Department of Electrical and Electronic Engineering
The Practice
The MSc in Digital Health is a new taught programme in the Faculty of Engineering at the University of Bristol. One of the first such programmes in the UK, it is motivated by increasing use of digital technologies (AI, apps, wearables, electronic health records) to address major healthcare challenges. It admits students with degrees such as Medicine and Psychology alongside students from Computer Science and Engineering. Students study 7 units (10-20 credits each), culminating in the 60-credit major project which is the subject of this nomination.
The MSc attracted 10 students in its first year (2020) and 20 students in 2021. The students are highly-international and usually intending to build careers in industry.
The values of the Programme, articulated to all applicants, centre on a commitment to responsible innovation – students should understand medical device regulations, GDPR, and be able to think critically from multiple disciplinary perspectives about unintended harms that could arise from new health technologies. Multidisciplinary teamwork is therefore indispensable to the student experience and stated in the Programme learning outcomes.
A traditional MSc involves an individual research project (or “dissertation”) which emphasises primacy of individual scholarship and, assessed by dissertation, which actively discourages collaboration with others. This is a poor fit to the above Programme values. Meetings with employers furthermore demonstrated that the individual research project doesn’t help employers looking for team-players who will collaborate to develop new products – rather than for individuals trained to do original research without involving others.
To address these issues, a highly multidisciplinary team, was assembled with skills across machine learning, behaviour change, life sciences, clinical trials and business to devise a project, believed to be unique in the UK, aligned to the programme’s values and specifically-designed for multidisciplinary student groups. During the team’s early discussions, it became clear that their experience had been that new digital technologies could present both benefits and unintentional harms to patients. Their experience was that maximising those benefits and minimising the harms invariably required a multidisciplinary perspective – for example a computer scientist might foresee how an algorithmic bias could accidentally cause a new technology to work poorly in an ethnic minority population, whereas a clinician would be more naturally aware of the quite different risk of a technology inadvertently eroding the relationship between doctors and patients. The programme had a responsibility to encourage students to think holistically about problems and it should never encourage a belief that a single disciplinary perspective is the right way to approach a technology for healthcare.
It was clear to the team that a group project would be a far better fit to the values and learning outcomes of the Digital Health programme. However, even though group work is an authentic activity within many fields (Dede, 2010), mirroring work practices, and despite a World Economic Forum report stating that ‘technical skills will need to be supplemented with strong social and collaboration skills’ (Gray, 2016), most forms of teaching and assessment used in Higher Education promote independent study and a focus on personal achievement (Mamas, 2018). This seems to be especially the case in Masters education.
The highly multidisciplinary intake of this MSc meant that each group of students would have an exceptionally broad skillset. It was logical therefore for the nominees to adopt a constructivist learning theory perspective; envisaging the instructor’s role as one of expert facilitator with the students taking an active role in learning within their zone of proximal development (Vygotsky, 1978), i.e., learning with support from their peers within the group and from expert “consultants”.
The project design draws heavily on Problem-Based Learning (PBL) in putting the responsibility for the learning process in the hands of the student. In addition, the nominees decided that it was also important for students to have a holistic view of product development – for example how very early decisions can have important consequences much later on. They therefore constructed an over-arching narrative of responsible product development, thereby creating a “well-defined curricular infrastructure under-girding the process” (Koschmann, 1994). This project narrative sees the student groups moving sequentially through six crucial phases of responsible medical product development for a fictional yet realistic medical device (an app to help patients manage their arthritis). These phases were decided to be:
- Market analysis
- User research (including qualitative research with actual patients)
- Clinical Trial design
- Quantitative data analysis
- Medical device regulation
- A real-time exercise during which their (fictional) technology is discovered by the media to have caused harm to individuals.
Although this overall structure was fixed (authentically reflecting the highly-regulated nature of medical device design), within the structure each stage was relatively open-ended. This ensured a constructivist emphasis on self-directed solving of problems of immediate relevance to the aspirations of these specific students (e.g. how to analyse data from a clinical trial of a new technology). Working in groups afforded excellent opportunities to learn by interacting with other students in the group (as noted in the evaluation), especially those from different disciplinary backgrounds.
