Reduced funding, rising student numbers, geographical dispersal, and increased competition in a complex global market have put medical schools under pressure to embrace computer assisted learning

New technologies may have important educational advantages, but without support and training for staff and students they could prove an expensive disaster

Expansion of computer assisted learning requires cultural change as well as careful strategic planning, resource sharing, staff incentives, active promotion of multidisciplinary working, and effective quality control

It is becoming “a truth universally acknowledged” that the education of undergraduate medical students will be enhanced through the use of computer assisted learning. Access to the wide range of online options illustrated in the figure must surely make learning more exciting, effective, and likely to be retained. This assumption is potentially but by no means inevitably correct.

Deans of medical faculties often receive requests for development funding for computer assisted learning projects. Decisions to introduce these projects into the undergraduate curriculum are generally justified by one or more of the arguments listed in box 1.

Box 1: Why fund computer assisted learning?

Computer assisted learning is inevitable–Individual lecturers and departments are already beginning to introduce a wide range of computer based applications, sometimes in a haphazard way. Planned and coordinated development is better than indiscriminate expansion

It is convenient and flexible–Courses supported by computer assisted learning applications may require fewer face to face lectures and seminars and place fewer geographical and temporal constraints on staff and students. Students at peripheral hospitals or primary care centres may benefit in particular

Unique presentational benefits–Computer presentation is particularly suited to subjects that are visually intensive, detail oriented, and difficult to conceptualise, such as complex biochemical processes or microscopic images.[1] Furthermore, “virtual” cases may reduce the need to use animal or human tissue in learning

Personalised learning–Each learner can progress at his or her preferred pace. They can repeat, interrupt, and resume at will, which may have particular advantages for weaker students

Economies of scale–Once an application has been set up, the incremental cost of offering it to additional students is relatively small

Competitive advantage–Potential applicants may use the quality of information technology to discriminate between medical schools. A “leading edge” virtual campus is likely to attract good students

Achieves the ultimate goal of higher education–The goal is to link people into learning communities. Computer applications, especially the internet and world wide web, are an extremely efficient way of doing this[2]

Expands pedagogical horizons–The most controversial argument for using computer assisted learning in higher education is the alleged ability of the virtual campus to alter fundamentally the relation between people and knowledge[3]

Developing applications

Computer assisted learning applications generally require the student to follow the content without immediate or direct supervision from the tutor. But the computer can be a temperamental and unforgiving beast, and computer assisted learning applications must therefore embody the quality features described in box 2. For all these reasons, computer assisted learning materials are initially much more labour intensive and time consuming to prepare than most face to face courses, and they often require input from fairly senior members of staff. Once the basic format is agreed and the initial materials have been written, however, materials can be maintained and updated relatively easily and by more junior members. Off the shelf templates that allow someone with no specific training to produce materials of professional quality are increasingly available. Introducing computer assisted learning technologies into a traditional course will generally occur in stages, as described in box 3. Adapting pre-existing materials designed as handouts or revision notes can sometimes save considerable time.

Box 2: Quality features of applications

Open learning (self study) materials–Applications must be prepared in advance, cover explicit course aims and learning objectives, and include a high degree of “signposting,” explanatory text, and trouble shooting information

Website design–Websites should have a logical structure and sequence, utilise features such as hypertext and graphics, and include links to public access, web based materials such as electronic journals where appropriate

Technical design–Applications must be user friendly and operate effectively within the hardware and software constraints of the end user

University culture–Applications must present an academic ethos in the untidy, commercial, and laissez-faire culture of web based publishing and protect the student from the distractions of the internet