Effective clinical practice requires that health professionals work within the dynamic, non-linear and complex environments of healthcare systems, and to engage with ill-structured problems that have no clear solutions . They need to “adapt to change, generate new knowledge, and continue to improve their performance” over time. These attributes (defined as capability)  require more from the practitioner than a mere set of knowledge and technical skills. In order to effectively operate within the complex environments of healthcare settings, practitioners need abilities that include, but go beyond the knowledge and basic technical skills (defined as competence)  that are emphasised in undergraduate training. This includes having positive attitudes towards continuing professional development, lifelong learning, evidence-based practice, information and knowledge management and interprofessional collaboration .
In addition to discipline-specific knowledge, technical skills and generic attributes, healthcare practitioners are also moral agents who make decisions about patients based on personal connections and relationships with them. Values, beliefs and emotional factors are embedded within the interactions between healthcare providers and patients, suggesting that these interactions are more than the exchange of information. This active engagement with, and acknowledgement of, the emotional response to patients’ stories can help to develop the moral agency that is a necessary part of ethical clinical practice .
However, developing these attributes and attitudes requires a cultural change in teaching practices that focus on the development of knowledge and skills. Many clinical educators still adhere to a lecture and transmission-based approach to teaching , which is problematic if capability is the goal because it cannot be passively assimilated, and requires significant changes in clinical education that move it from being product- to process-oriented . Teachers who adopt a transmission-based approach to teaching encourage the rote learning of facts, and a resultant superficial understanding of the topic. In contrast, teaching approaches that focus on the process of conceptual change lead to deep learning , and include informal and unplanned, self-directed and non-linear learning experiences. Specific strategies include, among others, experiential learning, reflective exercises, feedback, peer-supported small groups, case-based and problem-based learning, and role play .
Some clinical educators are beginning to experiment with technology-mediated teaching and learning practices, which blends classroom-based, face-to-face learning experiences with online interaction. This approach creates alternative means of communication between teachers and students, as well as deeper and more meaningful engagement with media-rich content. But, blended learning goes beyond the addition of technological components and requires a “…rethinking and redesigning [of] the teaching and learning relationship” [6, 7]. If the integration of technology into the curriculum is to be effective, it must move beyond content transmission and aim to facilitate communication and reflection in teaching and learning practices that are interactive, flexible, collaborative and authentic .
There are limited studies on the development and implementation of blended learning strategies within clinical education , with some authors asserting that “…the current pedagogic evidence base about these tools in the context of medical/health education is seriously lacking” . This presents a challenge. Technological components cannot simply be tacked on to traditional approaches without careful consideration  but clinicians are usually not course designers, and neither of them are necessarily educational technologists. The different stakeholders may therefore lack the diverse skills necessary to effectively integrate technology into a blended curriculum that aims to develop the attributes required for effective clinical practice. Without a sound evidence base to work from, technology-mediated instruction in clinical education may be implemented without the necessary preparation and design. In order to prepare healthcare students for the dynamic and complex clinical environment, how can we ensure that technology-mediated instruction facilitates the development of both competent and capable practitioners?
In order to address these challenges, this study used a modified Delphi approach to identify technology-mediated teaching strategies that aim to develop capability in undergraduate healthcare students. The study is significant in that it identifies attributes that go beyond knowledge and skills, as well as strategies that could be used to develop those attributes within a technology-mediated approach to teaching and learning.