Designing e-learning Systems in Medical Education: A Case Study

Transcription

1 Designing e-learning Systems in Medical Education: A Case Study Abstract Dr. Ahmed. I. Albarrak Family and Community Medicine College of Medicine KSU, Riyadh, KSA albarrak@ksu.edu.sa Purpose: this study represents a case study of King Saud University Hospitals (KSUHs) approach in designing a comprehensive medical e-learning system. This system takes into consideration the special requirements of medical e-learning and how these requirements are best met. Methodology: The study considers the requirements and challenges of medical education and e-learning, proposes strategies and techniques to satisfy these requirements and overcome those challenges, then express how these strategies and techniques are utilized in designing KSUHs e-learning system. Findings: A comprehensive and successful e-learning system can be developed given the techniques and strategies mentioned in this paper. KSUHs combined its database of patient cases with the e-learning systems to provide medical students with all the data they need to succeed in their field. Value: This paper proposes a modern approach that satisfies the special requirements of medical education through the integration between different hospital information systems, and e-learning systems. This integration is indeed required for the success of e-learning in medical environments. Key words: medical education, e-learning, integration, online education, learning management system.

2 1. Introduction For ages, Education has been centered on attending classes day after day, listening to a lecturer who provides the necessary information, and going through exams to assess knowledge. Education focused on the material itself rather than the "learners" and the differences between their capabilities and learning skills (Chen, Kinshuk, Wang,2005). The continuous and rapid advancement in information technology and communications led to the evolution of the e-learning environment. e-learning systems are educational systems that utilize information technology resources such as the Internet, networking, and multimedia applications to enhance the learning process. e-learning environments focus on the "learner" instead of the material itself. They allow the learners to study at their own pace according to their capabilities, communicate with colleagues and teachers through discussion groups and video conferencing, and assess themselves through online tests. e-learning environments provide the learners with the flexibility of studying regardless of their location, and time zone (Anderson,2003). E-learning systems are usually used in distant learning enabling students in different continents to obtain graduate and post graduate degrees. E-learning systems can also be used in conjunction with traditional learning (blended or integrated learning) (Hayashi, Tominaga, Yamasaki, 2006) to expand the resources available for students, and help them focus on their learning objectives. E-learning systems have greatly expanded in recent years. In 2005, about 3.2 million students had one or more online course in the United States (Sloan, 2005). A growing number of universities across the world are now offering many courses that require either no or very

3 little student attendance. E-learning is expected to grow even more with the growth of the Internet and information technology infra-structure. E-learning systems can be divided into four major components (Colace, De Santo, Pietrosanto, 2006); the infra-structure which is responsible for transferring the learning material, as well as providing the physical storage for this material; the learning management system (LMS) which integrates all services for managing teaching and learning activities; the learning content management system (LCMS) provides services for managing content; and the set of tools responsible for distributing content and providing interaction functions. The information content provided is organized in containers called "learning objects" which provide, in addition to the content itself, some descriptive data about the content (meta-data) that facilitates the retrieval of this content. Because of the great importance of e-learning in modern education, and its role in improving the students' performance (Gierde, Pipas, Russell, 2004), King Saud University Hospitals (KSUHS) started to implement a modern e-learning system containing the state-of-art e- learning components. The built system will be used to assist and support the current systems and to provide the students with tools to manage their courses, and assess their knowledge. KSUHS represent the college of medicine, college of dental medicine, King Khaled University Hospital (KKUH), King Abdulaziz University Hospital (KAUH), and King Fahd Cardiology Center (KFCC). The number of students in these colleges is over two thousands, and the number of college staff is over four hundred. The infra-structure in King Saud University (KSU) consists of a 100 Mbps intranet connecting the campus colleges and KKUH together, and a 32 Mbps microwave link connecting the campus to KAUH. The main functions of these hospitals are education, medical research, and providing medical services to the public. According to the Saudi traditions, male and female students are separated in class education but not in practice. The University academic environment encourages the students

4 to do research, and tries to provide them with the necessary tools like skill labs, and anatomy and physiology software packages. 2. Requirements of the e-learning system: The requirements of the e-learning system can be divided into three categories, general requirements, medical e-learning requirements, and KSUHS requirements. 2.1 General requirements: In order for any e-learning system to be successful, it must have some features including flexibility, which allows the system to adapt to the capabilities and goals of every student (Seng, Hok,2003); ease of use, which allows the learner to focus on the material itself rather than focusing on how to use the system (Seng, Hok,2003); interactivity(giroire, Le Calvez,Tisseau,2006), where the learners can interact with each other and with their teachers through video conferencing or discussion boards; and solid infrastructure to support the system and provide the learners with easy and fast access to the system. 2.2 Medical requirements: The nature of medical education adds some requirements to the e-learning system (Mansour, McGregor, Franklin, Poyser, 1992). Some subjects like anatomy and physiology require the students to be able to identify and understand the function of different parts of the body, other subjects like those involving practical medicine require the students to identify symptoms, and examine the patient history. It is not enough to provide the learner with text books and lectures, the learners need to have more details and clarity in order to understand medical subjects well. Therefore, medical e-learning systems must be able to provide the students with the tools to clearly identify and describe different parts of the body including videos and detailed figures; it also must interact with other medical systems to provide students with the medical history of their patients, their

