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MED-NET Conferences 1998, Lille & 1999, Maastricht
Anthology of presentations 5.1.
Guidelines for using computers in medical education
O. Winding (Copenhagen, Denmark)
Introduction
Within recent years there has been an explosive development in the utilisation of computers in medical education. This gives rise to great potentials but also to some difficulties emphasising the need for guidelines.
For that reason World Federation for Medical Education (WFME) has established a standing advisory committee for the use of computers in medical education and have asked the committee to suggest guidelines for the integration of these new tools into the curriculum. Members of the committee are listed at the bottom of this document.
This document represents the initial guidelines created at the first meeting of the advisory committee in Copenhagen, October 11-13, 1997.
Background
Medical research and practice are highly dependent on management of information. The existence of the Internet provides new opportunities for linking medical schools around the world for sharing computer-based learning materials. Information technologies open a wide horizon for acquiring and expending medical knowledge originated in any part of the world without limitations of time, space or distance. The revolution of communications and information technology attains pre-eminent pertinence in the field of medicine and health care for the practice of the medical profession, individually or collectively. The computer, with its capacity for managing information and linking, is the most powerful tool for processing medical knowledge and opens new avenues to the teaching-learning process.
Single computers can be used by the teacher in a classroom, in tutorials, or by students for self-studies. Linking computers together via a local network simplifies the management of computer based learning and introduces the possibility of computer based communication within an institution. Linking local networks via the Internet allows institutions to collaborate world-wide and exchange teaching materials and ideas. The skills that students acquire in computer based learning provide them with capabilities which will support life-long professional education.
There is increasing acceptance of the philosophy of evidence-based medicine and evidence health policy. Evidence-based medicine requires skill in literature searching and the use of relevant and on-line scientific information for sound clinical decision making.
As there is almost unlimited availability of increasing volumes of information on the Internet, there is evident risk of an information "overload". For that reason the medical schools and the teachers are responsible for directing and counselling medical students on the proper access to quality information. In the midst of the communication revolution, there is need to direct, orient and evaluate the student's use of the increasing volume of literature and the growing facility to the free access of information.
To understand the new technology we need to define some basic terms.
- E-mail: mail transported electronically, e.g. via the Internet or other means of electronic communication; may include attached files
- Internet: external network: global network of computers
- IT: information technology
- List-server: central computers that receive e-mails messages and relay them to a special member group, for discussing a particular topic
- Local network: network between computers, e.g. within an institution or medical school. In some cases this is called an Intranet and can be a closed circuit with password access only
- Multimedia: a combination of several of the following media: text, graphics, images, video, sound, animation, simulation
- Telemedicine: (as defined by WHO) "the practice of health care using interactive audio, visual and data communication. This includes health care delivery, diagnosis, consultation and treatment, as well as education and transfer of medical data"
- Virtual Reality: a computer created (3 dimensional) artificial "reality"
- WWW: (World Wide Web): the use of Internet to present various types of information. WWW web-sites or home pages may be accessed with the aid of a browser program, e.g. Netscape or Microsoft Explorer.
World-wide Guidelines to Medical Schools
1. Integrate the use of computers in the medical curriculum
- The change from the traditional teaching and learning methods should be driven by educational needs, rather than the availability of technology or by institutional politics.
- Computer support self-directed or small group/tutorial learning if used as supplement and not as a substitute. Using computers permits flexible hours and self-paced learning.
- A database covering educational curriculum should be established for each school.
- Teachers should be trained for appropriate use of technology in particular settings: Class lecture, small groups, self-assessment, online texts, and laboratories.
2. Provide access to computers, local networks and software for students and teachers.
- Medical software used in the curriculum should be made available to students for use outside of classrooms.
- Effective use of computers necessitates access to computers (24 hrs is desirable), subject to limitations imposed by security
- Access to a core of application programs: word processing, spreadsheets, databases, statistics, graphics, and dictionaries, should be provided -Training for students and staff in the use of Internet and Multimedia for medical education should be provided
- Establishing computer resources requires that both human and financial resources be allocated to maintain and update equipment and software.
- Remote access to central computer facilities via a dial-in service is desirable.
- Use of internal networks for communication: Installation and use of computers for internal communication within a medical school can be beneficial in many different ways. Some examples of what IT can be used for:
- Question and answer sessions in relation to lectures and courses
- Providing bulletin boards containing course information
- Receiving comments for course review
- Providing self-assessment material
- Secure delivery and return of students' work
- Discussion groups for students and staff.
- When integrating computer based learning into courses it is often useful to build on other computer-related resources such as computer based communication systems. In order to deal with these activities, teachers will need to become familiar with computers and, in due course, may become interested in using them for teaching, and for producing their own teaching material.