The Impact
Staff experience
The ambitious scope of this project (ranging from business studies, to statistics, to design, qualitative research, and public relations) is far broader than a conventional MSc research project; no single academic at the University would have been able to devise the task or supervise students undertaking it. Every aspect of the creation of the project framework therefore depended entirely on the nominees as a multidisciplinary team which brought together and integrated their diverse areas of expertise (machine learning, behaviour change theory and ethics, life sciences, clinical trials and medicine, engineering) and skills (e.g., qualitative and quantitative approaches).
This team ethos has a wider importance; the continued expansion of taught postgraduate programmes in the UK, especially in areas of societal challenge which are inherently multidisciplinary (e.g., sustainability, digitisation, cybersecurity) is already challenging institutions to find appropriate projects that fit within the skillset and capacity of individual academics. The team approach adopted by the nominees to the design of the MSc project therefore addresses an important, much wider, challenge for the sector.
On several occasions the diverse disciplinary background of the academic team was important at this stage in anticipating problems and finding solutions, which included adopting scaffolding approaches from Problem Based Learning (PBL) (Greening, 1998). Here, the team’s disciplinary breadth and network of contacts in different sectors led to the introduction of external consultants from industry and the NHS.
Other academic members of the team suggested elements of Team Based Learning (TBL) leading to a decision that, for reasons of fairness, the student groups would need to be carefully-constructed to have maximal disciplinary diversity within the teams. Each group therefore had a similar breadth of skills but relative evenness in ability between the teams (Michaelsen, 2008).
Student experience
Survey data from the students shows that they all agreed or strongly agreed with statements including “The project has given me skills which will improve my employability” and “My skillset made a meaningful contribution to the project outcome”.
The average individual-student score across 17 meetings ranged from 89% – 100%.
Typical responses from focus groups included “I thought it was valuable because, like I continued to like learn from everyone in the group and like it really pulled on each other’s like expertise and background and stuff, so that was really valuable.”
A second student commented on how much she’d learn from her peers: “I enjoyed working in the group … the four of us we worked really, really well together … I don’t think I would have achieved what I did without being in a group”.
A third student found that the group interaction enhanced her creativity “I think if you work individually you will like to think the same way, so it’s hard to get in innovation, so listening to other people’s thoughts actually will make you feel more creative and is most inspiring.”
Wider impacts
At a time when academics are under pressure to grow MSc programmes, the challenge of supervising 10 or more projects over the summer while also attending conferences and developing a research portfolio is stressful – especially for early career academics and those returning from a career break. While the model described here had extensive design input from academics, the groups did not have academic supervision; rather the project promotes self-directed and collaborative learning within the group, interaction with the consultants with engagement being monitored and assessed through weekly meetings with a Teaching Assistant.
The model developed by the team therefore addresses an important national need for the whole sector.
Next steps
The team have had a paper about the MSc accepted for the AdvanceHE Teaching and Learning Conference and are currently writing up the evaluation for a second journal paper. Encouraged by their experience, several members of the team are commencing a new piece of pedagogical research based another of the MSc taught units. Several workshops on the practice have already been delivered internally and externally.
Contact
Professor Ian Craddock (Department of Electrical and Electronic Engineering)
Ian.Craddock@bristol.ac.uk
Reference list:
Dede, C. (2010). “Comparing Frameworks for 21st Century Skills,” in 21st Century Skills: Rethinking How Students Learn, pp. 51–76, Solution Tree Press.
Gray, A. (2016). “10 skills students will need to thrive in the fourth industrial revolution” https://www.weforum.org/agenda/2016/01/the-10-skills-you-need-to-thrive-in-the-fourth-industrial-revolution
Greening, T. (1998) “Scaffolding for Success in Problem-Based Learning,” Medical Education Online, 3:1, 4297, DOI: 10.3402/meo.v3i.4297
Koschmann, T., Myers, A., Feltovich, P., Barrows, B. (1994) “Using technology to assist in realizing effective learning and instruction: a principled approach to the use of computers in collaborative learning,” Journal of the Learning Sciences, vol 3, pp. 227-264.
Mamas, C. (2018) “Exploring peer relationships, friendships and group work dynamics in higher education: applying social network analysis,” Journal of Further and Higher Education, vol 42, pp. 662-677.
Michaelsen, L., Sweet, M. (2008). “The essential elements of team‐based learning,” New Directions for Teaching and Learning, pp. 7 – 27.
Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes, Harvard University Press.