Technological literacy in biomedical laboratory science education: a mixed-methods study of curricula and student perspectives | BMC Medical Education

Operationalizing technological literacy in biomedical laboratory science education

The concept of TL within the BLS field exhibits a notable variability in definition and perception. The term “technological literacy” is not frequently employed in relevant studies or curricula. This is not surprising, as the term TL has only recently come into common use in the field of healthcare [28]. This underscores the need for a comprehensive definition and understanding of how to foster technological literacy within the realm of BLS. A study on student responses to creative coding in BLS defines TL as the ability of individuals to effectively engage with and utilize technology [30]. Students were encouraged to develop digital literacy skills through hands-on coding [30]. This exemplifies the highly application-oriented perception of TL [31], that we also see in this study, where the high proportion of learning objectives focuses on user-level competencies (SOLO 3). Students express that the hands-on experience and practical exposure gained through clinical training play a pivotal role in enhancing their TL skills. In addition, the students´ emphasis on the value of hands-on experience suggests a need for educational programs to incorporate even more experiential learning opportunities, such as internships or practice-based projects in clinical departments, to bridge the gap between theoretical learning and real-world application. Supporting this, Montesino et al. (2022) found that the integration of real-world applications and technology not only enhances student motivation but also fosters deeper conceptual understanding of technology and greater professional readiness [32].

In the field of BLS education, TL should involve more than just technical proficiency, as outlined by the International Federation of Biomedical Laboratory Science (IFBLS) core competence guidelines [33]. It should also include an understanding of the ethical, social, and economic implications of technology in healthcare [32,  34]. In line with this Mainz et al. (2024) highlights that digital competence in healthcare professions encompasses not only technical skills but also methodological (e.g. data analysis), social (e.g. digital communication), and personal dimensions (e.g. digital curiosity and lifelong learning) and emphasize the lack of a standardized way to measure such competencies [35]. Educating students to be technologically literate in BLS equips them with the knowledge and skills to navigate the complex intersection of engineering, biology, and medicine, ultimately contributing to advancements in healthcare and improving quality of life [36,37,38]. Studies have documented the integration of various technological modules that enhance students’ abilities to operate LIMS, automated systems, utilize digital microscopy, and apply advanced technology in diagnostic analyses [38,39,40]​. One study finds that students perceive themselves as technologically literate and view themselves as active participants in the ongoing technological development [30]. Nonetheless, despite these advancements, there remains a notable gap in the systematic and comprehensive incorporation of TL across many BLS programs, as shown in the curriculum analysis. While some programs have updated their curricula to align with current technological demands, others lack focus on TL, often constrained by limited resources or outdated educational frameworks [13, 41, 42])​. This disparity suggests a need for a more uniform approach to embedding TL into BLS education, ensuring all students gain the essential skills required for modern laboratory practice [43,44,45,46]. The literature calls for ongoing curriculum reforms, enhanced faculty training, and investment in up-to-date technological resources to bridge this gap and fully integrate TL into BLS education [39, 40, 44, 46,47,48,49]​.

Diversity in technologies utilized in healthcare settings

As technology continues to advance rapidly, students with a high level of TL are better equipped to adapt to new technologies across academic and professional contexts [50]. The increasing demand for enhanced problem-solving skills, data analysis competencies, technological fluency, and interdisciplinary collaboration highlights the importance of TL [31, 36, 46, 50]. Furthermore, TL enhances students’ career opportunities and equips them to navigate and contribute to a rapidly evolving technological environment [7, 50]. Due to the multitude of specializations within BLS, and therefore also diversity in technologies utilized, operationalizing TL can pose a significant challenge for the UCs. To navigate this complexity, existing collaborations with clinical departments could prove advantageous. This potential was also mentioned by the students in the interviews, where several state that their most relevant experiences (for TL) occurred in the clinical departments (e.g., quotation 6 in Table 1). These departments, often at the forefront of technological advancements, possess the latest technologies and in-depth understanding of the current relevance of technologies in practice. By tapping into these established educational partnerships, the UCs can integrate TL-related learning activities into authentic applications of technology within the BLS clinical laboratory field. This collaborative approach not only strengthens the alignment between educational objectives and professional demands but also enhances the practical relevance of TL training for students preparing to enter health professions [31, 46, 48, 51]. To ensure future readiness, BLS education needs to equip students with skills and mindset that includes problem-solving, data literacy and visualization, interdisciplinary collaboration, adaptability, innovation, and career-oriented competencies [30, 31].

Educational strategies, methodologies, and technologies employed in BLS education

The interest in development and assessment of core curriculum and competence-based education has increased in response to the growing trends in health education [43, 50]. Developing of TL content in curricula from scratch is a time-consuming and resource-intensive process [30, 31, 41]​. Faculties could leverage established frameworks e.g. The European Digital Competence Framework for Citizens (DigComp) to enhance their curricula, rather than starting from scratch, enabling more effective integration of TL into BLS education [52]​. Some studies point to faculty skepticism about integrating more TL into higher education, particularly in BLS educational institutions [30, 32]. The slow pace of curriculum development, dissemination of modular courses, curricular constraints and traditional teaching approaches may hinder the integration of technological skills into the curriculum 30. As mentioned, given the rapid advancements in technology within the healthcare field, it is essential for educational programs to address the incorporation of the concept of ‘technological literacy ‘[40, 45].

