Technological advance has had a profound impact on medicine over the past century. From the discovery of new forms of drugs such as anti-biotics to the development of devices such as magnetic resonance image scanners, the benefits of these advances have been shared by all of us.
But there are other, quieter advances which are also having a significant impact on medicine. The information revolution has improved the practice of medicine in many ways. From improved recordkeeping to access to the latest research on the Internet, the medical profession has benefited greatly. And now it is the turn of medical students with the introduction of information technology (IT) to medical education.
In 1999, the RCSI became the first medical college in Europe to issue all students with laptop computers. These machines are equipped with built-in modems, CD-ROM drives, Ethernet ports and can use wireless technology. Combined with the college's own impressive IT infrastructure, the laptops have enabled students to avail of computer-aided learning in the classroom, distance education and even exams on computer.
In this last respect the college created medical history with the completion by medical students of the first examination using computers in 1999. The first-year histology exam was provided to students through the college's intranet. Most students took the exam from one of the college's computer rooms but some took it from home and a few completed it from London.
Professor Stanley Monkhouse, who organised the ground-breaking histology exam, says that IT has a very significant role to play in medical education but should not be overestimated. "For the part of medical education that involves understanding the scientific background of treatment, it is equally as, or even more, useful than other types of education," he says. "But you will never replace the hands-on training element. Even in the sci-fi future of virtual reality you won't replace this element.
"Of course, there are some practical areas where it might help such as in the simulation of certain tasks requiring manual dexterity. The patient will become less of a guinea pig in such circumstances and this is to be welcomed."
Looking to the future Stanley Monkhouse is already seeing significant advances in the use of IT in medical education. "There are some surprisingly good interactive education programmes being designed by Swiss and US physicians," he says. "There is even a simulation of a conversation with a patient and the voice recognition facility is very good. Of course, the computer simulation is not as responsive as a `live' patient but it is still quite useful in terms of teaching the basics of patient interaction."
Another reason for the growth in the use of IT programmes such as this one is more limited access to patients. "Patients are in hospital much shorter now and, while they are in hospital, they tend to be more ill than in the past," says prof Monkhouse. "This means that there is less of an opportunity for trainees to talk to patients than in the past. This also means that it is more difficult to assess students in an examination context."
WHILE the use of IT as a method of delivering education is becoming more important, there is also a role for IT training itself. "As patient records are increasingly being computerised doctors really have to be up to date with the technology," he says. "The issue of laptops to every student here - the idea of deputy registrar Michael Hogan - has been very important in this regard. This makes us almost unique in Ireland and means that all of our students will leave with a good understanding of computer technology. They have to be.
"More and more patients are looking up their symptoms and conditions on the Internet and doctors have to be aware of this and keeping up to date with their own research. Education never stops and medical science keeps changing. The body doesn't change, but the methods of treating do and the Internet is a very powerful tool for keeping abreast of these changes."
He sees the possibility for IT and the Internet to make profound changes in the way medicine is taught in the future, but also cautions that the profession is more noted for reckless conservatism than radicalism. "The extensive use of IT could mean that all of the scientific aspects of the medical degree could be taught over the Internet and at a distance, while the practical, hands-on training elements would be grouped together in modules rather like Open University summer schools. But I don't see any rapid change in that direction in the future.
"The medical profession is naturally very conservative and will not make any changes unless it is sure that they will be to the ultimate benefit of the profession and to patients."
