EMERGING CHALLENGES IN

MEDICAL EDUCATION
NEED FOR ELECTRONIC RESOURCES

Dr.T.V.Rao MD

Dr.T.V.Rao MD 1
 Rapidly changing Medical Education
System
• Indian medical education system has seen rapid
growth in the last two decades. From a miniscule
number, private medical colleges have grown to
account for more than half of the 270 medical
colleges in 2008 and consequently, India has the
highest number of medical educators in the world.
This unregulated unequal growth brings two issues to
focus: the failing quality of medical education and
implementing effective solutions to address an
artificial faulty shortage due to doctor mal-
distribution.

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Can the Seniors cope up with Demands ?
• Increasing the retirement age
of Medical teachers up to 70
years will harness hard earned
medical experience of senior
professors to guide
preparation of efficient faculty
and will reemploy retired
teachers . This will also lead to
discipline enforcement, more
projects.
Will it prove right ? as Medical
Profession Watches

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Are we teaching right content for future
Doctors

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 Today’s Challenges in Medical
Education
• Today’s medical educators are facing different
challenges than their predecessors in teaching
tomorrow’s physicians. In the past few decades,
changes in health care delivery and advances in
medicine have increased demands on academic
faculty, resulting in less time for teaching than has
previously been the case.

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Traditional Education Methods Need
Change
• Traditionally, medical education had as its foundation
a combination of didactic instruction in the classroom
and integrated, hands-on "Socratic Method" learning
in the clinical setting. Of late, there has been an
increase in the use of problem-based learning
discussions (PBLD's) in an effort to integrate basic
science knowledge and clinical decision making with a
goal of teaching critical decision making skills to
upcoming physicians and other health care providers.

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We are all familiar with Pedagogy?
– The work of a teacher; the art and science of teaching;
instructional methods and strategies.
– The linked processes of teaching and learning.
– Teaching; assisting students through interaction and
activity in the ongoing academic and social events of
the classroom.
– Pedagogy is the study of the methods and application
of educational theory to create learning contexts and
environments.

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 Pros and Cons of Didactic Lectures
• Traditional didactic • The traditional didactic
lectures address the lecture is more passive
delivery of factual in nature and less
knowledge; however effective as a teaching
one can question both tool compared with
the effectiveness as active learning
well as efficiency of methods
this mode of
education.
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 Teaching helps in Knowledge Transfer
• Effective knowledge transfer is of paramount
importance for the maintenance and
advancement of our health care system. In any
discipline, effective knowledge transfers consists
of delivery of factual knowledge about the topic
and exposure to tools and thinking processes
required to make critical decisions about the
information at hand.

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 All should accept the power of
Computers
• During the last decade
processes in medical
education have started to
become enriched with
electronic learning and other
Computer Science features
and tools. In the meantime,
pervasive computing has been
gradually integrated in all
facets of everyday life
including the education
process.

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 We are late to adopt New Technologies
• The digital transformation of
all industries is driven by
technology and economics.
• Health care is “late” to the
digital transformation of its
information and work
because it is more complex
& complicated than other
industries.

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 Technology helps to improve
effectiveness
• Simulation
–Ability to show processes in
real time
–Safe environment
–Standards to determine
fitness for practice
–Improvement in teamwork
–Exposure to rare events

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 Internet Technologies
• E-learning is the use of Internet technologies to
enhance knowledge and performance. E-learning
technologies offer learners control over content,
learning sequence, pace of learning, time, and often
media, allowing them to tailor their experiences to
meet their personal learning objectives. In diverse
medical education contexts, e-learning appears to be
at least as effective as traditional instructor-led
methods such as lectures.

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 Learners differ in Requirements
•Different groups have different requirements:
•Learners:
– To learn
•Teachers:
– To support the learning
•Administrators:
– To support the administration of learning
•Technologists:
– To manage the e-learning technologies (performance, security,

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 Resourcing
Deployment Issues

•Provision of effective e-learning is not cheap:

– Who pays?
– What's the rationale: long-term cost savings or
enhanced quality of learning?
– Using / buying e-learning vs. developing e-learning
– Using in-house vs. selling to others
– Training staff
– Training users
Challenges in Knowledge and
Information
• In the current higher
education climate change
for three main reasons: the
way we now view
‘knowledge’; the
information society in which
we are currently immersed;
and the diverse background
and experience of today’s
student population.