5 X-ray pictures, and their prescribed medicine. Medical e-learning systems require a higher degree of interactivity than other types of e-learning systems in the hospital to allow the students to focus on some symptom for example, and ask specific questions regarding this symptom. 2.3 KSUHS Requirements: In addition to those requirements, KSUHS added more requirements to the desired e- learning system. The system must utilize the most advanced and most recent technologies in e-learning. This system must be scalable to be able to accommodate any increase in the students or university staff. It must be expandable, new features can be added to further improve the functionality of the system. There must be assessment tools both for the students and instructors to assess the students' knowledge. The system must have a web based interface to allow the students to access it using their Internet browsers with no regard to the position of the student. The system must provide class room automation capabilities, and is able to allow lecture broadcasting, and video conferencing. 3. Challenges: There are several challenges facing the deployment of the e-learning system. Some of these challenges are technical, and others are related to the skills of the students and university staff skills. 3.1 Technical challenges: The first technical challenge that faced the deployment of KSUHS e-learning system was the huge amount of information that needed to be included in the content. The content should include the different subjects, the lecture notes, lecture videos, text books, videos of surgeries, etc...this huge content is expensive in terms of both cost and effort, and it needs several servers with storage capacities enough to keep such content.

6 The second challenge was the infrastructure; students needed to have access to the system from everywhere inside the campus as well as outside the campus through the Internet. Access control methods had to be considered to prevent unauthorized access, infrastructure needed to be powerful enough to allow students to access the system reliably and easily. 3.2 Skill challenges: When studies to build the system started, it was necessary to measure the students' information technology skills to assess their readiness for the new system. In order to do this a questionnaire was introduced to the students (AlBarrak, 2005) with questions involving whether they own computers, and how they use computers in general. The result of this questionnaire showed that although the students had reasonable general computer skills, they lacked the capabilities to use their skills in medical study and research. This result proved that students should receive proper training in order to utilize the system in the best way, and urged us to add courses in medical informatics to the students. When the skills of the teaching staff were examined, it was observed that many of them also lacked the necessary skills to use this system in the best way (AlBarrak, AlGhammas, 2006). The above challenges had some impact on the design of our e-learning system as will be discussed in the next section. 4. System Design: The first step in designing the system was to build a model that takes into consideration the entire general, medical, and KSUHS requirements. This model should also overcome all challenges that may appear.

7 Figure 1 shows the model used to define the different components of the system. It also shows the system phases As figure 2 shows, we decided to build the system in a three phase procedure. In the first phase, classroom automation devices like interactive boards, control stations, projectors, audio visual equipment, document cameras as well as necessary software are installed. It was decided to install these devices in fifteen locations to start with; these locations included three remote classrooms, as well as six mobile classrooms to be set up as needed. The first phase also includes the installation of video conferencing equipment like cameras, voice recognition devices, and software. The video portal is also a part of this phase and it provides a searchable content database, live video, and video-on-demand capabilities. In this phase, data from classrooms (documents, notes, videos ) are uploaded into the portal which can be used by the students either to participate in the lecture live or for later use when they are studying at home. The portal will have a web interface to facilitate student and staff access. In order to support this phase, the network infrastructure is upgraded. KAUH local area network (LAN) is upgraded to support the new system capabilities, wireless networks are installed in KAUH and the faculty of medicine to allow students to access the system using wireless enabled devices like laptops, and necessary servers to carry the database and video files are installed and connected to the current network. The second phase includes the installation of an advanced LMS system to allow the learners to customize the content according to their needs and goals. This phase will also focus on enhancing the collaborative learning by introducing discussion boards and different collaboration tools to allow the students to interact with each other and with their instructors and professors to further improve their learning and understanding as previous studies have showed (Whitis, 2001) (Castle, 1963).

