The development of Oulu University Hospital also concerns medical education

University Hospital is undergoing a transformation as a result of the Future Hospital – OYS 2030 reform programme. The renewal of facilities and technology affects not only the treatment of patients, but also the hospital’s other core function, medical education.  

Training is an essential part of the activity of Oulu University Hospital (OYS), says Petri Kulmala, Professor of Medical Education. “Most of the medical education at the University of Oulu takes place at the University Hospital. The teaching of the four clinical years after the two years of preclinical studies is almost completely done at OYS.”

At the centre of the OYS 2030, therefore, are also the needs of education. The matter is being promoted by the Future Hospital Teaching and Research Planning Work Group, which was established in December 2019 under the leadership of Kulmala. The basic information collected by the work group during the spring does not yet tell in detail how teaching at OYS will be organised, but it is indicative.

The starting point is that both contact- and group teaching will remain at the core of the training of doctors. “Medical education, particularly the training of doctors, is very diverse. It requires skills practice and contact teaching, personally and in groups,” says Kulmala.

“Often, education takes place with a large number of people being in the same room at once. As the coronavirus epidemic has shown, this can also be done virtually. Since teachers and students can be remote from each other in different places, traditional lecture-based teaching may decrease.”

Actual contact teaching is not, however, disappearing, and it will also be provided as before on patient wards and at outpatient clinics. This sets its own requirements for renewed facilities in the OYS 2030 project.

“Facilities are needed in which a large group can assemble at the same time, but a considerable number of facilities are also needed where smaller groups can be taught,” says Kulmala.

The construction of buildings A and B, which will house key patient functions, has already begun, whilst building C is still being designed. According to Kulmala, teaching – particularly ‘mass teaching’ – will mainly be concentrated in building C. In buildings A and B, it will be taken into account through functional design.

Project manager of functional design Tuomas Holma says that the aim is to ensure the sufficiency of new facilities through a simulation model.

“This model takes into account functions according to the timetables of medical students and nurses, as well as the bookings of facilities by other parties. The dimensioning of the typical facilities in the Future Hospital such as patient rooms, operating theatres and operating rooms has taken into account that, in addition to the treatment of patients, future healthcare professionals will also be trained at the hospital.

Teaching will, however, also continue to be given in the old hospital for several more years yet. ”The construction of the hospital and the move to the new one will take place in several stages”, says Holma.

Professor Petri Kulmala leads the Future Hospital Teaching and Research Planning Work Group. According to Kulmala, the starting point is that both contact- and group teaching will remain at the core of the training of doctors (photo: Seija Leskelä / Kulmakuvaamo).

Digitalisation, multi-professionalism and adaptability challenges for facilities

Although contact teaching is in no way being eliminated, digitalisation is opening up new possibilities not only for lecturing but also for practising skills.

Currently, the main place for practice has been Knoppi, Clinical Skills Centre. “There it is possible to simulate procedures, above all treatment situations, for example with resuscitation dolls, in which all vital functions are simulated electronically,” says Kulmala.

Digitalisation increases the different ways in which simulation and virtual reality can be practised. Kulmala expects this also to be evident in teaching facilities.

“It will create the need for a larger, more extensive centre that provides the opportunity for the more diverse practice of simulation and virtual reality.”

Another development trend is the increasing multi-professional nature of education. This term means education provided simultaneously to several different professional groups. Depending on the content of the training situation, students training to be doctors, nurses or therapists of different fields may participate in it.

“There are already examples of this in Oulu, for example in diabetes teaching. Multi-professionalism will expand in education because patient work itself is becoming more multi-professional,” says Kulmala.

The hope is that this too will be visible in the new teaching- and patient facilities.

“Room sizes must be such that different groups of professionals can be in them at the same time. It is, however, sensible for facilities to be adaptable, so that they can also house hospital functions other than teaching. At present, adaptability does not work well: a room for 100 people may be used to train just 10, and I myself have taught in the lobby of a lecture theatre and even in the equipment storage room.”

According to Tuomas Holma, this issue is being taken into account. ”Teaching rooms will be multifunctional and will also be used by other parties.”

Digitalisation affects teaching but does not define its content

Kulmala says that, whatever the content of medical education will be, its development will not take place on OYS 2030 terms but in accordance with national and international guidelines. These will be determined, for example, by the learning outcomes of Finnish doctors, completed this spring, and by MEDigi, a project aimed at digitalising and harmonising the teaching of medical fields.

The latter is aiming for not only electronic teaching materials but also at dealing with content-related questions such as meeting a patient in a digital environment, digital decision-making systems for healthcare and cyber security. These will eventually be reflected in the education that will also be organised in the new OYS.

“Medical education, however, is developing all the time. What and how we learn forms a continuum,” notes Kulmala.

The OYS 2030 renewal programme is supporting the general development, for example using AV systems. “Image and sound connections from treatment situations will be enabled in lecture theatres and group teaching rooms,” illustrates Tuomas Holma.

A student team is also involved in the teaching and research work group of the Future Hospital. Valter Poltojainen, a third-year medical student who is a member of this team, has already gained a feeling for the opportunities of digital teaching.

“During the coronavirus epidemic, we have had simulated surgical assistance tasks online and gastroscopy, for example, can be simulated in the same way. It was also evident that remote teaching can be carried out flexibly.”

“However, in no way can these replace contact teaching. Examining and interviewing the patient are missing from them. Simulation practices and the teaching of manual skills like stitching on one’s own have also been very popular.”

The members of the student team hope that the traditional forms of teaching will also succeed better than at present at the Future Hospital. “For group teaching, the present facilities are too small, and the clinics do not have enough space for working and practice,” says Poltojainen.

Petri Kulmala is of the same opinion. “Digitalisation is an excellent opportunity to find new creative solutions. You can’t, however, make doctors just through online courses. Producing a doctor requires much master-apprentice-type contact teaching in a genuine patient environment.”

Text: Jarno Mällinen
Main photo: medical student V
alter Poltojainen. The Future Hospital buildings on the background (photo by Mikko Törmänen).

 

 

Last updated: 29.6.2020