Virtual Medicine

This article was published in the original Podium magazine on Dec 1, 2001, with the tag line, "A description of the state on online education for medical professionals." It first appeared in Family Practice Magazine on Sep. 15, 1997, written for an audience of "non-wired doctors".

by Raywat Deonandan

James Ryan, a vice-president at Pennsylvania State University, calls the explosion of on-line Internet courses “the hottest and most sweeping development” he’s ever seen. With the Internet’s maturation from a plain text medium to a textured cacophony of video and sound, an obvious evolution was the advent of high-tech distance education. Lately, the explosion has begun to serve the educational needs of family physicians.

Distance education has long been a dry but valuable option for physicians and other professionals living in remote areas, or for individuals whose busy schedules do not permit participation in rigidly structured classroom courses. Until recently, the path of “remote learning” involved mail-in exams, standard textbooks and an occasional phone call to a professor.

The Internet, however, offers several advantages over its low-tech forebear, the correspondence course. E-mail allows almost instantaneous two-way communication without the interference of an often unreliable postal service. The World Wide Web allows anyone with access to a connected computer to view images such as diagrams, graphs and photographs which can be updated instantaneously. Advances in multimedia permit audio lectures to be acquired over the Internet in “real-time” formats such as “Real Audio.” And the proliferation of Java-enabled browsers and Shockwave-equipped websites have made interactivity a meaningful everyday word. Education need no longer be limited to the reading of textbooks.

For the family physician, these developments can be particularly advantageous. A number of electronic medical courses have surfaced in recent months, some even striving to offer CME and CFPC certification.

To determine the efficacy of the medium for the continuing education of physicians in remote areas in Ontario, a pilot study was conducted by Dr. Truls Ostbye of the University of Western Ontario’s Department of Epidemiology & Biostatistics. Dr. Ostbye and his associates modelled an electronic clinical trials course after an existing graduate-level classroom course, and taught it in text modules via E-mail. None of the fancy Internet bells and whistles, like audio and graphics, were used.

“The idea was to keep it low-tech,” Dr. Ostbye says, “so that a minimum of computer expertise was required by the students.” What he found was that the course appealed to medical professionals around the world, not just in Ontario. Clinicians working in the Australian desert and in a small African community suddenly had educational access to a major Canadian university.

Students responded favourably to the anonymity of E-mail, and to being able to interact when and how often they chose. The design and administration of clinical trials, it seems, was a topic that diverse medical professionals were thirsting to know more about. No doubt, there are other topics that could benefit from this approach.

Even though Ostbye’s course was delivered without profit as a consideration, the tuition was still over $500 per student, just to cover expenses. The materials may be virtual, but the cost is still real. However, this cost is comparable to that of popular postal correspondence courses, such as those of the Canadian Securities Institute.

A more ambitious undertaking is the on-line public health course offered by the University of North Carolina. Covering all the major aspects of public health theory and practice, such as the evaluation of drinking water and the assessment of community disease outbreaks, this course seems tailor-made for the curious family physician. Further underlining the electronic medium’s global appeal, the course’s teaching assistant, Nicole Walker, created a minor media sensation by continuing to teach on-line while away in Portugal, her students never aware that she had moved.

This course is quite impressive in the variety of media it employs: streaming audio lectures in Real Audio format; powerpoint slides rendering excellent graphics; chat rooms so students can interact privately and synchronously; and bulletin boards for asynchronous communication.

Of course, North Carolina’s course’s greater complexity requires a prospective student to have more computer expertise and better equipment than the students of Dr. Ostbye’s clinical trials course. The University of North Carolina therefore requires students to complete an on-line skills test to ensure that everyone is comfortable with the computer medium.

Closer to home, Dalhousie University has stepped up its on-line offerings. Among its courses is one developed and administered by Dr. Anna Mary Burditt. Like Dr. Ostbye’s clinical trials course, Dr. Burditt modelled her course on an existing classroom offering: a second year family medicine course she had been teaching for 10 years. Titled “Alcohol Problems: A Family Medicine Approach,” the course is geared toward practising family physicians wishing to use the case method to learn more about treating alcoholism. Burditt stresses the interactivity of the medium, and has designed the course to take full advantage of the World Wide Web’s imaging abilities and asynchronous bulletin boards.

Burditt has applied for accreditation from the CFPC. Hopefully, from a certification point of view, the Internet medium will soon be ranked on par with live classroom courses.

Many of the larger American universities are enthusiastically developing profit-making Internet courses on a variety of topics. The University of Minnesota website offers a list of a variety of on-line science courses. And Gregory Allen, a medical undergraduate at California’s Loma Linda University, maintains a list of electronic medical courses and textbooks on his personal website.

Certainly, for medical professionals of all types, there now exists a host of educational opportunities to fit anyone’s schedule. All you need is a computer.


SELECTED WEBSITES AND CONTACT INFORMATION

Dalhousie University’s “Alcohol Problems: A Family Medicine Approach”. Contact Dr. Anna Mary Burditt.

University of Minnesota’s list of on-line science courses.