There are four focus areas of advanced medical education and learning where technology can play an important role and address gaps in our training capacity.

The first focus area lies in delivering practical training and skills assessment to the healthcare workforce. Skills such as IV insertion, suturing wounds, central venous catheter placement, cardiac stent placement, endoscopy, advanced cardiac life support, basic life support, blood pressure taking, and ECG monitoring, to name a few, are the basis of modern-day medical practice. Practicing these skills requires significant amount of time and resources. In addition to these technical skills, many skills are actually nontechnical such as team skills that require a healthcare workforce to function efficiently as a team. Traditionally these skills are practiced on patients, which is an extremely unsafe and inefficient method of acquiring such skills. Fortunately technology has been developed that allows for practicing such skills over and over again in a safe environment. Technology also exists for providing skills training on rare skills and rare treatments that enable the healthcare workforce to be prepared for any eventualities including disaster management. There are also provisions in technology for quantitative evaluation of skills that allows for development of benchmarks of examination and allows for competency-based training. This is critical in ensuring high-quality healthcare to the masses. Such technology centered on the core idea of medical simulation has matured rapidly in the past few decades and has been shown to translate to marked significant improvement in clinical skills and quality of care [1, 3, 9, 17–32]. Medical simulation refers to a suite of technologies available for healthcare professionals to practice skills in a variety of disciplines both individually and as a team. It is imperative to develop a coordinated approach to including simulation-based training in the medical education and training infrastructure.

Strategy: We will work with clinicians to identify low-hanging fruit in this area. We will also establish links with local and global engineering institutes to help realize the vision. Funds will be allocated for pilot projects in this domain, and the possible funding agencies will include Science Foundation (equivalent to NSF in USA). Clinicians may help point to direct impact on patient safety based on which institutes of Health (equivalent to NIH in USA) can be applied to. We will work with International Foundations by inviting them to visit the center and present to them skills relevant to their portfolio.

The second focus area lies in employing technology for remote education and monitoring. A key element of training the healthcare workforce is to contextualize the training to the sociotechnical condition of the environment. Traditionally this has been hard as such efforts require establishment of local infrastructure and local support system which is expensive. With the development of the information communication technology backbone, it is now possible to deliver didactic content and didactic training and examination remotely. The National Knowledge Network (http://​www.​nkn.​in/​) is an example of such efforts and displays an important example of leveraging ICT for education. In a similar vein we can deliver medical education and training remotely. There are however two additional opportunities that lie in further strengthening the mission of remote education and monitoring. The first lies in developing remote practice environments like the skills training systems described above so practical skills in addition to didactic material can be taught remotely. This is again possible with the technology of motion tracking, motion-based computing, and virtual reality. The second lies in using technology environments to create a personalized training module that is consistent with system practices of a region and its requirement. This can again be done through personalized content delivery and also by employing mobile units that deliver training through mobile systems.

Strategy: We will work with the telemedicine department to integrate our services with them. The content storage facilities of both the centers can be combined to achieve this goal.

The third focus area lies in delivering best practices design, implementation, and training. Best practices imbibed through guidelines, procedure checklists, and decision-making algorithms have become the corner stone of the quality drive in medical profession [33]. Training for best practices and implementing and designing best practices are however not trivial. Simple didactic training for best practices is not enough, and there is a need for a safe environment to practice implementation of best practices and adapting best practices to a particular sociotechnical system. There is also a need for a safe environment to design best practices. System-wide best practices and procedures can be designed and tested in a simulation environment, and such efforts have been shown to have a highly positive impact in improving clinical practice that is more significant than simply didactic training [34]. This is a golden opportunity for creating a culture of quality and safety in a system-wide sense.

Strategy: This is a high priority item. We will work with the quality department of our organization to identify metrics. Individual departments will be polled for impending rollout of best practices, and we will identify avenues where simulation can play a role. A joint committee would then be established for pursuing some best practice implementation. Funding can be obtained from Agency for Quality Research (equivalent to AHRQ in the USA). Funding for pilot project would be requested to our organization as it is a multidisciplinary effort.

The fourth focus area lies in practical training to ensure optimal use of equipment and resources for quality healthcare. An important part of training is to train usage of medical equipment, drug administration protocols, and optimal use of existing resources. Traditional training only serves as orientation training but does not allow for advanced usage. There are many features of equipment such as EKG monitors that are not used efficiently due to lack of training. Simulation environments allow interfacing medical simulators with equipment and provide the capability of designing training scenarios where equipment and resource usage can be taught.

Strategy: We will target equipment manufacturers and sales for this venture. Overall the vision would be to test medical devices in the simulation center. We will identify potential partners and work with them to showcase scenarios where the important points of the device are highlighted in practical use. Pilot funding will be obtained by industry collaboration. We will also keep the legal department in the loop for IP issues and transfer.

In order to develop viable solutions for these four focus areas, we need a comprehensive coordinated strategy to deliver skills education remotely and safely, allowing procedure standardization leading to best practices, objective measurement of skills and proficiency, and training for optimum usage of equipment and resources. With the availability of cheap computing infrastructure, readily available bandwidth, and growth of technologies such as medical simulation, virtual reality, movement analysis, computer graphics, persuasive technology, and mobile computing, it is possible to envision the future of advanced medical education that fully leverages the opportunities presented by these tools. There is a need to focus resources and develop these technologies for medical education and training for all levels of the healthcare workforce from senior physicians to paramedics. Such an effort will both lower the healthcare costs by decreasing medical errors and improving efficiency. We will develop a blueprint for 5 years for innovation.