December 2, 2020

Multi-media Teaching in Global Health and Social Medicine - Final Takeaways from 2018 Burke Fellow Daniel Palazuelos

Daniel Palazuelos, MD, MPH, is a global health implementer-educator who holds positions at Harvard Medical School, Brigham and Women’s Hospital, and Partners In Health (PIH). In 2018, he was awarded a curriculum development grant through the Burke Global Health Fellowship. We invite you to read about his educational project and experience below. 

Dan Palazuelos, November 2020 

Through multiple experiences training young doctors to address suffering globally, I realized early on that our traditional methods of education were ill-equipped to truly produce the clinically effective and deeply human agents of change that our toughest challenges demand. To confront global inequity, climate catastrophe, and political dissolution, the next generation needs to both understand the challenges intellectually, and have a deep understanding of how these problems affect real people in complex ways. A classic way of describing different types of education is to consider whether or not the approach provides information, formation, or transformation; transformational education remains the holy grail, but there isn’t clarity on how we can provide such experiences en masse. 

My experience as a Burke fellow gave me the opportunity to explore one potential set of tools: multimedia techniques. My goal was to develop a suite of tools and techniques that I could use in multiple educational settings, including the “Essentials of the Profession” class at Harvard Medical School, with residents in the Hiatt Global Health Equity Residency at the Brigham and Women’s Hospital, and with young trainees abroad in the sites where Partners In Health works. Because of the flexibility inherent within the fellowship, I explored widely and was able to successfully implement a number of experiences, including the creation of: 

• Animated videos to help explain concepts in social medicine
• Virtual reality (VR)/360° video experiences to help inspire compassion and understanding in medical students and residents
• Original 360° video footage to inspire collaborators and supporters to engage more deeply with community health programs abroad (an example shown here with the NGO PIVOT, in Madagascar.)

Although my Burke fellowship is officially over, the suite of technologies I developed with this award are only the beginning of much more work. The educational experiences I created taught me important lessons based not only on successes, but also on unanticipated challenges. This includes the reality that young students are already inundated with animated content explaining different topics; any new content will have to compete for their attention and have high production value standards to be considered compelling. Considering that countless news outlets and other groups are already producing high quality videos that touch on global health and social medicine concepts, I will probably not be focusing my attention on educational animations in the future. 

Still from a Video on “The Role of Medicine” in the social medicine section of the Harvard Medical School Essentials Of the Profession Class 2020

On the other hand, virtual reality and 360° videos are still not a common platform for students to engage with content. The ability of VR and video to immerse students in a context makes them a very powerful tool, the limits of which we do not yet fully understand. In my role as the Director of Community Health Systems at Partners In Health, a large part of my work includes visiting parts of the world that most of my students will never see, such as remote rural communities or refugee camps. My ability to capture images of these places, with participation from my colleagues living in these contexts, and then make them available to my students through VR headsets remains a very exciting tool for future educational offerings. Ethical concerns around “voyeurism” remain. This issue is not easily resolved, but we are approaching it with care, humility, and partnership, recognizing that capturing such footage represents a huge responsibility, and that the power of how that footage is used should remain with those who live in those contexts.

Still from a 360° video of a home visit, shot in Madagascar in partnership with the non-governmental organization PIVOT

In short, the Burke Fellowship allowed me to experiment with the acceptability and feasibility of a variety of teaching technologies and techniques. Future interventions will require close analysis to see which lead to transformative educational experiences for our students. We have conducted a series of anonymous post-experience surveys, and Harvard students have nearly universally praised their experience viewing 360° videos on a VR headset. We are currently planning a more in-depth analysis of how these offerings improve understanding, and potentially influence students’ career decisions.