Speculative futures in health care and higher education

The World Health Organization declared COVID-19 a global pandemic on March 11, 2020. That was only a little over 3.5 years ago. Yet when one considers all of the technological, social, and personal upheaval that has occurred since the pandemic was declared, it is quite significant to see how this unprecedented disruption has changed how people work, learn, meet, access services, and conduct business, just to name a few examples. For this assignment, we are invited to think about an aspect of teaching, learning, and education in 2030. Drawing from relevant literature in the field, and my own experience working in the health care and post-secondary sectors, I will examine some potential futures of learning and teaching in these spaces.

At the onset of the COVID-19 pandemic, public health measures brought about marked changes in the way that people were able to access health care services. I work for a regional health authority in British Columbia, and I observed how care providers had to adapt to these measures and find ways to connect with and care for clients and patients. Specifically, I heard from health workers who typically provide care in community settings, (as opposed to acute or critical care settings like inside emergency departments) struggle with finding ways to connect in light of restrictions and physical distancing. As a public sector organization that has high thresholds for information security and protection of privacy, our health authority had few accepted methods of communicating with patients and clients outside of face-to-face in 2020. Health care is a sector where fax machines and letter mail are still routine means of communication with clients and patients. In my role as leader of digital engagement, I received various requests for advice from health workers asking me how they might use digital technologies like social media platforms to connect with clients they could no longer see face to face, in particular those who are hard to reach, and more vulnerable to prolonged periods of isolation. Many health workers I talked to did not have employer-provided smart phones, and were struggling to find new ways to connect that worked for both them and their clients and patients. During this time, social distancing compounded patients’ ability to manage their health, and it brought to light how critical it is for health workers to have access to responsive and resilient infrastructure, tools, skills training, and knowledge to respond nimbly in the face of another public health crisis.

The World Health Organization estimates that by 2030 there will be a global shortage of about 18 million health care workers

World Health Organization, 2016.

The World Health Organization estimates that by 2030 there will be a global shortage of about 18 million health care workers (World Health Organization, 2016). Canada is not immune to this labour deficit, and the dire need for workers is putting a strain on the healthcare system (Mahler, Paperny, 2023). Even before the COVID-19 pandemic shone a light on the need for every sector to be prepared with ways to continue service delivery, the literature in education and technology has been warning about a future where digital literacy and competencies will be required skills across sectors and in various jobs. In a study analyzing 361 occupation types as categorized by the UK government, researchers concluded that over 90 per cent of the occupations in the UK workforce require at least basic digital literacies (UK Digital Skills Taskforce, 2014). In 2030, health human resource planners must accept that employers need to play a role in facilitating and /or providing opportunities for teaching digital skills and competencies. Whether this is through ongoing continuing professional development, mandatory new employee training, or a requirement of professional licensure, health workers are one of the most critical essential service workers who need these skills. Researchers have already come up with frameworks that define examples of digital competencies, and map out how individuals and employers alike can build capacity and accountability for becoming more digitally competent (Beetham, 2015). The unprecedented disruption of the COVID-19 pandemic, coupled with the global health human resource crisis should serve as a clear warning that health care systems must make significant investments in training, infrastructure, and digital competency.

As a part-time instructor in higher education I’m also reflecting on potential futures in this space. I was most interested to come across a panel discussion during the 2023 MALAT Virtual Symposium, on AI and Learning Design in Education.  All of the panelists shared the view that banning AI content generators from schools is not a practical or sustainable solution despite valid concerns that persist regarding plagiarism and copyright infringement (Royal Roads University, 2023). Some school districts in the United States have already made the move to ban the use of AI content generators, citing concerns with cheating (Roose, 2023). However, as Clint Lalonde put it, banning AI generator tools from classrooms is “like going to carpentry school and banning the use of a saw, but when you get into the workplace you’re going to be using saws so you need to know how to use these” (Royal Roads University, 2023). Indeed, educators have valid concerns about inappropriate uses of AI generators in school, because of the paradigm shift that the technology brings in conventional student assessment practices. Regarding these concerns, researcher David Mhlanga (2023) notes:  

It is feasible that this will result in regulations that ban its utilization; nevertheless, it is also conceivable that ChatGPT technology will become ubiquitous before institutions have the time to alter their policies. An approach that focuses on correcting the issues that have been caused by ChatGPT while also taking into account the potential benefits and drawbacks of the platform would be more effective.

