Truls Østbye (ostbye@uwo.ca) is with the Department of Epidemiology and Biostatistics at the University of Western Ontario in London and is Pro Cultura Visiting Professor at the Medical University of Debrecen, Hungary. Martin White (martin.white@newcastle.ac.uk) is a senior lecturer at the University of Newcastle-upon-Tyne, England. Medical student Gabor Hoffer (gabor@tot.dote.hu) and Professor Ferenc Bojan (bojan@tot.dote.hu) are at the University of Debrecen.
Canadian Medical Association Journal 1995; 153: 1327-1328
[résumé]
In a recent special report published in CMAJ (152: 1303-1307), Beth Ellenberger reviewed Internet resources of interest to physicians. The Internet can also be used in innovative ways to support medical education.
It has been argued that medical students develop a narrow perspective on medicine and health, and that broader exposure to other countries' cultures, diseases and health care systems would be beneficial.[1] Many medical schools provide students with an opportunity to take electives in other countries, but this option may not be available to all students and remains costly and logistically complex.
Electronic mail (e-mail) has become a common tool for international research collaborations and communication. With the fall of the Iron Curtain, collaboration with colleagues in Eastern Europe and the republics of the former Soviet Union is also flourishing.[2] However, e-mail has seen less use for teaching and learning purposes. Despite the hyperbole surrounding computers in education since the late 1960s, their most important use may be as a tool for communication.[3]
During the past academic year, we established a low-cost alternative to out-of-country electives that links universities in Canada (Western Ontario), Hungary (Debrecen) and England (Newcastle-upon-Tyne). In addition to introducing the students to electronic communication, the objective of the project was to further international collaboration and understanding and to emphasize the importance of a population perspective for health and disease. The participants constituted one group of seven medical students at each medical school (first-year students at Western, fourth-year students at Newcastle-upon-Tyne and third-year students at Debrecen).
The electronic exchange was conducted in the context of existing small seminar groups and problem-based learning (PBL) courses.[4] Students were given computer accounts and introduced to each other by tutors via electronic mail. After setting up the initial connections, the tutors played a relatively modest role as facilitators of the ensuing discussion. The students were linked as "triplets" so that each student had one main partner or electronic correspondent in each of the other countries. In addition, a "listserver" was established; if a message was sent to the listserver medex@biostats.uwo.ca, all students automatically received a copy. This allowed for both one-to-one and multiperson discussions. The tutors also received copies of messages sent to the listserver, and so were able to "listen in" on the discussion.
Six exercises, summarized below, were assigned on consecutive weeks:
The differences in scheduling at the three centres created some difficulties: since the terms were not parallel, the period during which all students were available was relatively short. For the future, we plan to integrate the exercise over several terms, thus reducing scheduling problems. We have kept the listserver active, so the students can stay in touch with their international colleagues informally throughout their medical training, and they may, of course, continue to communicate with each other individually.
It is also desirable to coordinate the actual courses with one another so that PBL material can be covered concurrently in the three centres, making it possible for all the students to form one integrated "multinational" PBL group.
Our students found this an enjoyable exercise, and with an increasing number of medical schools around the world joining the Internet, the establishment of similar collaborations elsewhere, in undergraduate as well as postgraduate settings, should be relatively simple.
At a less formal level, there is also scope for more widespread use of e-mail as a way for medical students to communicate with each other within faculties, both nationally and internationally. Students and teachers might also consider making more use of other Internet resources, such as bulletin boards and World Wide Web sites.