When a colleague proposed a plan two years ago for teaching medical students online, Dr. Stephen Smith admits he was a bit taken aback.
"I thought, wow, this is a crazy idea," said Smith, associate dean at Brown Medical School in Providence, Rhode Island. A sound medical education, after all, traditionally requires some decidedly un-virtual activities, from dissecting cadavers to examining living, breathing patients.
Outlandish as it initially appeared, however, Smith and fellow faculty members eventually warmed to the idea of providing some medical education online. Envisioning an opportunity for students in rural areas, Brown joined more than 30 other institutions to back the International Virtual Medical School, a pilot program for delivering medical education online.
The program, which will debut this year at England's Hull York Medical School, incorporates virtual case studies of patients to test students' diagnostic skills. Smith, who helped develop the program, plans to incorporate the case studies into a broader curriculum allowing students to complete the first half of medical school remotely, combining online courses with training at local clinics.
"The majority of time in the first two years of medical school is in that cognitive mode of learning a lot of material and isn't that hands-on," Smith said. "That's the aspect of medical education that we're focusing on."
While medical school is perhaps one of the less obvious candidates for Internet education, it's one of many traditionally campus-based programs that are experimenting with virtual components. In the related field of nursing, students can take courses over the Net while carrying out practical training at a local clinic.
Frank Mayadas, program director for online education at the Alfred P. Sloan Foundation in New York, said the approach of combining Internet learning with practical training is gaining ground as educators become more confident in the viability of structuring courses online.
"From my point of view, anything that people want to learn and they're motivated to learn should be available online just as much as it's available in a classroom," he said. "It's, to my way of thinking, a democratizing aspect of education."
It's not just medical education that is expanding online. While universities have been offering degree programs in fields like accounting, business administration and information technology for years, some have more recently branched out into fields in the sciences and humanities.
The University of Maryland University College, for example, recently began offering degrees in biotechnology studies. But to make the program suitable for online learning, administrators said, they focused more on management and policy issues than on hard science.
According to Mayadas, universities are still reluctant to attempt online learning in areas like chemistry or undergraduate physics, where laboratory work is a key component. While he expects educators will find ways to present even such difficult areas online, significant hurdles still need to be overcome.
For Dr. Ronald Harden, director of education at the International Virtual Medical School and one of its founders, the experiment in two years of virtual medical education is intended as a first step.
Eventually, Harden said, he would like to be able to offer a full medical degree through distance learning, with some online classes and local clinics serving as hands-on training grounds. He also envisions an international certification for graduates of the program.
Brown's Smith, however, said that, for the time being, two years is a radical enough proposition for a field not known for a trailblazing approach to education.
"There's still a lot of skepticism and hesitancy," he said. "The medical profession is a fairly conservative and traditional profession, so there are still a lot of people to be convinced."
