Simon Carlile, Department of Educational Development and Evaluation, Faculty of Medicine University of Sydney, N.S.W. 2006 and Department of Physiology, University of Sydney, N.S.W. 2006. Phone 02-9351-3205 Fax: 02-9351-2058 simonc@physiol.usyd.edu.au
Ann Sefton, Department of Educational Development and Evaluation, Faculty of Medicine University of Sydney, N.S.W. 2006 and Department of Physiology, University of Sydney, N.S.W. 2006. Phone 02-9351-3120 Fax: 02-9351-6646 anns@physiol.usyd.edu.au
James Uther, MedEdNet implementation group, Department of Educational Development and Evaluation, Faculty of Medicine University of Sydney, N.S.W. 2006. Phone 02-9351-7325 Fax: 02-9351-6646 hemul@gmp.usyd.edu.au
Stewart Barnet, Department of Educational Development and Evaluation, Faculty of Medicine University of Sydney, N.S.W. 2006. Phone 02-9351-5677 Fax: 02-9351-16646 sbarnet@medicine.usyd.edu.au
Intranet, medical curriculum development, medical informatics, problem based learning, learning resources, Australia
Medical teaching at the University of Sydney has moved from a six year undergraduate program based on a traditional didactic teaching model to a four year graduate program based on problem based learning principals which integrates clinical experience from the very beginning [HREF 1]. Information technology and informatics have been deeply embedded into the new program by delivering the majority of the teaching and learning resources to support student centred learning over a Faculty wide intranet. This system has also been exploited for the development of the curriculum, coordinating the contributions of more than 400 members of Faculty using email and digital document management based around Web server publication. A number of evaluation projects are also being developed which examine how the resources are utilized to support learning and the subsequent learning outcomes.
Medical education has recently been under considerable review: see for example "Tomorrow's Doctors", (GMC (UK), 1993) and "Physicians for the twenty first century" (AAMC (USA), 1984). These reports argue that an appropriate response to explosion of information that informs medical best practice is a shift in focus from teaching content to process and integration of the preclinical and clinical components. This is resulting in a number of major teaching initiatives in the UK and north America. Additionally, in Australia, three medical schools are moving from an undergraduate program to a graduate medical program and coupling this with a shift from a didactic teaching model to one of problem-based learning (see Sefton, 1995). These are also occurring in parallel with the explosive growth of the WWW and a maturation of these technologies.
There are three fundamental changes in the practice of medicine that now inform the methods we use in teaching medicine.
As computer systems are central to these themes it becomes critical that clinicians are appropriately trained to become sophisticated and comfortable users of these technologies.
We have exploited the University ATM backbone together with fibre, microwave and ISDN connections to teaching hospitals to facilitate Web-based communications to both on and off campus teaching areas in the Faculty. The systems need to provide high availability and very short response times. On campus the site is driven by two Sun Enterprise 2 servers in redundant configuration. The servers delivery to the ATM at 100Mb/sec and all of the campus based workstations are on switched ethernet at 10Mb/sec. There are about 100 workstations of campus (PentiumPro and Mac 7600) each with an Apple1710 audiovisual monitor. Each hospital teaching sites has a server (Sun Ultra 1) and a number of workstations appropriate to the number of students at each site. The Netscape SuiteSpot range of servers provides publishing, email and news services and we have standardized on Netscape clients. Cacheing is used extensively at all sites not only to speed up external access but to also allow tracking of external resource usage (see below). The workstation administration model is netcentric to provide a development path that incorporates emerging NC technologies.
There are considerable learning resources that need to be deployed to support problem-based learning. The first two years of the medical program are comprised of 70 medical problems which act as a vehicle for some 540 learning topics. Each problem and learning topic is supported by rich multi-media resources in the form of text, images (moving and still) and sound. The intranet also links to large biomedical databases, including Medline, the Cochrane databases, EMbase, etc., as well as links to the global database of the World Wide Web.
Electronic mail and electronic forums have been enabled for all students and Faculty. The eforums allow interesting discussions that have begun within small groups of students studying each of the problems to propagate out into the whole of the student body and also involve the relevant members of faculty. Some staff are offering "virtual office" hours with a promise to turn around email within some reasonable period, say, 24 to 48 hours, rather than require that the students visit their laboratories or rooms during designated times slots.
Student self-evaluation is encouraged by providing formative assessment modules associated with each of the learning topics. Formative assessment encourages habitual self-evaluation by the students and the students also get important feedback about whether their level of understanding of any particular learning topic corresponds with the intentions of the curriculum designers.
Continuous online feedback from students to designers about preferred learning sequences is helping the site to evolve from one which reflects the faculty's "construction" of the program's content to one which better supports problem solving, encouraging students to develop their own independent learning strategies and knowledge constructs. The faculty's view of the program is preserved on a separate site and used for ongoing curriculum development. This evolutionary process plus the quick response time of the email feedback system has given the site an educational life of its own.
The use of an intranet to deliver curriculum resources allows detailed tracking of their usage and provides important data for curriculum evaluation. In addition, performance on the formative assessment modules also provides information about the development of knowledge within individuals or groups of students. When combined with summative assessment performance and survey and interview data this provides an enormously powerful mechanism for evaluating the teaching efficacy of the application of information technology in the new curriculum.
AAMC. (1984). Physicians in the 21st Century: The GPEP report. Association of American Medical Colleges, Washington DC.
GMC (1993). Tomorrow's doctors. General Medical Council, London.
Coiera, E. (1994). Medical Informatics. Medical Journal of Australia 160, 438-440.
Sefton, A. J. (1995). Australian medical education in a time of change: a view from the University of Sydney. Medical Education 29, 181-186.
HREF1 http://blackburn.med.su.oz.au:80/medfac/teaching/gmp/index.html
HREF2 http://www.gmp.usyd.edu.au
Simon Carlile, Ann Sefton, James Uther, Stewart Barnet ©, 1997. The authors assigns to Southern Cross University and other educational and non-profit institutions a non-exclusive license to use this document for personal use and in courses of instruction provided that the article is used in full and this copyright statement is reproduced. The authors also grants a non-exclusive license to Southern Cross University to publish this document in full on the World Wide Web and on CD-ROM and in printed form with the conference papers, and for the document to be published on mirrors on the World Wide Web. Any other usage is prohibited without the express permission of the authors.
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AusWeb97 Third Australian World Wide Web Conference, 5-9 July 1997, Southern Cross University, PO Box 157, Lismore NSW 2480, Australia Email: AusWeb97@scu.edu.au