Medical Education

The amount of medical knowledge continues to increase exponentially

There has to be a way to keep abreast of the information explosion

Since it is no longer possible to "know everything" about a subject, or even part of a subject, then it becomes extremely important to know how to find knowledge

Teaching Methods

Traditional curricula at medical schools have placed heavy emphasis on the lecture method, supplemented with laboratory exercises

Lectures are highly efficent (e.g., one faculty per 100 students per hour)

Learning is mainly "passive" and not "active"

Laboratories and small groups can make learning more personal, but require more faculty time

Problem-based learning curricula at some medical schools have replaced traditional methods

Promotes "active" learning

Is more labor intensive for faculty, but does not necessarily require "expert" tutors for each PBL session

Supplementary teaching methods have traditionally included:

Syllabus (printed)

Textbooks (Robbins, Rubin & Farber, etc.)

Reference sources (library books and journals)

Multimedia

There is greater emphasis being placed upon clinical medicine in the first two years of medical school

Conversely, there are attempts at a "return to the basic sciences" in the third and fourth years

How Does Learning Occur?

Forward Reasoning: the "traditional" basic science curriculum

Memorize a lot of facts and try to organize them around a theoretical conceptual framework, then use this knowledge base for problem solving

Backward Reasoning: applied in the clinical years of the curriculum

Base knowledge upon clinical practice in which the knowledge is learned in the context of patient problems. This experience is continuous, real, and provides a variety of learning experiences

Teaching Methods

Traditional: lectures and labs

Relies upon many contact hours (for the students) but fewer overall hours for faculty

Heavy reliance on syllabus and textbooks

Non-traditional: PBL

Students have fewer contact hours, providing time for individual study

Heavy reliance on reference sources

Electronic Resources:

Can supplement either curriculum, but work better when there is more free time for students to utilize the resources

Resources can include: electronic syllabus or textbooks, MEDLINE searching, and a variety of multimedia teaching tools

Multimedia Resources

Traditional authorware programs are expensive (small market) and tend to have a steep learning curve for development of multimedia exercises

Traditional multimedia programs run on a single computer platform (HyperCard for the Mac, IconAuthor for the PC)

Once developed, traditional multimedia programs tend to remain static, because of the effort required to make them and modify them

The WWW and Teaching

Programs (host and client software) are freely available with documentation

Server software (Netscape, WebStar, ZB Server, WebSite)

WWW browsers (Netscape Navigator, Internet Explorer)

Programs are easy to learn, because there is on-line documentation, and there are ready made examples that can be found on the WWW

The Internet is already in place, and there are millions of computers that are already connected worldwide, though a medical school needs a network infrastructure; even a modem at home can be used (safer than the campus at night)

Platform independence (Mac, PC, UNIX)

Integration of WWW Resources

Electronic syllabus: lectures and labs can be placed on a server for access via the WWW

Multimedia teaching programs can be created to run on the WWW

WWW resources from outside your own institution can be accessed

Requires a reduction of traditional contact hours in the curriculum

Requires a "computer classroom" or at least computers on campus

Requires computer skills (is there a formal way this is done?)

Requires faculty support - a person or persons who can develop the resources (many faculty can be contributors without having to be "expert" multimedia authors)

Requires administrative support for developing the facilities and supporting the faculty

Resources for the WWW

WWW server: if much web traffic is anticipated, then a more robust UNIX machine is essential, but knowledgeable support staff are essential; even a desktop PC or Mac can be a WWW server that is simple to set up, but not in high volume situations

Computers (Mac or PC) accessible to students are required: lobby for the latest models with the fastest processors and the biggest monitors that you can get. Don't skimp, or you'll have lesser capacity for development, and the equipment will outdate that much faster

Though the Web browser software is free (or minimally priced shareware) for educational purposes, the resources (particularly time) for multimedia development is NOT free!! An estimated 50 to 100 hours of development time are needed per hour of multimedia

WWW Resources - Hardware for Development

Computer: desktop Mac (PowerMac) or PC (Pentium)

16MB RAM a minimum, and 32MB is better

A 17" monitor is a minimum

Digital images:

Existing kodachrome collections can be scanned via a desktop scanner or by use of Kodak Photo-CD's

Videomicroscope, digital camera, or Hi-8 camcorder can be used as direct image capture devices; the "Snappy" video capture device gives adequate resolution and is cheap

WWW Resources - Software for Development

HTML editors: HoTMetaL Pro for either Mac and PC

Can load and convert existing word processor files

Provides simple menus and a preview mode

Won't let you make a mistake

Alternative: text editor is adequate for experienced persons

Image Editing Software: Adobe Photoshop for either Mac or PC

Provides many tools for working with images

Save images as jpeg (gross and micro) or gif (line drawings and diagrams

Alternative: Paint Shop Pro for the PC

Site Management Software: Adobe SiteMill for the Mac, or WebAnalyzer for the PC; used to manage the resources of the site (track the links and editing changes)

WWW Teaching Resources

The WWW offers advantages:

Use of scarce resources - widely available for greater benefit

Unlimited content

Easy updating of resources (not like traditional publishing)

Problems or possibilities for the future:

How can mentoring and role modelling be applied?

What kind of access is needed?

Software limitations or continued progress?

Bandwidth

Who will support it?

Continuing Medical Education

Telepathology