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Possibilities and Limitations of E-learning in Medical Education Eun-Jung Im, PhD Office of Medical Education / Department of Medical Education, Kyungpook National University School of Medicine Tel : 053)420-4904 Fax: 053)420-1369 E-mail: eunjim@knu.ac.kr Abstract The purpose of this study is to review a variety of e-learning use in medical education, and to analyze the e-learning related research in medical education, finally to discuss possibilities and limitations of e-learning in future. Subjects of this research are 46 papers published in Korean Medical Database, PubMed, MEDLIS, RISS4U. Content analysis of 46 papers have been conducted based on the period of research, research methods, research subjects, study personnel, effectiveness. The results are as follows. First, various e-learning, such as hyper-media, simulation-based medical education (SBME), game-based learning, web-based learning, computer-based test (CBT) are implemented in medical education. Second, 35 research (76.1%) has verified the positive effect of e-learning. Third, in the case of Korean studies, experimental studies (46.2%) in a short period (46.2%) of 50-100 people (42.3%) to take the most. As a result, it is reported a lack of theoretical discussion and insight on e-learning compared to foreign research. Educational paradigms are currently shifting from off-line to on-line, from traditional classroom lecture to e-learning. But e-learning is not a substitution to traditional teaching, but a matter of choice. The choice is up to medical professors and students. Key Words: On-line, Hypermedia, Distance learning, Medical Education 21

KOREAN MEDICAL EDUCATION REVIEW JUNE 30, 2009 22

POSSIBILITIES AND LIMITATIONS OF E-LEARNING IN MEDICAL EDUCATION Fig. 1. Example of using hypermedia in medical education: www.mededu.or.kr Fig. 2. Example of using hypermedia in medical education: www.argosymedical.com 23

KOREAN MEDICAL EDUCATION REVIEW JUNE 30, 2009 Fig. 3. Example of using micro-simulation in medical education: screen of microsim made by Laerdal Medical (www.laerdal.co.kr) Fig. 4. Example of using game in medical education: screen of medical game, Remission(www.re-mission.net) 24

POSSIBILITIES AND LIMITATIONS OF E-LEARNING IN MEDICAL EDUCATION Fig. 5. Example of using CBT(Computer-Based Test) in medical education: screen of CBT in Kyungpook National University School of Medicine 25

KOREAN MEDICAL EDUCATION REVIEW JUNE 30, 2009 Table I. Analysis table of 46 studies on e-learning in medical education 26

POSSIBILITIES AND LIMITATIONS OF E-LEARNING IN MEDICAL EDUCATION 27

KOREAN MEDICAL EDUCATION REVIEW JUNE 30, 2009 Table II. Summary analysis of studies on e-learning in medical education based on research methods, subjects, study personnel, the period of research, effectiveness. 28

POSSIBILITIES AND LIMITATIONS OF E-LEARNING IN MEDICAL EDUCATION 29

KOREAN MEDICAL EDUCATION REVIEW JUNE 30, 2009 30

POSSIBILITIES AND LIMITATIONS OF E-LEARNING IN MEDICAL EDUCATION 31

KOREAN MEDICAL EDUCATION REVIEW JUNE 30, 2009 (2007).. 2 V: Technology, 129-135. (2005). :., 12(3), 290-297. (2000).., 12(1), 35-43. (2002).., 14(1), 61-71.,,, (2006).., 18(2), 183-192. (2008).., 20(4), 548-560.,,,,,,,,,,,,, (2006).., 18(2), 161-170.,,,,,,, (1998). - -., 5(1), 81-93. (2005).., 48(3), 267-276.,, (1999).., 11(1), 77-81. (2006).., 12(1), 87-105.,,,,,,,,,,, (2008). Computer-Based Test(CBT) CBT., 20(2), 145-154. (2003).., 30(2), 137-161.,,, (2005).., 17(3), 267-274. Baranowski, T., Buday, R., Thompson, D.I., & Baranowski, J.(2008). Playing for real: video games and stories for health-related behavior change. Am J Prev Med, 34(1), 74-82. Begg, M.(2008). Leveraging game-informed healthcare education. Med Teach, 30(2), 155-158. Brezinka, V.(2008). Treasure hunt-a serious game to support psychotherapeutic treatment of children. Stud Health Technol Inform, 136, 71-76. Good, M.L.(2003). Patient simulation for training basic and advanced clinical skills. Med Educ, 37, 14-21. Hammond, J.(2004). Simulation in critical care and trauma education and training. Curr Opin Crit Care, 10(5), 325-329. Hammoud, M.M., & Barclay, M.L.(2002). Development of a web-based question database for studentsself-assessment. Acad Med, 77(9), 925. Johnson, C.E., Hurtubise, L.C., Castrop, J., French, G., Groner, J., Ladinsky, M., McLaughlin, D., Plachta, L., & Mahan, J.D.(2004). Learning management systems: technology to measure the medical knowledge competency of the ACGME. Med Educ, 38(6), 599-608. Kneebone, R.(2003). Simulation in surgical training: educa- 32

POSSIBILITIES AND LIMITATIONS OF E-LEARNING IN MEDICAL EDUCATION tional issues and practical implications. Med Educ, 37(3), 267-277. Lin, C.C., Li, Y.C., Bai, Y.M., Chen, J.Y., Hsu, C.Y., Wang, C.H., Chiu, H.W., & Wan, H.T.(2005). The evaluation of game-based e-learning for medical education: a preliminary survey. AMIA Annu Symp Proc, 1032. Mann, B.D., Eidelson, B.M., Fukuchi, S.G., Nissman, S.A., Robertson, S., & Jardines, L.(2002). The development of an interactive game-based tool for learning surgical management algorithms via computer. Am J Surg, 183(3), 305-308. Nierenberg, D.W., Eliassen, M.S., McAllister, S.B., Reid, B.P., Pipas, C.F., Young, W.W., & Ogrinc, G.S.(2007). A web-based system for students to document their experiences within six core competency domains during all clinical clerkships. Acad Med, 82(1), 51-73. Petersson, H., Sinkvist, D., Wang, C., & Smedby, O.(2009). Web-based interactive 3D visualization as a tool for improved anatomy learning. Anat Sci Educ, 2(2), 61-68. Robert, H.(1991). Instructional Technology Past, Present, and Future. The Proper Study of Instructional Technology, 59-81. Rosenberg, M.J.(2000). E-learning strategies for delivering knowledge in the digital age. McGraw Hill Professional Publishing. Shepherd, S.S.(2004). Relationships between computer skills and technostress: how does this affect me? Association of Small Computer Users in Education. Supiano, M.A., Fantone, J.C., & Grum, C.(2002). A webbased geriatrics portfolio to document medical students learning outcomes. Acad Med, 77(9), 937-938. Wolcott, L.L.(2003). Dynamics of faculty participation in distance education: motivations, incentives, and rewards. In Moore, M. G., & Anderson, W. G.(Ed.), Handbook of Distance Education. NJ: Lawrence Erlbaum Associates. Ziv, A., Small, S.D., & Wolpe, P.R.(2000). Patient safety and simulation-based medical education. Med Teach, 22(5), 489-495. 33