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REVIEW ARTICLE Table of Contents  
Ahead of print publication
Exploring the role of WhatsApp in strengthening the delivery of medical education and clinical teaching


1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

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Date of Submission30-Apr-2022
Date of Decision12-May-2022
Date of Acceptance16-May-2022
Date of Web Publication04-Aug-2022
 

  Abstract 


The training imparted to medical students during their undergraduation period has to be multifaceted to ensure that upon the completion of the training, we succeed in producing competent medical graduates. The purpose of the current review was to explore the utility of WhatsApp in the delivery of medical education and clinical teaching. An extensive search of all materials related to the topic was carried out on the PubMed search engine, and a total of 14 articles were selected based on their suitability with the current review objectives. Keywords used in the search include social media, WhatsApp, and medical education in the title alone only. WhatsApp is the instant messaging applications, and with time, it has been observed that it has become an integral part of the community of medical students worldwide. Utilizing the medium of WhatsApp can prove to be an effective approach to bridge the existing gap between teachers and students predominantly because of the flexibility, instant messaging, and sharing additional information with the students for additional reading. To conclude, the delivery of medical education has shown significant transformation over the years to meet the needs of learners. Acknowledging the potential of WhatsApp, its user-friendly nature, and its popularity among medical students, it is very much necessary to utilize the medium for the delivery of the curriculum beyond college hours and at their time of convenience.

Keywords: Medical education, social media, WhatsApp


How to cite this URL:
Shrivastava SR, Shrivastava PS. Exploring the role of WhatsApp in strengthening the delivery of medical education and clinical teaching. APIK J Int Med [Epub ahead of print] [cited 2022 Oct 6]. Available from: https://www.ajim.in/preprintarticle.asp?id=353264





  Introduction Top


The training imparted to medical students during their undergraduation period has to be multifaceted to ensure that upon the completion of the training, we succeed in producing competent medical graduates.[1] These medical graduates should not only be well equipped with the knowledge and skills required for clinical practice but also acquire the noncognitive attributes (namely, team leader, professional, etc.).[1] It is an obvious fact that if we want the students to acquire multiple attributes, a single type of teaching–learning method will not suffice, and we have to resort to innovative methods, including the use of information technology, and tapping into the potential of social media.[2] The rationale for the same is that teachers are no more the only source of information provider to the students, instead, they have easy access to the pool of information through the Internet and social media applications.[2] The purpose of the current review was to explore the utility of WhatsApp in the delivery of medical education and clinical teaching.


  Methods Top


An extensive search of all materials related to the topic was carried out on the PubMed search engine. Relevant research articles focusing on the use of social media and WhatsApp in medical education published in the period 2017 to 2021 were included in the review. A total of 17 studies similar to current study objectives were identified initially, of which, 3 were excluded due to the unavailability of the complete version of the articles. Overall, 14 articles were selected based upon their suitability with the current review objectives and analyzed. Keywords used in the search include social media, WhatsApp, and medical education in the title alone only (viz. social media [ti] AND medical education [ti]; WhatsApp [ti] AND medical education [ti]). The articles published in only the English language were included in the review [Figure 1]. The collected information is presented under the following subheadings, namely, social media and medical education, WhatsApp and medical education, medical education and patient care using Twitter during coronavirus disease-2019 (COVID-19) pandemic, Twitter and continuous medical education, WhatsApp and clinical teaching, lessons from the field, and implications for research.
Figure 1: Flowchart for selection of research articles

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  Social Media and Medical Education Top


In the last decade, a number of social media applications and instant message applications have been launched worldwide and these applications have revolutionized the ways in which people communicate with each other.[1],[2],[3] Similar trends of higher acceptance and use have been observed among youths, including medical students, and there has been a significant change in human behaviors.[1],[3] In fact, gradually, medical colleges have realized the potential of mobile Internet devices in classroom settings (namely, mobile learning) and the number of educational opportunities it provides to the students.[2],[3] Further, medical students have gleefully accepted these instant messaging applications to communicate or share information among themselves.[3],[4],[5]