Mhlanga, D. (2023).

At the same time higher education is grappling with the spread of AI content generators, the sector is still struggling with the controversies brought forward by online exam proctoring technology, made more prevalent during the COVID-19 pandemic where public health measures required people to limit gathering face to face, especially in large groups. One study of such online exam proctoring technology cautions us that “there are a number of critical issues underpinning the adoption of this exam surveillance technology – not least the surrender of control to commercial providers, the hidden labour required to sustain ‘automated’ systems and the increased vulnerabilities of ‘remote’ studying” (Selwyn et al, 2023). As more classes are offered in alternative formats (e.g. hybrid, fully online), the higher education faculty and administrators of 2030 will have to succeed at finding new ways to assess and evaluate student achievement and attainment of learning outcomes. For example, the conventional assessment tool of a research paper, completed individually at home, may need to be replaced (or supplemented) with an oral exam, a problem-based applied project, or a small group project that must incorporate principles and literature taught in the course, to minimize opportunities to rely on AI generators.

Due to lost learning and other challenges all students have faced, faculty will need a wide range of competencies and students will need as much flexibility as their institutions can provide.

Educase, 2021.

 The COVID-19 pandemic has been a catalyst for events that continue to influence the delivery of essential services such as health care and education. In 2030, health systems must be more prepared, nimble, and innovative in how they support health workers with skills and tools to maintain safe, yet patient-centred relationships. In higher education, students and faculty alike have experienced challenge, loss, and fundamental changes teaching and learning. “Due to lost learning and other challenges all students have faced, faculty will need a wide range of competencies and students will need as much flexibility as their institutions can provide” (Educase, 2021). Budget pressures and technological change will be consistent factors that influence how higher education operates. For those working in this sector, they will need to play ‘catch up’ as institutions’ policies inevitably lag behind societal practice. The higher education institutions of 2030 must build capacity in digital competency, readiness, and flexibility to weather whatever global storm may come.

References:

Beetham, H. (2015, Nov 10). Building capability for new digital leadership, pedagogy and efficiency.

https://digitalcapability.jiscinvolve.org/wp/2015/11/10/framing-digital-capabilities-for-staff-deliverables/

Educase Horizons Report (2021). https://library.educause.edu/-/media/files/library/2021/4/2021hrteachinglearning.pdf?la=en&hash=C9DEC12398593F297CC634409DFF4B8C5A60B36E

Mahler Paperny, A. (2023, February 7). Explainer: What ails Canada’s healthcare system? Reuters https://www.reuters.com/business/healthcare-pharmaceuticals/what-ails-canadas-healthcare-system-2023-02-07/

Mhlanga, D. (2023). Open AI in education, the responsible and ethical use of ChatGPT towards lifelong learning. SSRN Electronic Journal  https://doi.org/10.2139/SSRN.4354422

Roose, K. (2023, January 12). Don’t Ban ChatGPT in Schools. Teach With It. The New York Times. https://www.nytimes.com/2023/01/12/technology/chatgpt-schools-teachers.html

Royal Roads University. (2023, March 7). AI and Learning Design in Education [Video].

YouTube. https://www.youtube.com/watch?v=IFrAs59sDHI

Selwyn, N., O’Neill, C., Smith, G., Andrejevic, M., & Gu, X. (2023). A necessary evil? The rise of online exam proctoring in Australian universities. Media International Australia186(1), 149-164.

UK Digital Skills Taskforce. (2014, July). Digital Skills for Tomorrow’s World.

http://www.ukdigitalskills.com/wp-content/uploads/2014/07/Binder-9-reduced.pdf

World Health Organization, 2016. Health workforce and services. Draft global strategy on human resources for health: workforce 2030. https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_38-en.pdf

People in the field – Dr. Maha Bali

We’ve been asked to write about a contributor to the field whose work is at the intersection of learning and technology and consider looking at the writing and scholarship of those who may not occupy an ‘obvious’ or dominant space in the literature.

I was pleased to come across Dr. Maha Bali, who was one of the guest narrators for the audiobook version of this textbook. She is a Professor of Practice in the Centre for Learning and Teaching at the American University of Cairo. Her areas of focus include digital literacies and intercultural learning.  

