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Rapid Responses: Rapid Responses published:
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A double edged sword
- Umber Agarwal, Manchanda Ranjit , Pundir Jyotsna, Chaudhry Pooja, Nair Sujit (13 May 2004)
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e-learning may augment clinical judgement!
- Dr.Naseem A. Qureshi, MD, IMAPA, LMIPS (17 May 2004)
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Let Us Agree on Terms First
- Vivienne Bachelet (17 May 2004)
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Learning through Internet: necessity not luxury!
- Md. Anwarul Azim Majumder, Sayeeda Rahman (30 May 2004)
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Umber Agarwal, Specialist Registrar Barnet general hospital , EN5 3HD, Manchanda Ranjit , Pundir Jyotsna, Chaudhry Pooja, Nair Sujit
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We read with great interest the article on E-learning and that whether it shall improve clinical judgement or not. We feel that the vast amount of information available via internet search engines, websites of authoritative bodies, online libraries, journals and books etc should be a supplement and not a substitute to the skills of an alert clinician. Having a good theory knowledge is of paramount importance , but such a knowledge is of little use if it not rehearsed by 'supervised bedside clinical teaching'.One should be able to search effective evidence based information and not get lost by information overload. I am personally aware of instances where clinical performance rather deteriorated as the student got lost in collecting internet based information and could not apply it to clinical practice and decision making , its consequences were demoralizing. On the other hand , availability of clinical decision algorithms will be welcome as they guide the clinician with a systematic framework of patient approach.We need to stress upon the reading of 'relevant information' and not just any information. Henceforth we feel that E resources are a double edged sword with potential to cause damage as well.One has to be alert in obtaining appropriate and relevant information before applying it to clinical practice. Sincerely yours Competing interests: None declared |
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Dr.Naseem A. Qureshi, MD, IMAPA, LMIPS, Medical Director(A), Director Of CME&R Buraidah mental Health Hospital,POB.2292, Saudi Arabia
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Sir: According to my analysis, all the four integrated and interrelated components, which include basic undergraduate/postgraduate medical training, continuing medical education, clinical experience and medical research have very powerful impact on clinical judgement of a physician. The e-learning may help a clinician in several ways; possibly collecting relevant medical information; enhancing and updating medical knowledge; and expediting research publications. Collectively, all this may have positive influence on physicians' clinical judgement and further help in delivering better health care services to the consumers. As regard e-learning improving clinical judgement of physicians, I am afraid that the similar basic medical precepts may not be generalizable to other groups of populations including public, patients organizations, and patients themselves. They may get substantial information electronically for learning purpose but it will be rather difficult for them to apply it into clinical practice. However, the e-learning may help them prepare solid ground to discuss with the health providers many relevant aspects of delivered medical services. Reference: Daniel J Klass. Will e-learning improve clinical judgment? BMJ 2004; 328: 1147-1148 Competing interests: None declared |
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Vivienne Bachelet, Director, Medwave Ltda. Santiago, Chile
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I have a problem with this article. The problem is that e-learning here is not defined, and my concept (informed) of e-learning is completely different from the implied definition contained in this article, as it were, e-learning being the capacity to have access to a huge body of information through search engines and others on Internet. That is not e-learning. E-learning has been defined as the use of network technologies (Internet) to design, provide, select and extend learning processes. It's main components are contents in multiple formats, a learning management system making it possible to track the learner's progress, and a community of learners, teachers, developers and network experts (see "E-learning: Current Status and International Experience, Joanne Capper, World Bank Consultant, 2002.) In consequence, I think that the title of this article is missappropriate. E-learning refers to a teaching/learning experience that is web-based but built upon an instructional design approach (maybe constructivist, maybe cognitivist). The wide availabilty of information on the Internet is a totally different phenomenon to e-learning. E-learning courses, for example, when well designed and well guided, can be an extraordinary learning experience, for physicians as well, helping guide clinical judgement and reinforcing appropriate clinical practices. This is so because of the high level of interaction between learners and tutors, element which is totally absent in the standard relationship that physicians have with the internet. Vivienne Bachelet, MD Director, Medwave Ltda. Santiago, Chile Competing interests: None declared |
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Md. Anwarul Azim Majumder, Lecturer Department of Medical Education, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia, Sayeeda Rahman
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We are convinced that this article will raise our awareness about a burning issue currently medical education is facing, and hopefully will ignite a spirited discussion among the medical education community. Whether it is e-learning or web-based learning, on-line learning or off- campus learning, traditional or innovative curriculum – medical students and practitioners are needed to be adequately trained to use the vast information available in the Internet or web. Web is “increasingly used both as a learning tool to support formal programmes and as a means of delivering online learning programmes”1. Many institutions have developed “virtual campus” on the web, which are gradually replacing traditional teaching approaches and are gaining popularity. A recent development is the establishment of the International Virtual Medical School (IVMEDS), a unique collaboration of 40 leading edge medical schools and institutions of the world (http://www.ivimeds.org/). It provides a blend of high quality student-centred e-learning and face-to-face learning with a promise to set new standards in medical education by offering “Just-in- time, Just-for-you, Just Anywhere” type of flexible programmes. Exponential growth of scientific knowledge in medicine and medical education leads to the ideas of evidence–based medicine and best evidence medical education. Professionals need to exercise their clinical or professional judgment to gather best evidences either present in the print form or in the web. Information technology has the potential to make fundamental change in medical education. We have to divert and manage the torrent of information and technology so that our tomorrow’s doctors and patients are benefited to the greatest extent. Reference: McKimm J, Jollie C, Cantillon P. Web Based learning. BMJ 2004; 326;870- 873. Competing interests: None declared |
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