3. Provide access to external networks, Internet, World Wide Web, and electronic mail, for students and teachers.
External networks provide individual electronic mail accounts, access to the Internet and in particular the World Wide Web. With such a global network, medical schools will be able to locate useful web-sites, and published reviews of educational software, and get assistance in creating their own web-sites.
A clinical approach is Telemedicine, (see definition) where the most skilled doctors can give their experience of a real patient related situation, e.g. during surgery, without being present in the same room or location. Another possibility for training students and young doctors are simulators and virtual reality, where they can train their skills without doing any harm to the patients.
4. Obtain information on current developments about medical education by using list servers
A list server is a computer that receives e-mail messages and relays them to a group of people who wish to discuss a particular topic. Regarding computers and software for medical education we recommend the use of the med-ed list server, which is already used by many medical educators around the world. Its address is: http://www.aamc.org/meded
We recommend that the medical schools/teachers/students establish contact via e-mail and other electronic routes to colleagues around the world
5. Exchange educational material between teachers and schools
We encourage the exchange of electronic resources on a national and international level between teachers who produce these materials while respecting copyright and crediting authors. Sharing resources particularly benefits teachers whose budgets are limited. Similarly, consortia of medical schools should collaborate on software production
6. Recognise educational work (also with computers) in the same way as for research in basic and clinical science
Institutions need to recognise the effort and skill necessary for successful production and integration of computer-based learning into courses. For example teachers whose work is recognised internationally should receive credit equal to that awarded to their colleagues who concentrate on research. This credit should take the form of promotion and recognition of professional standing. Unless such systems of reward are put in place, medical education will always suffer from a shortage of talented and dedicated individuals.
Recommendations to WFME
A network of identified contact persons with representatives ideally from every medical school in the world listed with an e-mail address (with permission) should be set up, supported by electronic mail if available. WFME should take responsibility for maintaining this database which should be available through the WFME web-site as well as the World Directory of Medical Schools (presently published by the WHO).
Contact persons may provide information on the use of computers in teaching and learning which may be of use in formulating the future policies of the WFME. Such a communication network should be used not only for bi-directional communication with the WFME but also for communication between medical schools.
WFME should organise to support medical schools in integrating computers into their curriculum. Suggestions: Arrange workshops/seminars, meetings with expert groups etc. and videoconferences.
WFME should encourage collaboration between medical schools and work to overcome cultural and linguistic barriers as well as curricular differences. While specialised academic studies can be communicated in a common language, the more elementary teaching levels are often carried out in the national language. Furthermore, different styles of teaching (teacher-led or problem-based) will require different approaches when introducing computer based learning.
Since the Internet provides access to very large numbers of educational resources there is a need for schools to critically evaluate each resource. WFME should encourage peer reviewing of educational software preferably published in on-line journals. WFME should stress that the use of computers in medical education should be regarded as an additional tool and must never be a goal in itself. On the contrary clinical medical education should always be centred on direct patient contact and bedside education.
Future role of WFME
WFME should follow the technological development meticulously, to be at the forefront of development. WFME should distribute information and guidelines in this respect to medical educators and medical schools all over the world. WFME should take initiatives to organise conferences, seminars, workshops, etc. regarding the use of new tools in teaching and learning. WFME should seek to enhance the quality of medical education by supporting the development of computer based educational material. WFME should support the development of a future network of medical schools, libraries and documentation centres.
Members at the WFME Standing Advisory Committee.
First meeting in Copenhagen 11-13 October 1997, at University of Copenhagen, Faculty of Health Sciences, the Panum Institute, Denmark
- Assoc. prof. Jens Dørup, Aarhus University, Denmark
- Assoc. prof. Edvin Bach-Gansmo, Oslo University, Norway
- Prof. Andrew Booth, Leeds University, UK
- Medical student Jakob Nicolaj Krarup, University of Copenhagen , IFMSA
- Assoc. prof. Göran Petersson, University of Lund, Sweden
- Prof. Torben Schroeder, University of Copenhagen, Denmark
- Prof. Suzanne S. Stensaas, Cornell University,USA
- Assoc. prof. Ole Winding, University of Copenhagen, Denmark
corresponding members:
- Assoc. prof. Simon Carlile, University of Sidney, Australia
- Assoc. prof. Martin Fischer, University of Munich, Germany
- Prof. José Patiño, University of Bogota, Colombia
- Assoc. prof. Anders Nattestad, University of Copenhagen, School of Dentistry, Denmark
secretary at the meeting:
ISBN Number 90.805758.1.X
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