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 Teaching aids will change

LCD
Blackboard OHP TV/VHS PC
Whiteboard
 Computers change the basis of
Learning
• In course of time, many modalities and theories
about learning have been elucidated with varying
degrees of effectiveness. With an increasing
prevalence of computers in and out of the
classroom and the development of more
sophisticated web-based tools, knowledge transfer
is increasing going high-tech.

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 What is E-learning?

The use of Internet technologies to

E-learning is Internet
Internet--enabled
deliver a broad array of solutions
learning
that enhance knowledge and
performance
http://www.cisco.com
Rosenberg,
2001

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 Learn the art creating e-learning
Material
• Creating e-learning material
involves several
components: once content
is developed, it must be
managed, delivered, and
standardized.
• Content comprises all
instructional material, which
can range in complexity
from discrete items to larger
instructional modules

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 E-learning
• E-learning is mostly associated
with activities involving
computers and interactive
networks simultaneously. The
computer does not need to be
the central element of the
activity or provide learning
content. However, the
computer and the network
must hold a significant
involvement in the learning
activity.

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Web-based learning
• Web-based learning is
associated with
learning materials
delivered in a Web
browser, including
when the materials are
packaged on CD-ROM
or other media. disk.

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 Truth of e-learning
Internet has started reshaping education.
Education will not be the same in the next decade

There is no going back. The traditional classroom

has to be transformed
Web--based Education Commission, US
Web

Many universities/colleges may not survive

by the end of this decade

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 E-learning: Blended mode

Chalk-and-board has long Interactive Digital Content:

ruled the classrooms • more emphasis
• will not be eliminated • on demand learning
• Less emphasis • interactive

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 The Faculty wishes a change to
Multimedia Teaching
• Faculty, administrators,
and learners find that
multimedia e-learning
enhances both teaching
and learning. These
advantages can be
categorized as targeting
either learning delivery or
learning enhancement

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 Evolution of Education Technology

I
T
Internet:
TIME Greatest
impact

TIME

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 Delivery mode will change

Growing student population More virtual universities

Increase in tuition fee Cost effective solutions

(e.g. e-learning)

Lack of facilities and Privatisation of

funding education
 Building an e-learning culture
Teacher:
Develop knowledge & skills
Understand learning and its need
Facilitate learning
Learner: Create learning opportunities
Self--directed
Self
Self--motivated
Self Building an
Self--regulating
Self E-learning
Lifelong learning Culture

Administrator:
Create Learning environment
Provide ICT infrastructure
Resources for lifelong learning

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Creating e-learning
• Creating e-learning
material involves
several components:
once content is
developed, it must be
managed, delivered,
and standardized.

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 Animations
• An animation is a
simulation of movement
created by displaying a
series of pictures, or
frames.
A cartoon on television is
one example of
animation.
• Animation on computers
is one of the chief
ingredients of multimedia
presentations.
•

Dr.T.V.Rao MD 30
Animation Impresses the Students

• Animations can be
made with special
techniques like Flash
or with image
applications like
Photoshop and
Fireworks and
exported as animated
GIF.
Dr.T.V.Rao MD 31
 Internet creates Resources
• The growth of educational
technologies and the
Internet, the number of e-
learning resources available
to educators has
dramatically increased.
Within medical education,
repositories or digital
libraries have been
established to manage
access to e-learning
materials.

Dr.T.V.Rao MD 32
 Thanks to Internet
• Thanks to the growth of
educational technologies
and the Internet, the
number of e-learning
resources available to
educators has dramatically
increased.
Within medical education,
repositories or digital
libraries have been
established to manage
access to e-learning
materials

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 Blended Teaching Universally Accepted
• The evolutionary approach taken to blended
teaching and learning through adopting
experimental e teaching and e Learning
techniques and technologies allows teaching staff
to adapt to changes in the dynamic of a diverse
student cohort. Optimizing developmental effort
in the more successful areas enables the mix of
techniques to be adaptive.

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 Student interface - functions
• Teaching part
– teaching materials
– solved examples
– lists of questions
– glossaries
– auto tests
• List of tasks and projects
– assignments and evaluations
• Communication tools
– message board
– chat
– discussion forum
• Other tools
– notepad
– links
– download section

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 Teacher interface - functions
• Creating study materials and
sources for studies
– own study materials
– glossaries, lists of terms, solved
problems
– exercises, summaries
– links, recommended sources, ...
• Creating tests
– online test with automatic
evaluation
– offline printed test
• Communication tools
• Assignments of projects and
tasks to students

