Computer assisted learning in undergraduate medical education
BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7277.40 (Published 06 January 2001) Cite this as: BMJ 2001;322:40
All rapid responses
EDITOR – I don’t think by now there is any doubt how much impact
information technology will continue to have on the future practice of
medicine as well as medical education in the 21st Century. Last week
Trisha Greenhalgh from Royal Free Hospital provided us with a
comprehensive review of previous experience in introducing the use of
computers in undergraduate medical teaching. Quite rightly she highlighted
the difficulties and potential pitfalls in using computers to teach. This
ranges from enormous financial cost to organizational apathy.
However, contrary to previous experience, the introduction of CAL
need not be a painful experience that demand radical behavioural changes
from users. The widespread use of mobile phones is a good example of how
technology can effortless blend into mainstream society. Even the most
techno-phobic person owns a mobile phone. Can using computers for medical
education be as easy as signing up for the latest mobile phone service
from the high street? In the case of mobile phones, the network companies
not only maintain and upgrade their network; they also subsidize all the
mobile phone sets. This frees the users completely from all technical
issues.
It is high time to realize that academics in medicine are not
computer technicians. Even endless amount of special courses and
multidisciplinary meetings will not alter this fact. With the easy
availability of Internet, it is now absolutely foolhardy for medical
school to embark on purchasing specialized computer equipment on their own
for setting up CAL laboratory. Firstly, there is a problem of lack of
technical support. Secondly, considering the rate of IT industry develops,
the equipment will be obsolete in no time.
A more effective way would be to rent a web site from local
university computing department, which can in addition provide web-editing
services. Lecturers and tutors can simply submit their teaching material
either as a web page with or without embedded multimedia for web
publication. In this way, students can access these materials from any
computer in the world without specialized software.
Finally although it is considered scientific to review efficacy of
any new methodology either with random-controlled trials or meta-analysis
from previous studies, I would like to point out that there is a serious
pitfall to apply such approach to computer-assisted learning. Firstly not
all computer-assisted teaching programs are identical. It would be
meaningless to generalize from a study comparing one particular computer-
assisted teaching method against a particular convention method. Secondly,
though we may learn something from the past, looking at the past will
unlikely give us a singular tried and tested method that will work
forever, as both technology and social condition continue to evolve. Just
like implementing any changes in life, there is no substitute for common
sense and willingness to get one’s hand dirty.
No commercial interest declared
Competing interests: No competing interests
Trish Greenhalgh's essay on CAL for undergraduate medical education
is timely. The issues raised concern not just undergraduate medical
education, but higher profession education too.
The RCGP CPEP program ahas been developed to improve knowledge in
several key areas for GP Registrars (and established GPs). There is,
however, little evidence available on the impact of CPEP on the quality of
GP education and whether there is a real change in clinical practice from
the use of such a program.
What the present essay does is couch CAL in a scientific framework
which provides a good starting point for appraising postgraduate
initiatives and I hope this occurs. The introduction of appraisals and
revalidation for UK doctors this year makes the need for reliable CAL
packages of paramount importance.
Competing interests: No competing interests
We welcome Trisha Greenhalgh's article Computer
Assisted Learning in Undergraduate Medical Education
(6 January 2001).
Readers wanting an example of a tried and tested
module used in both undergraduate and postgraduate
education should look at our Medicine and Human
Rights course on www.phruk.org. The course has been
available without charge on the internet since 1996,
has been down loaded to all corners of the world, and
is the basis of a number of courses taught in UK
medical schools.
Yours sincerely,
Peter Hall
MBBS, MRCPI, DGM
Competing interests: No competing interests
CAL enhances course information management
Sir,
Greenhalgh, in her paper on computer assisted learning in
undergraduate medical education (1) gives a good summary of the key issues
in the development and delivery of online teaching material. We agree
that it is essential that online materials have to be well designed and
structured with a clearly defined learning pathway. The need to employ
adequately trained tutoring staff is paramount, but we would add that the
accessibility of the Internet enables expert tutors to contribute, where
this would not have been possible previously due to geographical
constraints.
We would like to draw on our own experiences with the delivery of a
web-based distance-learning course in medical informatics – with 160
students in 19 countries (2). The availability of a number of course
delivery software packages facilitates the setting up of an online course,
but we have rapidly outgrown those and are developing our own system – an
option that will not be available to all. Any course requires continual
evaluation and modification, and the online nature facilitates this
process, and allows for free asynchronous tutor-student interaction. We
have found that the accessibility of message boards and discussion areas
can reduce the feeling of isolation that is common among distance-learning
students.
Although Greenhalgh has drawn attention to the need for multi-
disciplinary working, she has mentioned little of the information
management advantages that the electronic environment brings. There is
increasing awareness of the need to record accurately the training that
has been given to individual medical students for future validation. The
ability to track and monitor students as they progress through their
course is a major advantage of an electronic course and will become an
essential part of the seamless integration of undergraduate and post-
graduate training.
The Royal College of Surgeons in Edinburgh is implementing an
information management and educational delivery system that will escort
the surgeon of the future from medical school to retirement. At the heart
of this is the electronic delivery of educational material and support.
Paul Whatling – Director
paul.whatling@rcsed.ac.uk
W Angus Wallace – Dean
Andrew Lamb – Information management consultant
Faculty of Medical Informatics, Royal College of Surgeons of
Edinburgh, Nicolson Street, Edinburgh EH8 9DW
1. Greenhalgh T. Computer assisted learning in undergraduate medical
education. BMJ 2001;322:40-44
2. RCSEd. www.diploma.rcsed.ac.uk
Competing interests: No competing interests