As medical teachers, we cannot deny that the popularity of these social media applications has significantly increased among medical students, and thus, if we really want to meet the needs of the learners of today's era, we have to simultaneously adapt to the changing needs.[3],[4] The time has come when as educators we start exploring the positives of these applications and deliver the educational content to the students in a more organized manner and thereby ensuring that learning continues even beyond class hours.[2],[3],[4] As a matter of fact, different instant message applications have been used to deliver medical content to the students with encouraging results.[5],[6],[7],[8],[9]


  WhatsApp and Medical Education Top


WhatsApp is the of the instant messaging applications, and with time, it has been observed that it has become an integral part of the community of medical students worldwide.[9] The application offers the service to transfer and receive text – audio – images – videos to their contacts and thus stay connected. At the same time, the option WhatsApp Group provides a platform for 256 users to share information that can be accessed simultaneously by all the members of the group.[9],[10] This application has become popular owing to its easy accessibility, no costs involved, immediate transfer of information, provision to share different kinds of information, with the only prerequisites being the presence of a smartphone with an active Internet connection, and thus it is being preferred over emails.[10],[11]

This calls for the need to use WhatsApp to strengthen and supplement the ongoing conventional teaching–learning activities. The application can be used to encourage interactive discussion and support the same with the sharing of relevant documents to ensure collaborative or team-based learning.[9],[11] As these interactions can happen beyond office working hours, both students and teachers need not wait for in-person interactions and thus are benefited from better student interaction, and more opportunities to participate in the discussion, which is not feasible in-class sessions.[10],[11] Further, as all the shared media as well the interaction remains in the group or chat, students can revisit as and when required for their reference. The availability of the option for group audio or video call also gives an opportunity for the teachers and students to interact with each other, and it becomes quite useful while planning for problem-based learning sessions.[1],[10] However, there is a definite need to ascertain the effectiveness of these kinds of sessions and compare them with face-to-face sessions.[9],[10],[11]


  WhatsApp and Clinical Teaching Top


In general, the clinical teaching imparted to medical students in the current setup is opportunistic, wherein a student gets exposed to only a variety of clinical patients who presented during their clinical posting duration or were preferred by the teachers for discussion.[12] This kind of teaching is further impaired by the reluctance or the poor communication skills on the part of students to approach teachers and vice versa, which eventually accounts for irregularities in teaching and sub-optimal utilization of learning experience in clinical settings.[12],[13] Utilizing the medium of WhatsApp can prove to be an effective approach to bridge the existing gap between teacher and students predominantly because of the flexibility, instant messaging, and sharing additional information with the students for additional reading (which might not be possible during working hours due to heavy clinical caseload).[12],[13],[14]

Further, such communications also minimize the hierarchical divide and play an important role in strengthening teacher–student bonding, which in turn makes the learning experience satisfying.[12] Upon the emergence of the COVID-19 pandemic, the exposure of the students to the clinical materials got significantly minimized due to the fear of acquisition of infection.[4],[13] Under these circumstances, WhatsApp became the platform that gave adequate time for both teachers and students to get adapted to distant learning, and simultaneously aided in multiple ways to continue the learning process.[13],[14] Although concerns have been raised in the past about privacy and confidentiality pertaining to the details of patients, the addition of the “end-to-end encryption” feature makes the conversations and content safe.


  Lessons from the Field Top


Considering the fact that the number of medical students enrolled in a single academic year in a medical college in India varies from 50 to 250, all of them can be made a part of a single group and necessary information can be passed on to them by the individual departments. For instance, at Shri Sathya Sai Medical College and Research Institute, a constituent unit of the Sri Balaji Vidyapeeth, Deemed-to-be-University, Puducherry, different departments (namely, Physiology, Pathology, Forensic Medicine, Ophthalmology, General Surgery, etc.) have adopted the practice to create groups for each academic batch and ensure that the process of learning continues. These WhatsApp groups have been utilized to promote clinical case discussion (to inculcate critical thinking, clinical reasoning, and decision-making skills), sharing of notes, articles, and recent reports, patient reports (laboratory and radiological) to ensure prompt diagnosis and early initiation of management, etc. Further, the application has also been successfully utilized for the organization of conferences, workshops, student enrichment programs, etc. to interact with the participants and promote self-directed learning.


