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Rapid Responses: Rapid Responses published:
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The entry into the information age
- Jeevan P Marasinghe (16 June 2006)
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Is this the only future for broadband in medical education?
- John E Sandars (18 June 2006)
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Broadband learning as an innovation game
- Anis Fuad (18 June 2006)
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Broadband learning – firing on all cylinders?
- Geoff Wong (19 June 2006)
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A revolution indeed
- Graeme M Mackenzie (19 June 2006)
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Jeevan P Marasinghe, Registrar in Obstetrics and Gynaecology, Teaching Hospital ,Peradeniya,Sri Lanka.
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This is the era of information superhighway and the information communication technology has improved in an exponential rate. So a knowledge of it has become a necessity for the clinicians and the medical students. The editorial by Johnson et al (1) highlights the importance of it and the future trends in technology based clinical education. In certain centers in Taiwan, it has extended up to virtual medical schools where they have converted data from hospital information system into a problem based e-learning environment(2).There they have provided a great opportunity to medical students to learn certain typical cases online. Audio Visual Centre in University College London ,UK has set up a collaboration between six universities and has allowed the students to access to a large pool of surgical cases(3).There they have developed interactive surgical teaching system and have improved the efficiency of medical students in learning surgical cases. One medical institute in Adelaide, Australia has developed a virtual microscopy (4).It is a revolutionized development and the slides can be readily transmitted to users over a broadband connection. It is a giant digital image and can stimulate all the functions of real microscopy and can be panned, zoomed, and focused in a slide viewer. But the current infrastructure for this kind of technology based learning is limited especially in developing countries. More over one may not get the same feeling and the experience only by broadband learning as compared to being in the ward and clinically assessing a patient. So a combination of above might be much beneficial especially to a new comer to the field .But it is high time to think of broadband medical education and it will be a worthwhile investment to the medical students ,doctors and to the patients. References. (1)James Johnson, Stella Dutton, Edward Briffa, Dame Carol Black.BMJ 2006; 332:1403-1404. (2)Shyu FM,Liang YF,Hsu WT,Luh JJ,Chen HS.A problem based e-learning prototype system for clinical medical education.Medinfo 2004;11(Pt2):983- 7. (3)Jameson DG, O’HanlonP, Buckton S, Hobsly M.Broadband telemedicine: teaching on the information superhighway.J Telemed Telecare.1995; 1(2):111 -6. (4)Lee SH.Virtual microscopy: application to hematology. Lab Hematol.2005; 11(1):38-45. jeevanmarasinghe@yahoo.com Competing interests: None declared |
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John E Sandars, Senior Lecturer, Medical Education Unit University of Leeds LS2 9LN
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The editorial by Johnson et al [1] provides an exciting glimpse into the future of continuing medical education. Undoubtedly, high quality interactive multi-media can enhance this learning experience. No member of an audience will fail to be impressed by the technology. Learners will see educational material presented in a form that they have only witnessed at a cinema or in a computer game. Potential sponsors will clearly see what they are getting for their money. What the latest technology can do is seductive to all of us but we need to urgently consider if this should be the future direction of continuing medical education and also to examine other potential educational uses for broadband. An important aspect of continuing medical education is the opportunity to interact with a variety of fellow learners so that new knowledge can be shared, especially following application in the real world. The theory-practice gap has to closed if patient care is to be improved. The proposed use of broadband does not mention how online interaction can be facilitated by the use of technology. There is current interest in the future of the internet and its implications for learning. O'Reilly [2] describes Web 2.0 in which new software is profoundly altering how the internet is being developed and used. There is an increasing emphasis on active participation by users of the internet rather than being passive recipients of published material. A vast array of learning resources are already present, and will continue to be developed, on the internet. These include web sites, blogs and podcasts in a variety of media. Learners will be able to develop personalised learning by linking to these resources but also blogs can allow active interaction with other learners. New social bookmark software can allow easy management of these various resources and the future suggests that this software will become more adaptive to the needs of individual learners. The internet also provides opportunities for more direct interaction between learners, such as through instant messaging sevices and internet relay chat, and these can be integrated with other learning resources. The Web 2.0 approach to learning at first appears to be chaotic and uncontrolled. The strength is that learning is actively constructed, like preparing a meal from its ingredients, and this is in contrast to learners receiving pre-prepared packages that are not relevant to individual learners or the context in which they work. The main difficulties are the creation of a sense of order and the internet capability. Software that allows personalised and active learning with other learners is currently available and will become more sophisticated in the next few years. Broadband offers the necessary power to enable the internet to deliver the Web 2.0 vision. Broadband definitely offers an opportunity for continuing medical education. Learners and sponsors must not be seduced by fancy pictures but should critically consider the true nature of continuing medical education. Vast sums of money are at stake and it is important that the money is spent appropriately. The BMJ could provide continuing medical education along Web 2.0 principles and now is the time to commence the necessary development and implementation. [1] Johnson J, Dutton S, Briffa E, Black C. Broadband learning for doctors BMJ 2006 332; 1403-4 [2] O'ReillyT. What is Web 2.0. http://www.oreillynet.com/pub/a/oreilly/tim/news/2005/09/30/what-is-web- 20.html (accesed 17 June 2006) Competing interests: None declared |
