Use of instructional technologies for medical education

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Introduction

Medical education is a continuous process, life long learning, deliberate practice (Issenberg 2005) Reaches from undergraduate study of anatomy to a call with a specialist when facing a difficult case. >Needs are multiple and reach for quick, just-in time access to content (text or pictures) to sophisticated "fly-through" Virtual Reality systems inspired by military Bedside education: change in medical practice (shorter stays in hospital, more acutely ill patients and limited instructors time) make teaching and learning more difficult. Advanced simulation technology and other instructional technologies can help address this problem(Issenberg 2001, Choules). Another difficulty is lack of scientific founded and sound comparative studies on educational develoments in medicine > no serious meta study about pbl application could be done for example (Issenberg 2005). Each medical specialty looks only at its own litterature and seldom at other research (eg anaethesiologists look at anaesthesiology litterature etc...), not to speak of research other than in the medical education field (business industry, aviation and military).“There appears to be little awareness of the substantive and methodological breadth and depth of educational science in this field”(of high-fidelity medical simulation) (Issenber 2005).

Text

Repositories, just-in time learning, latest research findings (Choules) Link to some repositories: Medline of the National Library of Medicine in the US, many search sites that help doctors search in medline: eg for Switzerland univadis tellmed.

Multimedia presentations

Multimedia presentations of a patient or a case ("virtual patient", Choules) Could be a video clip showing a particular symptom in image and sound, a flash animation demonstrating a cellular process, or an x-ray with comments on the findings (Choules)

eLearning

Interactive "virtual patients", simulation of a clinical case. Also possible for training of "attitude" basics (Choules). Computer-Aided Instruction (CAI) like interactive CD-Rom based software, useful for learning repetitively. On demand learning. There are hundreds of programs available in many areas and levels. Example of a multimedia computer system is UMedic, a curriculum of 15 patient-centered case based programs for education in cardiology.

Simulation and Virtual Reality

Harvey, a cardiology simulation dummy and teaching device is often used together with UMedic and thus combines a physical simulation of a patient presenting a blood pressure, pulses and auscultatory findings with a multimedia computer system including computer and video graphics, sound and real-time digitized videos (Issenberg 2001). Simulation in medical education reaches from role playing over physical body simulators (dummies)(Issenberg 2001) to the virtual reconstruction of a patient's organ for "fly-through" exploration (Satava 1999) or to catastrophy scenarios involving dozens of participant "victims". The development of endoscopic surgery with surgeons working with a monitor started a new field of technical developments around the images and the haptic ("touch" quality of the instruments. The sureon is no longer directly looking at the patient's anatomy, his actions are no longer directly moving the instruments since there is a computer-assisted translation of motion. it is the idea of "...using biots instead of atoms" (Negroponte, from Satava 1999)

Synchronous and asynchronous communication

Trainig like elearning can be accompanied by forums, wikis and /or blogs that allow sharing experiences in cases where there is no evidence-based information readily available. Specialists advice just in time by phone, blogs while using an elearning course.(Choules)

Formative assessment, evaluation

e-portfolios for formative assessment MCQ, virtual patients for summative assessment. One difficulty in medicine are the multiple correct scenario(Choules)

References

Choules, A.P., 2007, The use of elearning in medical education: a review of the current situation.

Issenberg B.S.,Gordon M.S., 2001, Simulation and new learning technologies.

Issenberg B.S., 2005, Features and uses of high-fidelita medical simulations that lead to effective learning: a BEME systematic review.

Petrusa E.R:, Issenberg B.S., 1999, Implementation of a four-year multimedia computer curriculum in cardiology at six medical schools.

Satava, R.M., 1999, Emerging technologies for surgery in the 21st century.

ivimed, the international Virtual Medical School, lead by numerous Universities (UK, Canada, USA, Finland...), and offering IMS and authoring tool with virtual patient functions.

Harvey, the cardioology patient simulator.