"Computer-Based-Training - a user´s view"
World Conference on Medical Education
Copenhagen/Lund 2003
Tina Schweickert

Tina: "Not even two weeks ago the IFMSA had its general assembly in Estonia. There I had enough time to talk to a lot of students from different countries and continents. I wouldn't say that this was a scientific poll and I'm not going to publish it either. But the answers the students gave were very similar."

Tina: "My next question was if the students like CBT. The general trend I could see, was a very positive attitude towards computer based training."

Tina: "I think in this round of people we don't have to discuss if CBT is good or not.
Regarding some discussions going on in the medical education world about some totally virtual med schools, I consider the extend to which CBT should be introduced as more important.
Apart from the more or less usual arguments if CBT is a cheap excuse for teachers only not to show up in their classrooms and if life can be really simulated or not, I also want to stress more on one point, which I have the feeling is never considered enough. The impact of CBT on social skills and life style of students."

Tina: "Apart from the more or less usual arguments if CBT is a cheap excuse for teachers only not to show up in their classrooms and if life can be really simulated or not, I want to stress more on one point, which I have the feeling is never considered enough. The impact of CBT on social skills and life style of students.
Within the short time of this talk I find it hard to present a too differentiated point of view. Therefore I want to discuss a black-and-white pictured view on the issue, if you allow me.
When I was thinking of a totally virtual medical school, I had one picture on my mind: the student as a "lonely warrior"; in front of his computer, typing his essays and answering questions given by a tutor somewhere in the www."

Tina: "Communication skills are crucial in the interaction between doctors and patients. Many studies showed the great impact on patient compliance etc (see references on the last slide).
In the end, the patient is the one who should profit most from a good medical education, that is the reason why we are all here. Therefore a highly important issue -such as communication -should be in the focus of education. This was also recommended by huge health care organizations (General Medical Council, Association of American Medical Colleges, etc.)
It was shown that communication skills already deteriorate during studies (Helfer 1970; Poole et al. 1979; Bishop et al 1998; Pfeiffer et al 1998). The totally virtual medical school can not provide the student with an environment that enables him to develop appropriate communication skills.
One proof therefore are the positive effects of communication trainings on communication abilities. Those trainings are always based on the interaction between students, (simulated) patients and teachers (Maguire et al 1986; Sanson-Fisher et al 1981)."

Tina: "How would the lonely warrior behind his/her computer feel and live?
1. It may sound very trivial, but what makes your studies "the studies"; is very often the good friends you gain during your studies. I freely admit that my motivation to go to a lecture was the fact, that I meet my friends and can go to lunch afterwards! But why not? People are social animals.
2. Peer learning- Is a highly effective way to remember facts, helps through motivation deeps and so on
3. I hope everybody in this room can remember how exciting and motivating it was to see a real patient. That is usually the moment, when you remember why you choose for medicine. And that it is worth to stuff all the things the teacher tells you in your head!
4. Which in the end is a profit for the patient- And that's what it's all about- the patient.
5. Every body has a life crisis sometimes, doubts if the study was a good choice etc. The backup your fellow students can give you in such a situation is not comparable to support from other people (family, friends). I assume that a computerized medical school would have great drop out rates for that reason (and point 3.). A lot of students would stop during the first two years.
-> all this would not be possible so easy any more, how could you meet people?"

Tina: "Without a campus or students that don't gather regularly, that any kind of student initiatives a very difficult to organize. I think in the field of ME they would die. But the input from the student side is very important, we are the experts, we have a fresh, unbiased point of view."

Tina: "I put the practical skills in brackets because I didn't mention them before, but I think it's still important to name it."