The Human Dimension of Technology: Reflections on London's Enhance trailblazer workshop

Hear from Nikki Clarke and Amelia Martin, 2 Fellows on the Enhancing Generalist Skills programme, about workshops they have been running to examine the use of digital technology in healthcare.

In the past few decades, technology has completely transformed the ways in which we live our lives. This movement has extended into healthcare, with both patients and clinicians using technology regularly. Technology is currently used to access healthcare, diagnose, treat, communicate, document and much more. This transition to digital healthcare was accelerated by the coronavirus (COVID-19) pandemic. For example, teleconsultations became the norm, and many patients now access healthcare and records through NHS apps.

This is only the beginning, Artificial Intelligence (AI) is helping to establish novel diagnoses, sensor technologies can help to monitor response to treatment, genetic therapies may be able to prevent disease and care bots are being designed to help patients at home after discharge from hospital.

We must acknowledge however, that digital healthcare has the potential to widen, maintain, or narrow health inequalities, and we as healthcare professionals can play a key part to ensure this transition to digital healthcare remains equitable, ethical, and fair.

A potential problem

Social justice is a key component of the London Enhancing Generalist Skills programme . We would argue that without the right knowledge, skills and tools to critically appraise healthcare technologies there lies a risk that inequity could be inadvertently introduced into healthcare practice via the technology itself.

An AI tool is only as good as the data it has been trained on. For example, if algorithms are trained on biased datasets, they may make biased decisions. If an AI tool is developed to diagnose skin cancers yet has only been trained on photos of pale skin, it may not be able to diagnose cancers in other skin tones as accurately. If a dataset does not include a particularly rare diagnosis, otherwise known as an ‘edge case’, an AI tool may not be able to diagnose it. The consequences of this could be devastating, and even widen health inequalities through digital discrimination.

Our solution

Within the London Enhance Thinking Together Programme, we have designed a new workshop: ‘The Human Dimension of Technology’. The aims of the workshop are:

● to explore the strengths and limitations of different healthcare technologies in practice

● to consider the skills and thought processes clinicians need to develop to work effectively alongside technology

These themes are explored in more detail in the NHS Digital Academy and NHS AI Lab reports Understanding Healthcare workers Confidence in AI and Developing Healthcare workers Confidence in AI.

The Human Dimension of Technology Workshop

We ran two successful workshops in 2022, with speakers providing their expertise and stimulating discussion. In January, Professor Joanne Reeve joined us to discuss the unique skills we have as clinicians to apply wisdom, compared to the narrow intelligence of AI. In February, Professor Trish Greenhalgh spoke and raised the need for clinicians to be able to identify and address complexity within systems.

We then hosted small group discussions around ethical conundrums using case scenarios.

We wrapped up the session with a motivational talk by Dr Hatim Abdullhussein from the NHS Digital Academy on how to prepare for the digital future and opportunities it holds.

Workshop feedback

Feedback for the workshops has been positive, with participants reporting an increase in their knowledge of strengths and limitations of technology and the knowledge and skills we need as clinicians to help navigate this wave equitably. All participants have agreed they would recommend the session to colleagues or friends.

Anonymous feedback

“Great opportunity to stimulate the mind into discussion and learn from other people's experiences/insights”

“Important initiative to educate clinicians about tech - it is the future!”

The Enhance programme

The Enhance – Enhancing Generalist Skills programme sets out to ensure all clinical trainees have skills across six domains:

• social justice and health equity
• system working
• population health
• environmental sustainability
• multi morbidity
• person centered care crosscutting theme in this work is digital.

Future workshops

We are running further Human Dimension of Technology workshops as part of our expanded four-day London Trailblazer Enhance programme ‘Thinking Together’. Thinking Together has been designed based upon recommendations from the Future Doctor report. This is open to all specialties to help explore the six domains mentioned, develop skills and participate in quality improvement activity and improvement. The programme has already generated inspiring projects on social prescribing, peer support, cancer screening and improving induction for postgraduate doctors in training.

If you’re interested, please join an upcoming workshop. You are encouraged to join all four workshops, but you can join individual ones if needed. The upcoming dates are:

• Thinking Together 1: 12 September 2023, 9 January 2024
• Thinking Together 2: 16 May 2023, 3 October 2023, 23 January 2024
• The Human Dimensions of Technology: 30 May 2023, 31 October 2023, 13 February 2024
• Flourishing: 13 June 2023, 14 November 2023, 12 March 2024

Find out more about the workshops, and please email the team to register your place.