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Anis Fuad, Teaching and research staff Department of Public Health, Faculty of Medicine Gajdah Mada Univeresity, Yogyakarta, Indonesia
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Editor - While John Chambers, the CEO of Cisco Systems Inc ever called that education as the next big killer application on the Internet, the editorial by Johnson et al.[2] proposed the broadband learning as the next big potential in the medical learning environment. To allow the birth of this digital academic atmosphere, it requires three elements i.e.: modernised curriculum, broadband infrastructure and broadband learning services supplies. It will needs a big funds as well[2]. When the money is there, perhaps, IT doesn't matters. But, how with the changing curriculum? How about dynamics acceptance of the users? The new publication concerning the use of virtual learning environment in the problem based learning showed a rather disappointing result. While the student positively viewed that multimedia presentation enhanced the conventional text case, however they preferred face to face contact than computer-mediated interaction[3]. In practice, implementing broadband technology will be as complex as managing the innovation game[4]. This innovation will be challenged by different peoples with different behaviors. Hopefully, many of the new medical students, who are more and more familiar with digital technology, are the good examples of early adopters or even innovators. Their enthusiastic energies, supported by the faculty governance, should be utilised to ensure that the early majorities are on track. On the other hand, different strategies will be needed to tackle the late majorities and the laggards. It won't be an easy game to play. References [1]John Chambers at the COMDEX ’99 conference [2]Johnson J, Dutton S, Briffa B, Black DC. BMJ 2006; 332:1403-1404 [3]de Leng BA, Dolmans DH, Muijtjens AM, van der Vleuten CP.Student perceptions of a virtual learning environment for a problem-based learning undergraduate medical curriculum.Med Educ. 2006 Jun;40(6):568-75. [4]Rogers EM. Diffusion of Innovations, 3rd ed. New York: Free Press, 1983;5. Competing interests: None declared |
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Geoff Wong, Clinical Lecturer Department of Primary Care and Population Sciences, UCL, London N19 5LW
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Johnson et al (1), in their editorial on broadband learning quite rightly point out that more resources need to be devoted to developing this new technology for learning. However, in their call for funding, they seem to focus purely on the need for developing high quality teaching materials and forget to highlight the importance of teaching. For learning to take place, learners need to have their assumptions and ways of thinking challenged. This is much more likely to happen when learners are able to enter into a dialogue with a tutor/facilitator and/or other learners and obtain feedback from them (2). The potential power of the internet on learning is to enable such a dialogue to take place through interaction. Four types of interaction have been described in learning over the internet (learner-learner, learner- instructor, learner-content and learner-interface) (3). The best that any high quality stand-alone learning resource can do is to enable learner- content and learner-interface interaction. This may be good enough in some circumstances, but does not use the internet to its full potential as it does not allow learners to have this dialogue and feedback with others. What we need are not only high quality teaching materials but also the tutors/facilitators and/or fellow learners to help make the best of these resources. Otherwise, we risk letting learners down by failing to understand how best to harness the power of the internet for learning. Reference List 1. Johnson J, Dutton S, Briffa E, Black C. Broadband learning for doctors. BMJ 2006;332:1403-4. 2. Laurillard D. Rethinking University Teaching: a conversational framework for the effective use of learning technologies. London: RoutledgeFalmer, 2002. 3. Vrasidas C, Glass G. A conceptual framework for studying distance education. In Vrasidas C, Glass G, eds. Distance Education And Distributed Learning, pp 31-55. Greenwich, Connecticut: Information Age Publishing, 2002. Competing interests: I work as a tutor and course developer on a web-based MSC course run by UCL and the University of London External Programme |
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Graeme M Mackenzie, GP Whitehaven CA28 7RG
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In our practice we have an ad hoc electronic learning club where articles, patient experience and interesting facts and cases and posted and discussed. With over 1000 postings in 3 years, the degree of exposure to anecdotal learning combined with evidence and research is many, many times that which participants could have been exposed to in the old days by attending evening meetings, the occasional chat at coffee or even paper journal reading. The exchanges accelerate the whole acquisition of experience and knowledge. Attractively for those committed to this form of continuing education, it can mostly be done during the day and enables a much healthier life/work balance. Competing interests: None declared |
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