When Spain went to Brazil: a COIL module for Medicine

One might think that Medicine is one of those degrees for which all the learning activities need to be in-person. However, globalization has revolutionized our ways of working and made online activities both attractive and feasible. In fact, technological progress has been such that students can now use clinical simulation equipment and facilities to learn important skills with zero risk to patients.

Chirag C. Sheth, who lectures on the Dentistry and Medicine degrees, is one of the driving forces behind Collaborative Online International Learning (COIL) modules in the Faculty of Health Sciences. This new approach to teaching – totally online-based – connects students from different universities across the world, as they work on a case or project together.

Chirag, can medical training be provided online?

The world is getting smaller every day and we can now be in contact with people from many different social and cultural backgrounds. So, the opportunities for the development of skills in intercultural cooperation and interaction will only increase in importance. I’ve developed this project in order break down the barriers for second-year Medicine students and to raise awareness amongst them of the different ways of working in the profession through international collaboration.

Given that some things can now be studied online via initiatives like COIL, do you think the activity of the medical profession in general will become more online in nature?

Since it emerged at the beginning of the 20th century, telemedicine has changed so much that it’s almost unrecognizable. Telemedicine began in the Netherlands simply as a means of exchanging electrocardiograms over long distances. The approach has gradually gained ground since then, so that we can now talk about telediagnosis, teletreatment, teleradiology and teleducation. They’re all a part of modern telemedicine. The combination of the fast pace of modern life, the inconvenience of being away from work for hours or even days in order to attend appointments, the long waits people often face even when they get to the healthcare centre and the digitization of modern society has really driven the increased importance of telemedicine in our lives. There’s no doubt that the medical professions are and will continue to be more and more telemedical.

Our Medicine students now have a COIL module as part of their curriculum.
As well as introducing students to telemedicine, in the “Introduction to Medicine and Research Methodology” course, the goal is also to help students develop soft skills such as communication and critical thinking. How can COIL help students to acquire these skills?

The intercultural skills that I want students to develop and use as part of this project are absolutely essential for young people training to be doctors. Working within multidisciplinary and multicultural teams has become the norm. This COIL project that I’ve designed forces students from different countries and cultures to undertake an analytical comparison of similarities and differences. This analysis requires students to meet, talk, and share experiences, opinions and ideas and then write a joint final report. To do all this, students have to develop and use these soft skills.

An analytical comparison between Spain and Brazil

What exactly does this COIL module you’ve created for the Medicine degree involve?

The students are given a clinical case, representative of a typical patient in Spain or Brazil. They’re then split into balanced international teams, and then, after undertaking discussions and carrying out research, they draw up a report regarding different aspects of the case. The idea is to be continually making comparisons between Spain and Brazil. The things they have to research include epidemiology, healthcare systems, monitoring, risk factors, and sociocultural concerns. Finally, the students submit a dossier of information on their theme and give an oral presentation together with their Brazilian colleagues.

They do all this by working alongside Brazilian students from the Universidade Estadual Paulista. Why did you choose this institution as your partner for this activity?

I came into contact with this university through another organization which provides academics and universities interested in working together with opportunities to come together and share ideas and objectives. It’s been really satisfying to see that the outcome of that has been new cooperation projects, new ideas for working together and the strengthening of links between the two institutions. It’s just a matter of time before the two universities sign a collaboration agreement.

What have the lecturers and students from each side found out about their partners in this? Is there anything that Brazil has shown you, or is there something about Spain that has surprised the people in Brazil?

The discussions and presentations have been very interesting and revealing for both groups of students. Our aim was to look for similarities and differences and we found both. Brazilians presented greater exposure to certain risk factors, and Spain showed a different risk profile. Diet, lifestyle and the national health systems have all been important sources of information and issues for debate. For example, Brazilians consume more salt in their diet than Spanish people, whereas the latter consume more alcohol.

UNESP, our partner for the COIL project in Medicine
You probably go on this same journey of discovery during every class, given that there are students of some many different nationalities in them. What have you learnt, as a lecturer, from this interchange of knowledge between students from Sweden, the UK, Germany and Taiwan?

Really, this is what makes my day-to-day work as a lecturer interesting and rewarding. The mixture of opinions and personal experiences from non-Spanish contexts enriches the debates we have and gives us new ideas that we probably wouldn’t see if we had more homogeneous groups.

In my course, we look at issues that we can debate and for which there isn’t a definitive answer. Every group of students is unique, with the blend emerging being based on the different experiences the students have had. Every class is different from the last one and, of course, I learn so much from them!

Going back to the COIL module for Medicine, what has the experience been like for students? Have you been pleased with their reactions?

Before starting the COIL experience, I prepared the students and helped them to see the possible differences that they might find between the two countries. We prepared ourselves and worked on our communication and teamworking skills before the first session. The students’ reaction to the experience was very positive. We brought all the students together for a feedback session for them to take about what they liked and didn’t like. They all agreed that having an experience like this was very positive for their education and they expressed an interest in doing it again if possible. Many of them said that the first few contacts were cautious and tentative, but, once they got past that, they really enjoyed the project.


From your point of view as the lecturer, has this COIL module achieved the objectives you had in mind at the start?

Absolutely, this project has achieved the objectives I set at the beginning. We’ve brought two groups of students together from two countries which are very far away from each other and which have very different cultures, social conditions and lifestyles, and then the students have contacted each other, communicated, interacted and worked on a project together. The project has been undertaken in the very peculiar social context of the COVID-19 pandemic. Yet still, that hasn’t affected the project and the online nature of the module has been integral to its success.

This project is just the first stage of a close, long-lasting and fruitful collaboration between CEU UCH and the Universidade Estadual Paulista: there’ll be more COILs on this course for many years to come!


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