Abstract
This reflection is based on the premise that clinical education can be improved by more widespread use of computer-assisted instruction (CAI) and that a roadmap will enable more medical educators to begin using CAI. The rationale for CAI use includes many of its inherent features such as incorporation of multimedia and interactivity yet the use of CAI remains limited, apparently because educators are not convinced about the role for CAI. Barriers to CAI use are discussed including misinterpretation of the literature for CAI effectiveness; a disconnect between CAI developers and the educators who make decisions about CAI use; and the paucity of knowledge regarding how to integrate CAI effectively into clinical education. Specific roles for CAI in undergraduate and graduate medical education can include improving uniformity of instruction, providing documentation of exposure or competence, improving the learners’ educational experience or outcomes, and assessment that is matched to learning. Funding for CAI remains an important barrier but the authors believe that this will be overcome when use of CAI becomes more widespread.
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References
Adler M., Johnson K. (2000) Quantifying the literature of computer-aided instruction in medical education. Academic Medicine 75(10):1025–1028
Bell D., Fonarow G., Hays R., Mangione C. (2000) Self-study from web-based and printed guideline materials. A randomized, controlled trial among resident physicians. Annals of Internal Medicine 132(12):938–946
Carraccio C., Englander R., Wolfsthal S., Martin C., Ferentz K. (2004) Educating the pediatrician of the 21st century: Defining and implementing a competency-based system. Pediatrics, 113(2):252–258
Chumley-Jones H., Dobbie A., Alford C. (2002) Web-based learning: Sound educational method or hype? A review of the evaluation literature. Academic Medicine, 77((10 Suppl)):S86–93
Clayden G., Wilson B. (1988) Computer-assisted learning in medical education. Medical Education, 22(5):456–467
Cook D. (2005) The research we still are not doing: An agenda for the study of computer-based learning. Academic Medicine, 80(6):541–548
Cook D., Dupras D. (2004) A Practical Guide to Developing Effective Web-based Learning. Journal of General Internal Medicine, 19:698–707
Cooksey K., Kohlmeier M., Plaisted C., Adams K., Zeisel S. (2000) Getting nutrition education into medical schools: A computer-based approach. American Journal of Clinical Nutrition, 72(3 Suppl):868S–876S
Desch L. (1995) Pediatric computer-assisted instruction. Archives of Pediatrics & Adolescent Medicine, 149(3):303–304
Eynon, R., Perryer, G. & Walmsley, A. (2003). Dental undergraduate expectations and opinions of Web-based courseware to supplement traditional teaching methods. European Journal of Dental Education Aug; 7(3): 103–110
Falck A., Escobedo M., Baillargeon J., Villard L., Gunkel J. (2003) Proficiency of pediatric residents in performing neonatal endotracheal intubation. Pediatrics, 112(6 Pt 1):1242–1247
Fall L., Berman N., Smith S., White C., Woodhead J., Olson A. (2005) Multi-institutional development and utilization of a computer-assisted learning program for the pediatric clerkship: The CLIPP project. Academic Medicine, 80(9):847–855
Fischer M., Kopp V., Holzer M., Ruderich F., Junger J. (2005) A modified electronic key feature examination for undergraduate medical students: Validation threats and opportunities. Medical Teacher, 27(5):450–455
Fliegel J., Frohna J., Mangrulkar R. (2006) A computer-based OSCE station to measure competence in evidence-based medicine skills in medical students. Academic Medicine, 77(11):1157–1158
Friedman C. (1994) The research we should be doing. Academic Medicine, 69(6):455–457
Gelfand D., Podnos Y., Carmichael J., Saltzman D., Wilson S., Williams R. (2004) Effect of the 80-hour work week on resident burnout. Archives of Surgery, 139(9):933–938
Greenhalgh T. (2001) Computer assisted learning in undergraduate medical education. British Medical Journal, 322:40–44
Gupta B., White D., Walmsley A. (2004) The attitudes of undergraduate students and staff to the use of electronic learning. British Dental Journal, 196(8):487–492
Haluck R. (2000) Computers and virtual reality for surgical education in the 21st century. Archives of Surgery, 135(7):786–792
Hulsman R., Mollema E., Hoos A., de Haes J., Donnison-Speijer J. (2004) Assessment of medical communication skills by computer: Assessment method and student experiences. Medical Education, 38(8):813–824
Issenberg S., Pringle S., Harden R., Khogali S., Gordon M. (2003) Adoption and integration of simulation-based learning technologies into the curriculum of a UK Undergraduate Education Programme. Medical Education, 37(Suppl 1):42–49
Karnath B., Thornton W., Frye A. (2002) Teaching and testing physical examination skills without the use of patients. Academic Medicine, 77(7):753
Keane D., Norman G., Vickers J. (1991) The inadequacy of recent research on computer-assisted instruction. Academic Medicine, 66(8):444–448
Leong S., Baldwin C., Adelman A. (2003) Integrating web-based computer cases into a required clerkship: Development and evaluation. Academic Medicine, 78:295–301
Lyon H., Healy J., Bell J. (1992) PlanAlyzer, an interactive computer-assisted program to teach clinical problem solving in diagnosing anemia and coronary artery disease. Academic Medicine, 67(12):821–828
Maleck M, Fischer M., Kammer B., Zeile C., Mangel E., Schenk F., et al. (2001) Do computers teach better? A media comparison study for case-based teaching in radiology. RadioGraphics, 21:1025–1032
McNulty J., Halama J., Dauzvardis M., Espiritu B. (2000) Evaluation of Web-based computer-aided instruction in a basic science course. Academic Medicine, 75(1):59–65
Norman G., Schmidt H. (1992) The psychological basis of problem-based learning: A review of the evidence. Academic Medicine, 67(9):557–565
Olson A., Woodhead J., Berkow R., Kaufman N., Marshall S. (2000) A national general pediatric clerkship curriculum: The process of development and implementation, Pediatrics, 106(1 Pt 2):216–222
Piemme T. (1988) Computer-assisted learning and evaluation in medicine. Journal of the American Medical Association, 260:367–372
Reeves R., Aschenbrenner J., Wordinger R., Roque R., Sheedlo H. (2004) Improved dissection efficiency in the human gross anatomy laboratory by the integration of computers and modern technology. Clinical Anatomy, 17(4):337–344
Ruiz J., Mintzer M., Leipzig R. (2006) The impact of E-learning in medical education. Academic Medicine, 81(3):207–212
Shea S., Nickerson K. G., Tenenbaum J., Morris T. Q., Rabinowitz D., O’Donnell K., et al. (1996) Compensation to a department of medicine and its faculty members for the teaching of medical students and house staff. New England Journal of Medicine, 334(3):162–167
Steele D., Johnson Palensky J., Lynch T., Lacy N., Duffy S. (2002) Learning preferences, computer attitudes, and student evaluation of computerized instruction. Medical Education, 36(3):225–232
Vogel M., Wood D. (2002) Love it or hate it? Medical students’ attitudes to computer-assisted learning. Medical Education, 36(3):214–215
Acknowledgement
The authors wish to thank Carol Edwards for her outstanding contributions to our collaborative work, and for her editorial assistance in preparing this manuscript.
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Berman, N.B., Fall, L.H., Maloney, C.G. et al. Computer-Assisted Instruction in Clinical Education: a Roadmap to Increasing CAI Implementation. Adv in Health Sci Educ 13, 373–383 (2008). https://doi.org/10.1007/s10459-006-9041-3
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DOI: https://doi.org/10.1007/s10459-006-9041-3