Will Face to Face Communication Fade in a Digital World?

By: Jaclyn Boyle, MS, MBA, BCACP and Jonathan Lang, PharmD Candidate 2023

With the technological advances of today’s age, will students lose the ability to communicate face to face (F2F)? The newly revised AACP Curriculum Outcomes and Entrustable Professional Activities (COEPA) stress the importance of communication. COEPA 2.2 states that students should “actively engage, listen, and communicate verbally, nonverbally, and in writing when interacting with or educating an individual, group, or organization.” Additionally, two Entrustable Professional Activities reference patient education.¹ COEPA 1.1 expanded the knowledge domain such that learners must also demonstrate the ability to integrate digital health into their practice. A multimodal approach to communication seems important for the future of the profession. With changes caused by the COVID-19 pandemic, many educators shifted from F2F communication to many new modes of digital communication, utilizing synchronous/asynchronous lectures online or deploying virtual breakout rooms for smaller group discussion. Practicing pharmacists were forced to engage in new and accessible means for patients. On one hand, digital communication has benefits of speed, efficiency, and reach relative to F2F communication. However, digital communication cannot replicate the benefits of closeness, empathy, connectedness, belonging, and inclusion that F2F communication provides. Another limitation of digital communication would be ensuring equitable access particularly for underserved or marginalized populations.

How do we adapt communication skills in a new hybrid environment?

Given the potential benefits and limitations of our ‘new normal’ related to communication, it is interesting to note that only about half (53.2%) of colleges and schools of pharmacy include technology as a part of their strategic plan.² With pressure to integrate Artificial Intelligence (AI) and hybrid learning/work into our everyday lives, colleges and schools should be proactively considering how changes in communication will impact education, organizational effectiveness, and well-being.

Honing in on the discussion of how AI will integrate with pharmacy education, it is important to consider how we will train students to work alongside AI and leverage it. Dr. Jeff Cain recently published a CPTL Pulses blog deploying AI which mentions the benefits and potential ethical dilemmas of how faculty consider using these tools in teaching, scholarship, and service. 

Additionally, other changes that have led to the on-demand nature of high-speed communication can contribute to the ‘always at work’ culture and lead to unsustainable or challenging retention issues in the work environment. The Academy should determine how to adapt to new communication methods in a way that is beneficial while not sacrificing well-being. 

Will AI further complicate or minimize the need for F2F communication?

As we learn how to teach alongside machines effectively, faculty may question what communication modalities will lead to better student outcomes. In one small study by Skoy et al, the authors evaluated the experiences of 82 second year pharmacy students, comparing students’ scores on a communication simulation using F2F and telepharmacy communication skills. The authors found that faculty ratings of the counseling session were statistically better in the F2F group vs. the telepharmacy format (p<0.01).³  This study reminds us that F2F communication remains important and may be superior to digital communication techniques, however, both modes of communication can work synergistically to achieve desired outcomes.

Considering patients’ perceptions of digital technologies including AI, one experimental study demonstrated that patients are increasingly concerned with AI reducing or eliminating the human aspect of the relationships between a patient and a physician (p=0.01).⁴ Even with many of the perceived benefits of integrating AI technology into healthcare, patients may not be amenable to such changes in their healthcare interactions.

Given that this topic is evolving at lightning speed, and with recent news that AI is smart enough to pass standardized tests like the USMLE, pharmacy education should consider implications of F2F and digital communication integration in the context of teaching, learning, and assessment. Even with these potential changes, authors would advocate that F2F communication skills will remain important in the training of student pharmacists. 

A recent discussion around the use of AI in practice from leaders in the 2023 ASHP Pharmacy Forecast emphasizes the point that AI is only as effective as the information that is input into its algorithms or prompts. AI cannot recognize contextual factors such as bias or navigate complex situations, and therefore the authors discuss assigning AI to solve and operate in low-risk, low complexity environments.⁵ With these considerations in mind, pharmacy educators should consider these implications in light of how we train our future pharmacists. While we recognize that tools like AI can help rapidly advance communication, save time, and expand the reach of what we teach and learn, one could argue that the human to human connection of F2F communication cannot be replicated by AI. Will AI be welcomed or banned from the classroom? How can we strike the right balance of F2F and  digital communication?

Acknowledgements: 

Dr. Jeff Cain is acknowledged for his guidance and advising in the development of this article. 

References:

1. Medina MS, Farland MZ, Malcom DR, et al. AACP Curriculum Outcomes and Entrustable Professional Activities (COEPA) 2022. Available from: https://www.aacp.org/sites/default/files/2022-11/coepa-document-final.pdf. Accessed on January 17, 2023. 
2. Kebodeaux CD, Mak V. Using Technology to Enhance Teaching and Learning in Pharmacy Education. Pharmacy (Basel) 2021;9(3):150. Available from: https://www.mdpi.com/2226-4787/9/3/150
3. Skoy ET, Eukel HN, Frenzel JE, Schmitz TM. Performance and Perceptions: Evaluation of Pharmacy Students’ Consultation via Telepharmacy. J Pharm Technol. 2015 Aug;31(4):155-160. doi: 10.1177/8755122514568123. Epub 2015 Jan 12. PMID: 34860914; PMCID: PMC5990185. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990185/
4. Esmaeilzadeh P, Mirzaei T, Dharanikota S. Patients’ Perceptions Toward Human-Artificial Intelligence Interaction in Health Care: Experimental Study. J Med Internet Res. 2021;23(11):e25856. Published 2021 Nov 25. doi:10.2196/25856. Available from: https://pubmed.ncbi.nlm.nih.gov/34842535/
5. Dipiro JT, Nesbit TW, Reuland C, et al. ASHP Foundation Pharmacy Forecast 2023: Strategic Planning Guidance for Pharmacy Departments in Hospitals and Health Systems. Am J Health-Syst Pharm. 2023;80;10-35. https://doi.org/10.1093/ajhp/zxac274 

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Author Bio(s):

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Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning