of assignments, and facilitation from tutors. Another important and feasible impact of Peoples-uni is its specific orientation to academic credit. Indeed, the platform managed to establish an accreditation procedure by concluding a partnership with Manchester Metropolitan University to provide the online graduates with a fully recognized academic award (Sridharan 2018). Hence, eHealth education gradually becomes a fully legitimate part of health care training from the standpoint of accreditation and recognition.
Sridharan et al. (2018) also outline such potential impacts of eHealth education on career development in health care as obtaining the knowledge necessary to enhance one’s professional practice and streamlined navigation in the health care context. In addition, eHealth strengthens the research capacity and ensures the increased awareness of education and its significance in improving one’s quality of life.
That is to say, eHealth can be of paramount importance to one’s advance and promotion in a health care career. Among other benefits in terms of career advancement, one should also mention “new responsibilities, appreciation by the employer, as well as accessing the next educational step of a PhD” (Sridharan et al. 2018, 11), as frequent positive outcomes of eHealth education. Hence, online education can be a feasible foundation for a doctorate degree.
More than that, eHealth education has a significant impact not only on trainees and graduates but on trainers and tutors as well. For instance, Peoples-uni and other online applications offer a wide range of possibilities for health care professionals to volunteer for mentoring and develop their teaching skills in the frame of eHealth training programs. This practice suggests new directions for academic staff to test their methodologies in a different context, thus promoting their self-development, which will induce motivation to self-improvement, and ultimately increase job satisfaction.
In addition to enhancing one’s professional skills, online trainees have an opportunity to develop their cross-cultural competency, which is also an essential tool for cooperation in the globalized world of today. More than that, online education enhances interpersonal and communication skills, which is also essential for continuing professional development. E-learning can address these needs by distributing a range of highly flexible, collaborative, widely accessible, and adaptable medical, educational materials. It can be easily delivered through electronic media, such as the Internet, Web-based programs, smartphones, and the like. Car et al. (2019) revealed positive impacts of eHealth in terms of trainees’ increased self-convenience, perception of user-friendly learning, faster development of competencies and skills.
Furthermore, interactive activities of online education provide a positive emotional background, encouraging and motivating trainees, thus ensuring a deeper memorizing of medical information. Car et al. (2019, e12913) point out such benefits of digital education as “ubiquitous delivery and flexible access to learning content, personalization of learning experience, the better sensation of content, cost-effectiveness, and equity.” Besides, eHealth ensures deeper comprehension and processing of information, improved collaboration skills, increased motivation to learning, and outcome satisfaction.
Apart from formal advances in career, such as promotion or salary increase, online education ensures a profound impact on one’s personal development and motivation. Wentink et al. (2019) observe that interprofessional collaborative education is a potent facilitator for eHealth education. Indeed, team learning involves a certain extent of competitiveness, which thus contributes to the overall positive impact of online education.
Furthermore, online education can be easily tailored according to one’s schedule, preferences, and pace of learning, thus providing an individualized approach, which is also a substantial benefit. All these advantages provide a positive attitude towards lifelong learning and continuous perfection, thus preventing professional burnout. In such a manner, the ancient requirement – “Physician, heal thyself!” – is met.
In addition to numerous personal benefits found in the context of eHealth education, one should also emphasize its potential in providing capacity building and sustainable development for third world countries. For instance, supplying qualified medical staff through train-the-trainer online courses can contribute to the education of future generations, eventually exerting a tangible influence on the population’s health and quality of life. Scholars point out that eHealth education can have an “even broader relevance to the field of health and beyond” (Sridharan et al. 2018, 10). That is to say, the impact of eHealth has an extensive and far-reaching implication.
Indeed, online education inherently stipulates communication between representatives from different countries and contexts. Hence, it becomes obvious that eHealth extensively contributes to the development of a unique professional framework of health care experts from around the world. This network is based on the international, intercultural and inter-institutional dialogue between professionals and ensures a highly valuable resource for the global advance of medicine and health care. In addition, a remarkable benefit of eHealth is its availability for individuals from a large variety of countries. In fact, eHealth education is largely rooted in the theory of change (Sridharan et al., 2018). In other words, it is inherently aimed at promoting social development.
Implementation of eHealth in continuous professional development potentiates the following beneficial outcomes:
- upgrade of curricula and staff capability in developing countries;
- reciprocal exchange of best practices and skills;
- designing a homogeneously developed international academic environment, equally competitive in the global economy;
- establishing and developing a strong transnational network for medical education of excellence;
- achieving the sustainability of the international academic model through unification and standardization of medical education.
eHealth education can be particularly beneficial for career development in health care since these tools enable shared decision making, effective contact, and communication between physicians and patients on a global basis. Hence, it becomes possible to exchange experiences with colleagues, improve the quality of diagnosis and treatment outcomes, and consult patients who otherwise would be unapproachable.
