Medical E-ducation

Associate Professor Jill Gordon,
Faculty of Medicine

In Issue 3 of “Synergy” (1996) Professor Ann Sefton referred to plans for a new medical program: “To ensure that students become competent with computers, we are developing a major initiative, an intranet (and) computer-based learning packages, databases, electronic forums and applications like spreadsheets”.

What has happened in the last six years as a result of this “major initiative” in online learning and teaching? What may be of value to other schools or faculties? Here are just some the things that we have found:

1. The new Program has led to a dramatic improvement in students’ perceptions of their medical education, as reflected in the Course Experience
Questionnaire.

2. Continuous quality improvement is much easier when curriculum management is electronic. Students and faculty provide feedback which is constantly translated into improvements to the Program. Our custom-designed content management system responds to our precise educational needs.

3. Some staff need more support than students, almost all of whom are computer-literate on entry. Students rapidly develop core skills such as literature searching and the use of electronic databases for the practice of evidence-based medicine.

4. Excellent resources for independent study can be developed for use on line. For example, an electronic clinical reasoning guide assists students in the transition from fully supported PBL tutorials in Years 1 and 2 to more independent clinical reasoning during Years 3 and 4.

5. Students’ responses are not always predictable - electronic forums are not as popular as we had expected, a fact that students explain by reference to the amount of direct interaction in small groups and the availability of electronic bulletins and email.

6. Online learning has prepared us for an expansion in rural education and training. Commencing in 2004, the Department of Health and Ageing will require at least 25% of medical students to spend a minimum of one year in a rural setting during their third or fourth year. This process will be facilitated by online learning in clinical schools and department of rural health in Broken Hill, Dubbo and Northern Rivers. Our AV/IT network will eventually provide state-wide communication. In fact our major challenge in rural education will not be the online curriculum, but the provision of on-the-ground clinical teachers for students in rural areas.

The costs are considerable. Our IT Group alone comprises around 20 support staff for teaching and research, distributed across the campus and clinical schools. To sustain the process of continuous quality improvement in education and ICT, the Faculty has needed to identify new income streams.

To help underwrite the cost of the medical program, the Department of Medical Education (DME) and the Faculty IT Group have combined educational and technical skills to educational consulting, courseware design and delivery, educational software solutions and web hosting services.

Experience with online learning in the health sciences has led to:

• Consultancies: Curriculum review; Curriculum design; Curriculum change management;
Instructional design; Review of available IT options; Managing IT in educational programs

• Online courseware design and delivery: Blending educational and IT expertise

• Online workshop design and delivery: Facilitated discussions forums for
remote access

• Specialized educational software solutions: Multiple choice question databanks
Image banks; Online clinical audits

• Commercialisation of Faculty's intellectual property: University of Sydney Medical Program (USydMP); Wilson Anatomy Museum

• Web-hosting services: Hosting for general websites; Hosing for specific projects

• Face-to-face workshops: Impact of IT on Education; Problem and case-based learning; using IT

Years 1 and 2 of the Program have been licensed to the University of Witswatersrand in South Africa and the University of Nottingham in the UK and we are about to establish a licensing agreement with Australia’s newest medical school at the ANU. The income from licenses will fund innovations that benefit each of the universities involved.

Other direct benefits include the further development of an online image bank in Anatomy. With the help of the Teaching Improvement Fund, the Departments of Anatomy and Medical Education are developing the ‘Virtual Anatomy Tutor’. We have assisted the Faculty of Veterinary Science to develop the OLIVER Veterinary Image Bank, a storage and retrieval system for undergraduate and postgraduate students. Finally, the Project Development Group has collaborated with colleagues in Health Sciences to develop StudyAge a postgraduate program in ageing and aged care.

In her discussion paper in this issue of Synergy, Anne Forster mentions continuing professional development. The Faculty’s postgraduate arm has now been incorporated into the DME an increasing amount of postgraduate training is being prepared for online delivery. Professional training colleges have sought our expertise to develop a Basic Surgical Training Program online for the Royal Australasian College of Surgeons and a Basic Physician Training Program online for the Royal Australasian College of Physicians. We are also working on a project to promote rational test ordering with the College of Pathologists.

Other clients have included the Drugs Program Bureau of NSW Health, which commissioned an online accreditation program in pharmacotherapies to replace a face-to-face program. The online program comprises typical clinical cases, self-assessment and an electronic discussion forum facilitated by clinicians with expertise in drug and alcohol problems.

We could not have predicted these developments in 1996 in the days of “Synergy 3”. The total number of contributors makes it impossible to acknowledge everyone involved, including our students, during the first few terrifying years. Our students are being transformed into junior doctors, now working in hospitals across the state. The early responses from clinical supervisors applaud their generic and specific skills. We look forward to meeting them again during their postgraduate training and continuing professional development – both in person and online.

Jill Gordon is Associate Dean, Medical Education, in the Faculty of Medicine. She chairs the Faculty’s Education Committee and recently succeeded Joy Higgs as chair of the College of Health Sciences Education Committee. Her research interests include students’ acquisition of personal and professional values.
Email: jillg@med.usyd.edu.au

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