One of the concepts that Bali writes and speaks of, is “intentionally equitable hospitality” in learning design (Bali and Zamora, 2022). This is a notion that teachers, or workshop facilitators, are hosts of a learning space, and to practice intentionally equitable hospitality means to be cognizant of who that space is hospitable for, and who it is not.

A related idea, which is Bali expands on in this keynote presentation about an equitable, community-oriented approach to AI in education, is that of the “equity care matrix”. The origins of this concept was a question which Bali posed at a talk she presented at the OpenEd20 conference, which was: “What is equity without care, and what is care without equity?” (Bali and Zamora, 2022). Here, with a lens on educational technology, she demonstrates with examples how there cannot be one without the other.

References:

Bali, M., & Zamora, M. (2022). Intentionally Equitable Hospitality as critical instructional design. Designing for Care.

Bali, M. Towards an Equitable Community-Oriented Approach to AI in Education, YouTube, July 14, 2023.

Bali, M., & Zamora, M. (2022). The equity-care matrix: Theory and practice. Italian journal of educational technology30(1), 92-115.

Relevance and conflict: applying context to Weller’s lessons in chapters 9 to 18

Confession time: reading this third of Weller’s book made me nostalgic. I started getting into publishing and sharing content online during a time when most spaces I engaged with were filled with people using social media and blogging for good. So my reflections in this post draw on some of those experiences.

From ivory tower to online community

One lesson from 2002 to 2011 that has immediate relevance is how blogs and social media enabled greater access to information and learning opportunities. In Chapter 10, there is a fulsome discussion of how the advent of blogs gave academics and other public intellectuals the ability to share their work outside the traditional confines of the ivory tower and perhaps a pathway out of the dreaded “publish or perish” option for those in academia. I have benefitted from the ideas and teachings from those who have chosen to maintain an active presence on social media and give freely of their knowledge online – perhaps because they see it as a privilege and a duty to contribute to civil society. Current toxicity online notwithstanding (cue sad music here), I think this kind of knowledge and information sharing by reputable, credible experts is needed more than ever.

Hmmmm….are we really ready for this?

One of my other professional hats is contract instructor in higher education where I work for a teaching-focussed, public polytechnic university in the lower mainland of British Columbia. As I read Chapter 16 about Personalized Learning Environments, I thought of the well-intentioned goals of seeking to provide learners with experiences tailored to their individual needs. However, anyone who has experience with public, accredited post-secondary schools will tell you that getting a course from conception to open for registration is not an easy feat. Between acquiring Senate approval for the course, identifying learning outcomes, and aligning the course with appropriate skills and knowledge, it is a lot. Throw in varying levels of language proficiency, pre-requisite skills, and learning styles, and you have a very challenging threshold for scaling Personalized Learning Environments in this kind of environment.

References: Weller, M. (2020). 25 Years of Ed Tech. Athabasca University Press

Reflection on Weller – Chapters 1 to 8

As I was reading the first eight chapters of Weller’s book 25 Years of Ed Tech, there were a couple of concepts that really resonated with me, both as a student who has taken courses via e-learning, and an instructor who has delivered courses using methods made possible by the innovations mentioned in these chapters. Specifically, the ideas of: e-learning having a “less-than” status in comparison to face to face instruction; and the challenges with developing consistent and practical standards to govern the quality and usability of digital resources. These ideas stood out to me, as I have encountered all of them in my own work and academic experiences.

In Chapter 6, we read about the “angst about the implications of e-learning for higher education at the end of the 1990s” (Weller, 2020). In this chapter, we see some of the history of the long-held belief that face-to-face instruction is the legitimate gold-standard of teaching and learning. Even today, we see some of the legacy of that thinking played out in our biases. As a post-secondary instructor, I have heard students and faculty raise concerns that a program or course that is offered online is somehow less rigorous, engaging, or worthwhile.

In Chapter 8, I found the ideas about standards very interesting. As someone who is at this time in the midst of creating an online course for employer, I have a keen interest in SCORM compliance as this is one of the standards of our organization’s Learning Management System. In reading about the history of attempts to create standards using meta data and other requirements, I could fully appreciate the balance between rigour and pragmatism. If standards are too onerous, they won’t be used. If standards don’t exist at all, the quality of resources will ultimately suffer and not address user needs.

Reference:

Weller, M. (2020). 25 Years of Ed Tech. Athabasca University Press