Dr.T.V.Rao MD 36
 Analog Vs Digital Information Management

Analog
• Data in Atoms
• Information is idiosyncratic
• Organization very costly
• In one place at a time
• Moves at courier speed
• Weight in pounds & tons
• Analysis is extraordinarily
difficult and expensive
• Knowledge is anecdotal and
emotional
Digital
• Data in Bits
• Information is standardized
• Organization Inexpensive
• In many places at a time
• Moves at light speed
• Weightless
• Analysis is fast and inexpensive
• Knowledge is quantifiable and
verifiable

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 E-Learning not as simple as said
by Many
• E-Learning
– It is not a cup of web pages! It is a complex learning
environment!
– We need a possibility professionally to create our
learning materials.
– We need a professional LMS system, which is
compliment with all e-learning relevant standards.
– We need a money and peoples!
– And lot of optimism ☺
Dr.T.V.Rao MD 38
 Acceptance
Deployment Issues

•Is your e-learning:

– An interest of a group of enthusiasts
– A pilot experiment for your department
– Part of your institution's overall strategy
•Small-scale usage:
– Can provide quick, effective solutions
– Danger of lack of sustainability if enthusiasts leave,
priorities change, etc.
– Concept proven – but organisation selects alternative
application for deployment
 Group Exercise
Exercise

•Based on what you have learnt so far you will now:

– Develop a plan for an e-Learning strategy for your
organisation
– Work in small groups
– Selection of groups to report back on key issues
– Team work is the basis of success
 Digitalization helps the Progress of
Institutions
• The purpose of science
• Predict the future to prepare for it and improve it
• Scientific method
• Preventive health care
• Prospective medicine
• Health risk assessments
• Human genome project and genomics

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 Creation of Digital Data Benefits the
Organization
• Safer patient care
• Better informed clinicians
• Better preventive care
• Better informed patients
• Better scheduled and organized care
• Less redundant or unnecessary care
• More efficient and effective use of resources

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 E- learning – Potential area of Research
trends for everyone
• Numerous research opportunities exist in the
relatively new field of e-learning.
• Faculty, administrators, and the public will
demand that educators evaluate the impact of e-
learning on the quality and efficiency of medical
education.
• Extrapolating methods from other clinical and
educational research

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 Integrating E-Learning into
Medical Education
• The integration of e-
learning into existing
medical curricula should
be the result of a well-
devised plan that begins
with a needs assessment
and concludes with the
decision to use e-learning

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 Contribute knowledge on www
• There is evidence for the effectiveness and
acceptance of e-learning within the medical education
community, especially when combined with
traditional teacher led activities in a blended-learning
educational experience. Several digital repositories of
e-learning materials exist, some with peer review,
where instructors or developers can submit materials
for widespread use or retrieve them for IT in Medical
Education Academic Medicine,

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 Get your e-teaching methods reviewed
• The evaluation of e-
learning should include a
peer-review process and
an assessment of
outcomes such as learner
satisfaction, content
usability, and
demonstration of
learning.

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 E-learning changes the future of
Education
• The integration of e-learning into undergraduate,
graduate, and continuing medical education will
promote a shift toward adult learning in medical
education, wherein educators no longer serve
solely as distributors of content, but become
facilitators of learning and assessors of
competency.

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 Seniors need Support and
Encouragement
• Senior users need support and
social encouragement to
overcome stereotypes of
computerspsila complexity and
inappropriatene
• In transition to information
society, a development of new
methods of education,
including e-learning, is
emphasized, and equal access
of all groups of society to
information technologies is
advocated.

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Students expect Newer Technologies
• Internet-savvy students are
coming to Medical colleges
with different expectations,
different skills, and access to
different
resources.…Students are
frustrated and increasingly
dissatisfied by the digital
disconnect they are
experiencing at Medical
colleges.

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Students wish Newer Technologies
The single biggest problem
facing education today is
that our ‘Digital
Immigrant’ instructors,
who speak an outdated
language (that of the pre-
digital age), are struggling
to teach a population that
speaks an entirely new
language.

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We should Adopt to Newer Demands
• Instruction is becoming
more learner-centered,
non-linear, and self-
directed.
• There is a growing
emphasis on academic
accountability.
• Academic emphasis is
shifting from course-
completion to
competency

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Our performance is for Review with
More Eligible Faculty
• Higher education as an
investment opportunity.
Increasingly viewed as
poorly run, low in
productivity, high in cost,
and still not effectively
using technology, the
traditional higher
education community is
seen by the for-profit
sector as the next
health care industry

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E-learning helps young and old

Dr.T.V.Rao MD 53
Created by Dr.T.V.Rao MD for
awareness on e-learning
Email
doctortvrao@gmail.com

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