Computer assisted Learning

Dr.G.Sidhartha Kiran

Recent advances in technology have resulted in an everexpanding body of medical literature.

While this growth faces physicians and medical trainees
with a challenge in keeping up to date, the technologies
that have facilitated the expansion may also provide
doctors and students with new methods of learning.

Computer-assisted learning has the potential to enhance

medical teaching.

The computer can be made

to assist learning in many ways:
1. Dense storage of data in an organised form, e.g., a large
textbook could be stored in a classified manner on a 13 cm.
disk.

2. Quick access to the data-base in milli-seconds.

3. Logical comparison of the learner's respon-ses with the stored
key and evaluation of the learner's performance.
4. Instant feedback of evaluation (both forma-tive and
summative types).

Computer as a Teacher
The computer can never replace a teacher. It merely
complements a teacher's role. However, in some areas of
interaction, it may be better than a human teacher. e.g.,
1. It never gets bored or irritated
2. It never makes mistakes on its own
3. It permits individual attention
4. It permits the learner to decide his own pace of learning.
5. A well created lesson uses multi-media to enrich and enhance
learning.

Roles for Computer in CAL

A variety of roles/modes are possible in CAL, giving much flexibility.

a) Drill and Practice mode

b) Tutorial mode

c)Laboratory mode
d) Case-simulation mode
e) Consultant Mode
f) Manager of Educational Process

a) Drill and Practice mode:

The learner can learn facts and memorise them by the
drill-method (e.g., use an MCQ bank for practice).

b) Tutorial mode:
In this mode, a module (lesson)consists of presentation of the
content in a structured way,task-prescription to elicit learner's
response, and instant feedback and reinforcement to the
learner.

This mode, if used well, could result in 90% retention of the

content (compare with 30% retention after the best lecture!).

c) Laboratory mode:
The computer could be programmed to simulate a variety of
biological processes to supplement or do away with laboratory
experiments.
The learner explores various options and learns by inference.

d) Case-simulation mode:
A variety of diagnostic and therapeutic problems of the
patient management type could be effectively computerised.
This has proved quite useful in learning problem-solving, the
highest cognitive domain.
Simulated Patient Management Problems (SPMP) is one of
the most useful areas of CAL in medical education.

e) Consultant Mode:
It is one of the frontier areas now.
Knowledge based "Expert" program-mes have been devised using
artificial intelligence.

These could bring the expertise of a consultant within easy reach

of a primary care physician.
Real life experts are also accessible by videoconferencing.

f) Manager of Educational Process:

Computer based management-information-system (MIS) could
keep track of student performance and offer suitable advice to
make the process more effective (see HMIS).

The Current Use of CAL in Medical Education

Medical educators already make use of CAL to provide students
with increased exposure in their respective fields.
This can allow for students to learn at a time and location that is
convenient for them, as long as there is a computer available to
work at.
In addition to the implementation of CAL in UME, there has been a
shift toward the use of CAL for continuing medical education (CME).
By 2003, there were over 11,000 online CME courses available.
Additionally, accredited CAL modules may be used to obtain credit
when they meet the requirements of the Structured Learning
Projects category, which has no cap for credit hours.

Advantages of CAL

In principle, computerassisted learning can be done at the

individual's convenience and pace, and the same material is available
to a large number of people over a wide geographical area, which
standardizes the learning experience whenever the learner logs on.

CAL applications are of particular value for highly visual content, such
as demonstrations of surgical procedures and technical skills.
While print-based learning materials are mainly limited to text and
image based information, CAL can additionally utilize multimedia
capabilities.

CAL can be designed to incorporate not only text images but also
video to enhance student learning.

Interactive features of CAL, such as quizzes and learning games, can

augment the learning process by providing feedback in a manner that
makes students feel comfortable.

Disadvantages of CAL
The development of hightech computerassisted learning
programmes is labour intensive, requiring appropriate hardware,
backup and frequent upgrading.

In addition, a dedicated information technology staff is necessary

to provide practical advice and maintenance of the software and
hardware.

Some people may be less inclined to use electronic resources

because of perceived lack of computer literacy.

A study by Church et al. showed that in a survey of 489 medical registrars,

76% had Internet access at work and 30% at home; 24% reported no
access.

Debate
Currently, there is debate as to the effectiveness of CAL as a
teaching modality.
There are several studies that have compared the use of
CAL to other methods of education.
Many of these studies show that there is no significant
difference in knowledge and skill retention between those
taught didactically or by seminar when compared to those
taught by computer teaching modules.
some studies suggesting that other forms of teaching (e.g.
didactic lecture) are still superior.

The Future of CAL

While research is still ongoing into the effectiveness of CAL for medical
education, this new learning modality is a rising form of medical
teaching.
The Association of American Medical Colleges (AAMC) has established
MedEd Portal, a peer-reviewed collection of online teaching tools.
This resource contains a database of learning resources that include
tutorials, virtual patients and case-based learning among other medical
education resources.
Not only does the MedEd Portal provide easy access to CAL modules,
but it also provides incentive to academic physicians to create more CAL
tools by providing their work with recognition as a peer-reviewed
publication.

The Future of CAL

Initiatives such as this will likely increase the production of CAL
modules.
The use of computer-based teaching in medicine has the
potential to change the way medicine is taught to both current
and future generations.
Between the conveniences afforded by CAL, enhancements over
current learning modalities and increased recognition for
publishing CAL modules, there appears to be a bright future for
computer-assisted learning.

References
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