I. Introduction
Digital health (DH) encompasses the application of digital technologies to improve health [1]. The integration of those tools has revolutionized medical practice [2]; nonetheless, healthcare university programs have overlooked the crucial issue of incorporating DH education into the curriculum. Thus, future professionals are not adequately prepared to leverage these tools, despite the increasing need for graduates qualified in health informatics [3].
Recognizing this issue, the Brazilian Ministry of Health has acknowledged the importance of DH education in the Brazilian National Digital Health Strategy 2020–2028 [4]. This initiative aims to enhance healthcare delivery, improve patient outcomes, and promote data interoperability through the integration of DH technologies. However, the successful implementation of this strategy hinges on making changes within undergraduate and graduate programs, involving updates to curricula and training for faculty members.
To bridge this educational gap, the scientific committee of the Brazilian Congress of Health Informatics (CBIS) created a Junior Scientific Committee (JSC) for the CBIS conference. The main objective of this study is to describe the experience of the JSC at the CBIS and to affirm its importance for promoting DH among students.
II. Case Description
1. JSC Composition
Brazilian students from various regions and academic disciplines, all with notable experience in promoting DH, were invited to collaborate from June to December 2022. All nine students accepted the invitation, comprising five males and four females. The group included five medical students, two biomedical informatics undergraduates, one computer science undergraduate, and one computer scientist currently enrolled in a health sciences PhD program.
Remote meetings with a 1-hour duration were scheduled weekly, accompanied by a monthly follow-up meeting with experts from the CBIS Committee, totaling 18 meetings. The experts consisted of three renowned professionals with expertise in digital health, each with either a computational or medical background.
2. Warm-up Event
The JSC decided to organize a warm-up event prior to the CBIS in order to stimulate discussion on DH among students. This took the form of a remote roundtable discussion. The chosen theme for the event was “Artificial intelligence (AI) in healthcare: is a new concept of health about to arise?” To enrich the conversation, three speakers with expertise in AI were invited: a businessperson, a professor of medicine, and a professor of computer science.
To promote the event, members of the JSC reached out to Brazilian medical students via WhatsApp, sending a message accompanied by an event card. Of the 83 students from various medical schools who were contacted, 56 shared the event card in their university’s group chats, representing a 67.4% engagement rate.
Out of 241 registered participants, 85 (35.2%) attended the event live. The speakers explored ethical considerations and practical applications of AI in medical practice. Throughout the discussion, interactive online polls were conducted with the attendees to gauge their perspectives on current and potential DH scenarios, yielding an average of 41 responses per poll. Figure 1 presents an overview of the warm-up event results.
Considering the nature of this initiative, this study did not require approval from the Brazilian Ethics in Research Committee (CONEP), in accordance with Resolution 510/2016 [5]. Additionally, all responses were collected anonymously, and the study was conducted with strict adherence to Brazilian legal and ethical standards concerning data collection and sharing [5,6]. The event was hosted on a free-to-use platform, and all attendees provided their consent to the platform’s terms and conditions voluntarily. Furthermore, during the event registration process, all participants consented to the sharing of their information for scientific purposes.
3. CBIS
The main event took place in person and spanned 3 days, each consisting of two 4-hour blocks, with several rooms hosting events simultaneously. The JSC was granted the freedom to develop the scientific schedule for an entire 4-hour block in one of the rooms. The chosen format involved splitting the block into two distinct sections, with each section featuring lectures followed by a question-and-answer period. Figure 2 provides an overview of the JSC’s involvement in the CBIS.
1) First presentation: status of DH in Brazilian universities
This section presented the current state of DH education in Brazilian universities. The speakers included a member of the JSC and a PhD student who was engaged in a project to map DH-related programs in Brazil. The session was presided over by another JSC member, who facilitated the discussion. The roles of JSC members were outlined, and findings from the warm-up event were shared. At the conclusion of the roundtable, participants engaged in a robust dialogue concerning the impact of insufficient DH initiatives within universities on student education. There was a consensus that the academic community should scrutinize this issue more thoroughly. The challenges associated with implementing these initiatives that were discussed are listed in Table 1.
