Post-COVID Mantra for Health Profession: Combine “High Tech” with “High Touch”

High Tech vs High Touch

High tech means the application of high-end technology to deliver a product or a service. High tech often results in increased output, effectiveness, and efficiency. For example, you can apply high tech in your training, reach out to a large number of people, transmit a huge volume of information, assess trainees’ knowledge, and show an impressive graph to show that you did a great job. However, the question remains. Were you able to “touch” the hearts of trainees to enhance their performance or practice? No doubt, we cannot undermine the importance of technical performance based on the knowledge (cognitive domain) or the skills (psychomotor domain). They are absolutely essential. However, they are quite useless, unless you can develop good professional behavior and practices (affective domain) including the use of effective communication, emotions, values, and reflection for the benefit of individuals and the community.²

Causes of Deficiency in the Training of Professional Values

The causes for the erosion of human touch can be attributed to many factors. First, how students are admitted to medical colleges is based on the school achievement or the marks scored in entrance tests which are MCQ-based and focused on knowledge of scientific facts. There is no scope for assessing the aptitude of students to render social service. Second, the traditional curriculum overemphasizes the acquisition of knowledge and skills at the cost of attitudes and values. There is no agreed list of professional behavior which should be taught and assessed. Third, research in this field reveals that qualities, such as empathetic listening, compassion, and caring, are learned by the students, by emulating their seniors who act as “role models”. This is called the effect of “hidden curriculum”. Fourth, the inculcation of these values requires rich contextual experiences from real-life situations or simulated experience, which are very few in the present scenario. Finally, there is no systematic mentoring opportunity for the teachers and students to give and take feedback either way, which is very critical for developing professional behavior.^3–7

The Way Forward and Potential Obstacles

The way forward appears to be a four-pronged approach: setting expectations by way of defining the goals and expected professional behavior and outcomes, inducting well-trained, passionate mentors who can set role models, providing rich contextual experience from real life or simulated and finally, promoting an institute-wide culture where everyone demonstrates professionalism.^3–7

Bringing out changes in an interdependent and interconnected world is extremely challenging. The students are influenced by the faculty. The faculty members are directed by the institutes and their managements, who tend to toe the line of regulators who are bound by their own criteria of assessment and accreditation. They are prompted by the governments who are the policymakers. We cannot ignore the participation of civil society especially, the role played by the homes, families, workplaces, employers, and the consumers in this mega exercise. The way forward is to bring all stakeholders together to address this complex issue.

Positive Signals

Fortunately, the pendulum of medical education has been shifting from the traditional role of a doctor as a “disease fire fighter” to a “holistic professional”. The role of the Indian Medical Graduate (IMG) as defined by the National Medical Commission as a clinician, health team payer, communicator, professional, and life-long learner is a most welcome development. This has paved way for introducing a longitudinal model of Attitude, Ethics, and Communication, what is called AETCOM modules.^8,9 Impetus to medical humanities, the introduction of a foundation course, and the study of electives are other welcome propositions.^10,11 The National Assessment and Accreditation Council (NAAC) has come out with a manual for health sciences universities which reflects its emphasis on all aspects including efforts made for achieving continuous professional development.¹² The National Education Policy (NEP 2020) is yet another landmark document that is likely to bring fresh ideas such as the role of education in the individual capacity building linked with nation-building in the spirit of self-reliant Atmanirbhar bharat.¹³