Speed Up and Slow Down: Changes and Challenges of Blended Learning in Medicine during the Pandemic

Concurrent Session 5
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Brief Abstract

A virus has become the most significant driving force of medical education transformation.  It has blended learning in medicine at an unprecedented speed.  In this panel, the educators from different medical schools discuss the changes, challenges, lessons learned; and thus shed some light for optimal blending in the future.


Dr. Zhang taught her first class at the age of eleven. Since then, her passion for teaching has continued to grow. After eight years of medical school in China (Shandong University School of Medicine), she came to the United States and got her Ph.D. in biochemistry and molecular biology from Southern Illinois University-Carbondale. Dr. Zhang has taught a wide range of basic medical science and clinical laboratory courses including anatomy, physiology, cell and molecular biology, molecular diagnostics, microbiology, genetics, biochemistry, pathophysiology, pathology, pharmacology and reproductive medicine at both the undergraduate and graduate level before joining the Department of Pathology and Laboratory Medicine at the Robert Larner, M.D. College of Medicine at the University of Vermont. Dr. Zhang has been the recipient of many awards in speech competitions, presentations, and teaching during her school years, both in China and the United States. Since she began teaching online in 2004, Dr. Zhang has been interested in new technologies that bring teaching and learning to a new and higher level. She has been invited to host several national and international workshops in online teaching since 2009. Dr. Zhang enjoys reading, writing, painting, cooking, and nature in her free time.
Dr Horneffer has been working to advance medical education as a passion formany years. After attending Yale as an undergraduate and Johns Hopkins for medical school and residency, he practiced medicine as a cardiac surgeon in Maryland, USA. In mid-career, he was asked to help bring medical education to the underserved in the Pacific area. He accepted the position as Dean of a medical school, based in Independent Samoa, which he led to be the first accredited in the world to use an entirely online-delivered didactic curriculum and educate students simultaneously on multiple continents. Today he is helping evolve medical education models and serves as Executive Dean for a small Jamaican school (AAIMS) to help improve its teaching and train physicians for an underserved part of Jamaica. At Lecturio, he serves as Director of Medical Education, helping shape its innovative offering which includes supporting development initiatives in Africa and Afghanistan.
Mark A. Best, MD, MBA, MPH, MS (Med Ed) is a board-certified pathologist with over 25 years medical education experience, and with the last 19 years focused on teaching. He completed a two-year fellowship in healthcare quality improvement, and received a Patient Safety Improvement Award in 2002. He has been facilitating problem-based learning groups (medical students & masters degree students) since 2005, and received the 2019 John M. & Silva Ferretti Award for Distinguished Teaching. He is the Co-chair of the medical sciences section of the Florida Academy of Sciences.
Dr. Everett is a Gynecologic Oncologist at the University Of Vermont Medical Center with a strong interest in medical education and simulation. Dr. Everett did her undergraduate education at Williams College and then matriculated to the University of Washington for her medical school education and residency. She then went to the University of Virginia for her gynecologic oncology fellowship. After fellowship, Dr. Everett, joined a private practice group in Seattle and had a busy clinical practice. Her clinical research interests include neoadjuvant chemotherapy for ovarian cancer and robotic surgery. In 2011, after 5 years in private practice, Dr. Everett transitioned to the University of Vermont to pursue a career in medical education. She is currently the Obstetrics and Gynecology Clerkship Director for the University Of Vermont College Of Medicine, the Director of Student Career Mentoring within the Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Vice Chair of Education for the department. Dr. Everett serves on numerous medical school, hospital, and departmental committees related to medical education. In addition to her role as Clerkship Director, Dr. Everett is active in career mentoring and advising for students, and student/resident research both in the clinical and educational arenas. In addition she has experience in curriculum development in the areas of robotic surgery, laparoscopic surgery, simulation, and communication. Dr. Everett has been recognized locally for her commitment to medical education through student and resident teaching awards. In 2014, 2016, and 2017, she was awarded the UVM COM clinical teacher of the year award, the highest teaching honor. She is a graduate of the Association of Professors in Gynecology and Obstetrics (APGO) Scholars Program in 2014, a program designed to prepare her for leadership in medical education. Her educational work has been presented nationally at the Association of Professors in Gynecology (APGO) meeting, APGO/CREOG meeting and internationally at the International Association of Medical Science Educators meeting. She is currently serving a 6 year tenure on the Undergraduate Medical Education Committee (UMEC) in Obstetrics and Gynecology, a national committee dedicated to curriculum and tool development in medical student education.

Extended Abstract

Fast-evolving technology, along with our culture, and federal, state, and local policy changes, has significantly remolded health care in our society. The traditional model of physician training has become awkward in facing the exponentially increased knowledge, the new generation of learners, shifting patient-physician relationships, and continually evolving healthcare settings. Medical education is reforming, accordingly, to the call for learner safety and education effectiveness, along with safe and high-quality patient care.


In recent years, the content, structure, and delivery of medical education have been significantly altered into what is now called blended learning. Blended learning has become the central theme in the medical curriculum in conjunction with developing and proliferating technologies. Technology has helped to rebuild a more coherent and better structured medical education; while simultaneously disrupting the traditional model that served us well for almost a century. Combined with new methods in psychology, communication, and data science, educational technology has become an integral part of medical education renovation. Innovative educational technology has changed all facets of physician training. It contributes to refining the content, structure, and delivery model of reformed medical education.


