Virtual classroom part of plan.

E-learning to play vital role in delivering quality education

Although planning of the Northern Ontario Rural Medical School (NORMS) is. still in the conceptual stages, e-learning and the virtual classroom will be an integral component in delivering a high-quality medical education comparable to any national program.

About 25 per cent of the curriculum will rely on Internet technology for distance education, and students will also use the link-up to stay in touch with the school while completing their hands-on medical and residency training in communities across the North.

Great emphasis is being placed on medical school students having the latest research and basic science material from electronic library databases at their fingertips within the framework of the clinical teaching process, says Geoff Tesson, executive director of health initiatives at Laurentian University in the City of Greater Sudbury.

"The electronic challenge is making sure they have access to the same level and quality of material sitting in the library at the University of Toronto," Tesson says.

Preliminary discussions are already underway to use existing telehealth networks used by rural Ontario physicians in delivering health care as an assisted knowledge system designed to train students working in specialty placements across the North.

"We're developing a relationship with telehealth networks in order to explore their educational value for training students at remote locations," Tesson says.

With many northern communities already connected to fibre optic networks or in the process of doing so, much of the infrastructure for this non-traditional medical school concept is already in place, including a telemedicine network considered one of the best in the country.

The Northern Ontario Remote Telecommunications Health Network (NORTH) is one of a number of sophisticated networks designed for consultation in rural areas which delivers services at distance. Dr. Rob Williams, medical director of the North Network based at Timmins and District Hospital, is following the discussion with great interest, wondering what their expected role will be.

The NORTH network provides specialist consultations, continuing medical education and patient education through video conferencing.

"It's a great service," says Williams, a former hospital chief of staff at Timmins and District Hospital. "The education that we can deliver to remote physicians and health-care providers is very well receive, and most importantly, it makes city services so much more accessible to people in remote Ontario."

The network began three years ago with connections to hospitals in Timmins, Kirkland Lake, and Cochrane with Sunnybrook Health Science Centre and the Hospital for Sick Children in Toronto. They currently maintain teleconference studios in 13 hospitals across northeastern Ontario and as far south as Barrie.

Over the next 18 months, they will be expanding to 50 hospital-based sites across the North, west to the Manitoba border- all of which are potential educational centres for the medical school - armed with a $24-million budget from public-and private-sector partners like Placer Dome and Weyerhaeuser.

Besides providing two-way real-time video conferencing, the network incorporates such diagnostic tools as stethoscopes and X-rays. It's provided consultations in 30 specialties such as dermatology, orthopedics, neurology, cardiology, speech pathology and plastic surgery.

The aim of the network, which is jointly administered between Timmins and Sunnybrook, is to reduce patients' travelling time to see out-of-town medical specialists.

"The numbers of the people who use it aren't large, but it helps equal the playing field," says Williams. "Now they have the same accessibility in health education and services as their urban counterparts."

For ongoing educational purposes, they schedule two interactive sessions a week hooking up health-care providers and physicians at multiple sites with medical school professors in Toronto for Power Point presentations and discussions.

"It's like being the same room," Williams says. "There's very high satisfaction with the technology in supporting the virtual classroom and I expect that will extend to the medical school."

Although his discussions with the NORMS planners have only just begun, "we're certainly interested in partnering wherever we can in supplying them the backbone through our network and studios if it makes sense in their project," Williams says.

Williams expresses little doubt that e-learning meshes perfectly with the problem-based model being proposed for the school through chat lines and Internet discussions supported by video conferencing.

Telehealth has gradually gained a foothold right across Canada and the technology revolution is developing new partnership opportunities.

He recently travelled to South America with a delegation of Canadian telemedicine providers to discuss a possible partnership with medical schools in Chile and Argentina in developing problem-based curriculum for primary-care physicians.

Both the federal and provincial governments have committed their support in developing framework for a province-wide network in which all sites can join in and share resources.

Similar distance learning networks are already in place across Canada including Memorial University's system covering Newfoundland and Labrador.

Williams says some experimentation has been done in the United States with video conferencing setups being placed in operating rooms for specialists to review the procedure and give advice to real-time operators and robotics has been used to assist in operations.