2) Second presentation: promoting DH inside and outside universities
For the following 2 hours, the JSC presented different perspectives and strategies to address the lack of preparation of current and future professionals for using DH in medical practice. To facilitate this discussion, three speakers were invited: a JSC member, a physician, and a nurse actively engaged in working with medical devices and DH education.
The representative from the JSC presented a student perspective, highlighting the initiatives developed within academic circles. A medical doctor recounted his dual roles as a professor in the field and as a podcaster, specifically in relation to DH, while a nurse detailed her involvement in continuing education programs designed to keep graduates updated on and trained in the latest medical technologies. Following the presentations, the JSC collected feedback from the audience, and the overwhelming response was that the lectures offered valuable insights for addressing the issue at hand in their respective settings. The initiatives that were discussed are summarized in Table 2.
3) Workshop
At CBIS, JSC members were invited to participate in a workshop about the expected skills for an optimal DH academic curriculum. These skills were based on the International Medical Informatics Association’s latest revision of educational standards in health informatics [7].
After a presentation on the importance of a standardized curriculum for fostering DH, participants filled out a checklist indicating the skills they deemed most crucial for future DH professionals. Subsequently, the attendees were split into groups to discuss their selections and share their conclusions. One group consisted of current members of the JSC, who were actively encouraged to contribute their insights on the integration of DH within university settings during the discussions.
The CBIS committee highly valued insights from JSC members when determining the ideal healthcare curriculum, which includes the expected skills. The results from the workshop have been described elsewhere [8].
III. Discussion
To our knowledge, this is the first JSC for a national DH event. The hallmark of the JSC was the engagement of students alongside seasoned professionals in mapping out the present landscape of DH in Brazilian healthcare initiatives. These students had the opportunity to hone the necessary skills for organizing large-scale conferences, such as the CBIS, which is the premier DH event in Latin America. The primary benefit of this strategy is that it equips the upcoming generation to take the lead on a topic that, despite being underexplored, is already significant in medical practice. The advantages of the JSC are depicted in Figure 3.
As crucial as it is to prepare current practitioners, it is equally important to equip future professionals with the necessary skills, and universities should serve as nurturing environments that disseminate knowledge and encourage initiatives in DH. However, most efforts to raise awareness about DH in healthcare programs are currently led by faculty staff, with little to no engagement from the true catalysts of this transformation—the students themselves. It is unsurprising, then, that only 14% of the students who participated in our public opinion survey felt that their health sciences programs adequately prepared them to apply artificial intelligence in healthcare. Moreover, Machleid et al. [9] revealed that 85% out of 451 European students consulted agreed that more DH subjects should be implemented in their curricula.
Although DH remains an undervalued theme, there are emerging initiatives about DH education worldwide to fill this gap. German researchers [10] described the implantation of a 3-week curricular module about DH in a medical school, and all students involved agreed that this module motivated them to study more about this topic. As DH is a broad concept involving AI, big data, robotics, and other domains, efforts have been made to identify specific topics that medical students should be familiar with [11,12]. Moreover, Echelard et al. [13] conducted a scoping review investigating current DH training for medical students, and suggested that the broad concept of DH should be studied at the same time as more specific subjects such as programming. To address this issue, the CBIS workshop gathered the most important skills expected of professionals involved with DH, facilitating the formation of a standardized curriculum, as has also been done in other initiatives worldwide [14–19].
This study has some limitations. It represents a pioneering initiative from Brazil, which necessitates validation in various other contexts. Additionally, we did not systematically evaluate the satisfaction levels of the students, experts, and audience involved with the CBIS initiative.
The establishment of a JSC during a national DH event was deemed a valuable endeavor to promote DH. This strategy is important not only on a national level, but we also believe that it will inspire new initiatives at universities. Encouraging students to take an active role in organizing events such as the CBIS allows them to engage confidently with the evolving healthcare sector and benefit from the stimulating atmosphere generated by the collaboration between students and distinguished experts.
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