An important finding of this study is that there appears to be a gap between theory and practice in TL of BLS students (e.g., quotation 3 and 4 in Table 1). This highlights the need for educational programs to bridge the gap between theoretical concepts and practical application, ensuring that students acquire both knowledge and skills necessary to navigate the technological landscape of the BLS field. Addressing this gap can inform curriculum design and teaching approaches to better align students’ theoretical knowledge with practical technological applications. BLS programs that primarily focus on application-oriented TL (SOLO 3) may encounter limitations that could impact the education and preparedness of students. One limitation is the potential lack of emphasis on higher-order critical thinking skills, seen in the low content of TL on SOLO 5, as a strong focus on technical applications may overshadow the development of competencies necessary for adapting to new technologies and solving complex problems [30, 36]. Additionally, a narrow focus on current technologies may limit students’ exposure to emerging trends in the BLS field, potentially hindering their readiness to embrace technological advancements in their future careers. An application-oriented approach may not adequately address the ethical and social implications of technology in healthcare, which are essential considerations for responsible practice [30, 50]. There is also a risk of graduates facing technological obsolescence if programs do not incorporate innovation and future-oriented perspectives alongside their current technological focus [40, 50]. Furthermore, a heavy emphasis on technical skills may pose challenges in fostering interdisciplinary collaboration with professionals from other healthcare disciplines, which is crucial for comprehensive patient care and innovative problem-solving [29, 31]. To mitigate these limitations, it could be beneficial for BLS programs to integrate critical thinking components, ethical considerations, exposure to emerging technologies, and opportunities for interdisciplinary collaboration within their curriculum alongside the application-oriented technological focus [4, 7, 29, 32, 38, 40, 46]– while also fostering an optimistic mindset about technological development [51]. Such holistic approach can better equip students to navigate the dynamic and complex healthcare landscape effectively [48].

Teacher competencies

During the interviews, several students expressed concerns about teacher competences within the TL field. This is also supported by the UC not ranking high when asking the students what supports their TL. Gough et al. (2023) found a significant challenge in the insufficient expertise among biomedical faculty educators required to teach TL to students [30]. Thus, it is imperative that educators must be equipped with the necessary skills and knowledge to support students in achieving TL and effectively guide students in harnessing technologies. Faculty educators´ lack of the adequate experience or background in TL, may constitute a barrier to implementing TL activities within the curriculum. Educators’ TL plays a critical role in the successful implementation of TL learning activities in BLS education [30]. Sidhu et al. (2023) recommend that educators in health professions not only develop comprehensive competencies in technological literacy, but also skills in designing, facilitating, and assessing learning activities involving technology [51]. To address this, fostering interdisciplinary collaboration among faculty with diverse expertise, alongside providing support and training in TL is essential. Furthermore, active engagement of educators in TL-related activities with students, may enhance educators´ own competencies, thereby enabling them to more effectively support students in developing TL [30].

Progression and assessment of students’ technological literacy

We applied the SOLO-taxonomical interpretation of the learning goals, as the UCs already use this taxonomy to assess student learning and facilitate progression throughout the BLS study program. As the level of understanding is divided into five hierarchical levels, the goals are supported by verbs that reflect active engagement with the learning goals. However, numerous repetitions and genetic statements are seen throughout the curricula, many of them similar to political policies, agendas, and interventions. This generality in description makes it difficult to identify concrete learning activities and specific content within the BLS program. While the SOLO-taxonomy promotes a linear model of learning progression – from surface to deep strategic learning– actual learning processes tend to be iterative and non-linear. Students may move back and forth between these levels depending on the context, task, or their progression of understanding. This is also reflected within the coding of TL content in UC curricula, where an overall progression is observed, but learning goals go back and forth between SOLO levels both within and across semesters. While the SOLO- taxonomy offers a framework for designing assessments that target different levels of understanding, some educators may find it challenging to create assessments that accurately “measure” learning [52]. Furthermore, it was not possible to identify, within the curricula, how learning activities of TL are assessed in a reliable and valid setting.

Strengths, limitations and future directions

This study offers insights into TL within BLS programs in Denmark, with a comprehensive analysis of curricula providing a solid understanding of the current educational programs, elaborated by surveys and interviews. However, the focus on intended learning outcomes, rather than achieved learning, is a limitation. Future research could benefit from observing actual TL learning activities and conducting longitudinal studies to track TL development over time. Comparative studies with international programs could also highlight best practices and areas for improvement. One limitation of this study is that the focus group format, while valuable for exploring shared meanings and social constructs, may have influenced the way students expressed their views. Since participants were familiar with one another, social dynamics such as peer alignment, self-censorship, or dominant voices may have shaped the discussions [18]. As a result, some perspectives may have been muted or negotiated in relation to the group context rather than expressed as individual, unfiltered opinions. However, since the aim of this study was to explore how technological literacy is constructed and experienced in social and educational contexts, these dynamics are considered a strength as much as a constraint. We attempted to address this by being reflexive during analysis and by using direct quotes to illustrate variation in responses. Additionally, exploring the integration of emerging technologies and the impact of TL on professional practice would provide a deeper understanding of the field. Future research could also supplement these findings with individual interviews or longitudinal tracking of students’ TL development to provide further depth and reduce group-based influence.