8 The third phase provides the instructors with the tools to build and publish their own content (lectures, books, notes ) and provides assessment tools for the students and the instructors. This phase will also allow the instructors to follow up the progress of their students and if they are spending enough hours reviewing the content. There is another important part of this phase as well which is providing the necessary interaction between the e-learning system and other hospital systems including the hospital information system (HIS), and surgery videos from the operating room which may be instructive to the students. This model fulfils all the requirements for the e-learning system. It is interactive, easy to use through its web interface; it contains the necessary servers and infrastructure to carry the bandwidth and storage consuming videos and presentations; it is expandable and scalable because it follows international standards and can accommodate any new component; it interacts with different hospital systems; it provides class room automation, and lecture broadcasting; and it is an up-to-date system. Figure 2 shows the level of interaction for the students and instructors with the system, as well as the integration of the system with the existing hospital systems. This figure shows clearly how this e-learning system will increase the level of involvement for both students and instructors with the system, and how the integration process will enhance the learning experience for the students. The three phase design has some important advantages in handling the different challenges. The first phase will provide the students with a starting point where they can use the skills they already have to benefit from the system and enhance their learning experience; it also gives them the chance to enhance their capabilities in medical informatics and computer skills making them ready for phase two where the features of collaborative learning are added to the

9 system. This will make the students comfortable with using the system and prevent any disappointment that may prevent them from benefiting from the system. For the instructors, this design will also give them the chance to gradually improve their information technology skills, and start benefiting from the system before they are asked to interact with the students in phase 2 and build their own content in phase 3. The first phase will help build a huge content (lecture notes, videos ) that will be added to the system and will decrease the effort and cost of building content from scratch. Besides the execution of these phases, there will be continuous training for both the students and the instructors to maximize their benefit from the system and to get them ready for next phases. 5. Future additions: There are many extensions that can be made to the system in the future. One of the important additions is sharing the content with different institutes in the kingdom, and in the world which can improve the quality of learning in KSUHS and medical institutes around the world. The expandability of the system will enable the addition of any new tool or feature that may appear and to take advantage of the latest developments in e-learning technology. 6. Conclusion: The advances in information technology and e-learning made KSUHS keen to utilize this technology to enrich the learning environment, and to provide the students with the tools to enhance their learning capabilities. It is believed in KSUHS that integrating an e-learning system with traditional classroom teaching is the best approach for the students. The model discussed in this paper is a student centered model that uses both traditional and e-learning systems to provide the students with the flexibility they need to learn at their own pace and according to their needs, and to solve problems like lack of space in operating rooms and practical classes. The model introduces a high level of interactivity further enhancing learning

10 capabilities. The three phase design simplifies the change management process, and improves the students and instructors capabilities to use the system in the optimum way. 7. References: AlBarrak, Medical informatics in undergraduate medical study. Technology and Health Care; Volume 13, Issue 5; Pages: AlBarrak, AlGhammas, Information Technology in Medical and Patient Education. First International Conference & Exhibition on e-learning; April Anderson, Modes of interaction in distance education: Recent developments and research questions; Moore, M. G. & Anderson, W. G. (eds.), Handbook of Distance Education; Lawrence Erlbaum Associates, N. J. Castle, Open-Circuit Television in Postgraduate medical Education. Journal of Medical Education 1963; 38: Chen, Kinshuk, Wang, Cyber Schooling Framework: Improving Mobility and Situated Learning. Fifth IEEE International Conference on Advanced Learning Technologies; Taiwan. Colace, De Santo, Pietrosanto, Evaluation Models for e-learning Platform: an AHP approach. The 36 th ASEE/IEEE Frontiers in Education Conference; San Diego, CA. Gierde, Pipas, Russell, Teaching of medical informatics in UME-21 medical schools: best practices and useful resources. Fam Med United States, Jan 2004; 36: S68-73.

11 Giroire, Le Calvez,Tisseau, Benefits of knowledge-based interactive learning environments: A case in combinatorics. Proceedings of the Sixth International Conference on Advanced Learning Technologies. Hayashi, Tominaga, Yamasaki, 2006 Blended learning contents for university education. The 7 th International conference on Information Technology Based Higher Education and Training. Mansour, McGregor, Franklin, Poyser, Intelligent Medical Multimedia-Based Tutoring Systems: Design Issues. IEEE Colloquium on Intelligent Decision Support Systems and Medicine. Seng, Hok, Humanizing e-learning International Conference on Cyberworlds, Singapore. The Sloan Consortium; "Growing by Degrees: Online Education in the United States, 2005"; Whitis, A Survey of Technology-Based distance Education: Emerging Issues and Lessons Learned. Association of Academic Health Centers; WashingtonDC.

12 Tools (Content authoring tools, assessment tools ) Phase III LMS (Customizing content to students' learning styles, discussion boards, collaborative learning ) Phase II Portal (Live and on-demand videos, lecture notes ) Automated Classrooms (Intelligent boards, video capturing devices, video publishing equipment ) Infra-structure (Servers, Wired/wireless network ) Phase I Figure.1. System Model and phases

13 Student interaction Interactive Phase 3 Integrated with HIS, PACS & EMR Teacher interaction Interactive Interactive Phase 2 Integrated with HIS, PACS & EMR Interactive Access Portal Access Access Automated classroom Interactive Figure.2. Interaction and Integration of the system