Effective implementation of technology in medical education requires an insightful understanding of the technology itself, learning and teaching pedagogy, as well as the ever-changing dynamic medical care. Technology has transformed medical education steadily.  The global COVID-19 virus pandemic has drastically accelerated the process that keeps most communities of learning in quarantine spaces.  In this discussion, the panelists will review a variety of technologies and best practices that transform medical education to blended learning, share the users' experiences and skills acquired, examine their effects on students learning and patient care, as well as lessons learned in the quick adjustment during the pandemic. The discussion will include the following:


  • Technology enhances a new wave of the medical school curriculum. The reformed, more diversified, dynamic, and flexible curricula address learning gaps and health systems science.  The revised curricula focus on competency, communication, serving, and collaboration. In dealing with the pandemic, medical schools have learned to quickly sort through the "online" and "offline" components of the curriculum, turning the previously impossible into the possible.


  • Learning engineer technologies that foster the shift of pedagogy to develop master adaptive learners who are self-directed and regulated lifelong learners. The pandemic speed up the transformation of the students as learners themselves. The new generation of intelligent and adaptive learning and administration tools are designed to provide a sufficient, efficient, and personalized learning experience for each student. They have been continually gaining popularity among students.  


  • Computer-assisted assessment in the evaluation of effective programs that facilitate knowledge and skill acquisition, improve decision making and critical thinking, and enhance interprofessional teamwork. Technology to aid the measurement of success and the dissemination of innovations. When face to face examination is not even a choice during the pandemic, labored exam proctoring by a person(s) is replaced by a much more efficient and effective computer proctored exam.


  • Teaching has become more collaborative. The pandemic has highlighted the importance of communication and collaboration. The educators are linked unprecedently during unprecedented times.  Opinions, strategies, methods, and even documents are more openly shared. Resources are being swiftly consolidated and made accessible and usable. Faculties are developing themselves in a way that was hard to imagine just a few months ago.  Working from home has been widely accepted as a new norm.


  • Turn the crisis into educational opportunities.  The pandemic itself can be an epidemiology study to learn in real-time. Telemedicine has gained increased attention with enforced social distancing. Contact tracing arises above the horizon as a new academic discipline.


Though led by the panelists, the discussion will actively involve the audience from the beginning, by having the audience vote on what they want to hear the most. The original topic list provided to the audience includes:


  • Successful and struggled courses online
  • TBL and PBL migration online
  • Online exam proctoring
  • Simulation and objective structured clinical examination (OSCE) during the pandemic
  • Popular learning tools and resources used by students
  • Popular teaching tools and resource used by faculty
  • Student and faculty support during the pandemic
  • Teaching and learning moments from the crisis


The audience will be invited to modify the list by offering topics that are most intriguing to them. They will be asked to work in groups to sort through the topics that are most relevant. The panelists and all participants of the session will work together to finalize the list of topics to be discussed. The session is designed to be interactive by starting with the Q and A instead of ending with it. This way, the discussion is tailored to be more relevant to the audience, who will be part of the conversation throughout the session via live polling, pair and share, and small group activities. Students will be invited to the session for the live interview by both the panelists and the audience. Their input and perspectives will significantly enrich and inspire the conversation. After all, the collaborative effort in teaching and learning between teachers and students cannot be fulfilled without students’ participation.  


From the panel discussion, the participants will:

  • Identify changes and challenges of medical education during the pandemic 
  • Categorize the online and offline components of a blended medical curriculum
  • Share best practices, practical strategies, effective methods, and tools
  • Consolidate accessible and usable resources for both faculty and students


Medical education does not exist as a lonely vacuum. It has been inter-weaved with undergraduate, public health, and other professional or allied health education, including pharmacology, dentistry, clinical laboratory science, physical therapy, etc. Technologies that have sustained learning at medical schools during the pandemic can be easily adapted to other school curriculums. Lessons and experiences gained from medical education can be valuable resources for many others who are blending their curriculum or courses.  


There is no doubt that technology, with the COVID-19 virus, has changed how we learn and educate monumentally. The combination of the two has blended learning in medicine at an unprecedented speed with unexpected challenges and successes.  In this time in world history, the changes are more convenient and compulsive when technology enables us, and the barriers are more easily overcome when a virus forces us to do so. However, we are aware of technology's limitations in medical care, just as we realized how much we are longing for human interactions while being distant from each other. After all, the art of ambiguity in medicine and the variability of real situations cannot be solely replicated by technologies. No technology can replace the human being in the "care" of another person from birth to death. The application of technology in medical education should not be at the cost of meaningful human interactions. The perpetuation of humanitarianism has an unwavering fundamental component in health care, which cannot be overshadowed or compromised by either proliferating technologies or a disruptive, unpredictable virus. COVID-19 virus does, however, quickly help us to sort through the elements of medical education that can be done successfully online, and what has to be done offline with authentic human contact. Indeed, and surprisingly, it is a virus that teaches us how to use technology smartly in medical education to create humanistic doctors who are respectful, compassionate, and sensitive to the needs and demands of patient care in the 21st century.