Wash et al. (2019, e12515) assert that eHealth education “contributes to the development of core competencies in patient care, medical knowledge, and practice-based learning.” In fact, Varsi et al. (2019, e14255) argues that “there is growing evidence of the positive effects of electronic health (eHealth) interventions for patients.” Online education ensures the development of health care professionals in terms of basic roles, which they usually perform in their practice, namely:
- as medical experts who integrate theoretical knowledge and clinical skills;
- as communicators who constantly build relationships, collect information, share data, and maintains contact with patients and their families.
- As collaborators who establish cooperation with peers in order to exchange experience and provide high-quality health care.
- as managers who systematize their time and take responsibility for their actions;
- as scholars who pursue a lifelong commitment to research and continuous learning.
At the same time, there is a range of obstacles in the process of eHealth implementation. For instance, Wernhart et al. (2019, 10) found a significant amount of skepticism among health care professionals as to the reliability of eHealth applications since “digitized data could potentially be misused and damage caused cannot be reversed.” Indeed, scholars remark that “the fear of inadequate data protection negatively influences the positive assessment of health technology” (Wernhart et al., 2019, 10). Similarly, Waseh et al. (2019) detected such barriers as doubts regarding the quality of health care delivered through eHealth applications. In particular, the security of patients’ digitalized health data and the lack of personal connection between patients and health care providers arouse the greatest concern.
One should also bear in mind that eHealth-based curricula are newly integrated phenomena. Indeed, the scholars emphasize “the lack of eHealth studies reporting implementation strategies in a comprehensive way” (Varsi et al., 2019, e14255). Wernhart et al. (2019, 11) conducted a survey at the Medical University of Vienna and found “a lack of familiarity with the concept of eHealth” among employees, whereas medical students demonstrated “more experience with eHealth tools.” Wentink et al. (2019, 1) identified a number of barriers in the process of eHealth embedding in the curricula, as perceived by health care employees, such as “unclear concept of eHealth, lack of quality and evidence for eHealth, (lack of) capabilities on how to use eHealth.” Hence, there is an obvious gap between the education providers and consumers.
In this context, it is necessary to keep in mind the dichotomy of digital natives vs. digital immigrants. This opposition was suggested by Prensky in 2001 (Wernhart et al. 2019, 8). Hence, medical staff belonging to the age group of digital immigrants need to adjust their teaching methods and tools to the virtual learning setting and the needs of the current and future generations of students, who are digital natives by definition.
Therefore, successful adoption of eHealth technologies requires a well-designed system of its introduction into the continuous professional development of health care professionals, since “it is to be expected that digitalization is an irreversible process worldwide” (Wernhart et al., 2019, 9). It is obvious that developing eHealth literacy in the framework of ongoing medical education will ensure the shift “from digital immigrants to digital natives” (Wernhart et al., 2019, 2). Incorporating eHealth in the advanced training of health care professionals should aim to change their attitudes to this phenomenon, increase their awareness and ultimately bridge the gap between digital natives and digital immigrants, thus satisfying the demands of the modern world.
Despite the fact that electronic health records and other eHealth solutions are already extensively used in clinical settings, numerous surveys demonstrate that health professionals frequently do not feel confident in their eHealth skills in general (World Health Organization 2016). Indeed, the scholars are unanimous about the fact that “eHealth training should both be integrated into medical education curricula and be an integral part of continued professional education” (World Health Organization 2016). Therefore, it is essential to incorporate ICT literary skills in the programs of ongoing training for health care professionals in all specialties.
In this context, further research is needed for the development of tailored methods to implement eHealth in medical curricula as effectively as possible. There is a consensus of opinion among the scholars that eHealth should complement the conventional curricula rather than replace them completely (Car et al., 2019; World Health Organization, 2016; Wentink et al., 2019). In particular, the concept of “blended” learning is a promising trend in this direction, involving both traditional (face-to-face) and online education modes (Car et al., 2019).
Despite the fact that e-learning may be more comfortable for individual trainees, blended learning is widely regarded as more effective since it preserves the best practices of traditional education and major advantages of electronic-based learning.
Hence, eHealth is an effective tool to help health care professionals to switch from the group of digital immigrants to digital natives. The benefits of e-learning in health care careers are reduced cost as compared to physical in-class training, enhanced speed in the delivery of the result of education, instant feedback, and customized pace of learning. The uptake of eHealth in health care includes a wide range of professional opportunities, such as “web and mobile applications, electronic patient records, health-sensors, and wearable devices, telecommunication” (Wentink et al., 2019, 2). Moreover, eHealth promotes the development of stakeholders’ interrelationships.
Thus, eHealth is a promising trend in the modern world since it has the potential to enhance the quality of health care delivery by reducing inpatient stays. More than that, it ensures patients’ independence in daily regimens and decreases medical care costs via telemedicine services and other ICT applications. Furthermore, eHealth revolutionizes the traditional education system since it transforms learning into a deeply individualized process (adaptive, or customized, training). In addition, it promotes trainees’ interactions with each other (collaborative, or team, learning) and modifies the teachers’ role from the content distributors to facilitators in the development of competencies. In a more comprehensive sense, online education contributes to the improvement of health care delivery on a global basis.
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