  Implications for Research Top


The available literature clearly indicates that WhatsApp has been linked with multiple benefits for the students and teachers.[9],[10],[11] However, there is a significant need to explore the precise utility of the application in delivering a structured curriculum.[12],[13],[14] In addition, there is also an impending need to compare the effectiveness of teaching imparted through WhatsApp with face-to-face teaching.[10],[11],[12] These studies can be either carried out in the form of a quantitative survey or with the help of a mixed-methods study design to explore the pros and cons of WhatsApp as teaching–learning tool.


  Conclusion Top


The delivery of medical education has shown significant transformation over the years to meet the needs of learners. Acknowledging the potential of WhatsApp, its user-friendly nature, and its popularity among medical students, it is very much necessary to utilize the medium for the delivery of the curriculum beyond college hours and at their time of convenience.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Khamis N, Aljumaiah R, Alhumaid A, Alraheem H, Alkadi D, Koppel C, et al. Undergraduate medical students' perspectives of skills, uses and preferences of information technology in medical education: A cross-sectional study in a Saudi Medical College. Med Teach 2018;40:S68-76.  Back to cited text no. 1
    
2.
Guckian J, Utukuri M, Asif A, Burton O, Adeyoju J, Oumeziane A, et al. Social media in undergraduate medical education: A systematic review. Med Educ 2021;55:1227-41.  Back to cited text no. 2
    
3.
Sterling M, Leung P, Wright D, Bishop TF. The Use of Social Media in Graduate Medical Education: A Systematic Review. Acad Med 2017;92:1043-56.  Back to cited text no. 3
    
4.
Katz M, Nandi N. Social media and medical education in the context of the COVID-19 pandemic: Scoping review. JMIR Med Educ 2021;7:e25892.  Back to cited text no. 4
    
5.
Sharma N. How Twitter can move the medical education debate forward? Med Teach 2018;40:532.  Back to cited text no. 5
    
6.
Nicolai L, Schmidbauer M, Gradel M, Ferch S, Antón S, Hoppe B, et al. Facebook groups as a powerful and dynamic tool in medical education: Mixed-method study. J Med Internet Res 2017;19:e408.  Back to cited text no. 6
    
7.
Curran V, Simmons K, Matthews L, Fleet L, Gustafson DL, Fairbridge NA, et al. YouTube as an educational resource in medical education: A scoping review. Med Sci Educ 2020;30:1775-82.  Back to cited text no. 7
    
8.
Timothy PG, Jeffrey B, Kaitlyn L, Margarita VD. Delivery of educational content via Instagram(®). Med Educ 2016;50:575-6.  Back to cited text no. 8
    
9.
Salam MA, Oyekwe GC, Ghani SA, Choudhury RI. How can WhatsApp® facilitate the future of medical education and clinical practice? BMC Med Educ 2021;21:54.  Back to cited text no. 9
    
10.
Coleman E, O'Connor E. The role of WhatsApp® in medical education; a scoping review and instructional design model. BMC Med Educ 2019;19:279.  Back to cited text no. 10
    
11.
Raiman L, Antbring R, Mahmood A. WhatsApp messenger as a tool to supplement medical education for medical students on clinical attachment. BMC Med Educ 2017;17:7.  Back to cited text no. 11
    
12.
Woods J, Moorhouse M, Knight L. A descriptive analysis of the role of a WhatsApp clinical discussion group as a forum for continuing medical education in the management of complicated HIV and TB clinical cases in a group of doctors in the Eastern Cape, South Africa. South Afr J HIV Med 2019;20:982.  Back to cited text no. 12
    
13.
Thorp M, Pool KL, Tymchuk C, Saab F. WhatsApp linking Lilongwe, Malawi to Los Angeles: Impacting medical education and clinical management. Ann Glob Health 2021;87:20.  Back to cited text no. 13
    
14.
O'Connor E, Coleman E. Response to “How can WhatsApp facilitate the future of medical education and clinical practice?” BMC Med Educ 2021;21:55.  Back to cited text no. 14
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava,
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajim.ajim_60_22



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