The internet provides opportunities for outstanding medical and nursing education.

The ease of transmission of text, images, videos, audio and interactive files has transformed many aspects of medical training and will likely have an even larger impact in the future.

Internet resources are accessible every day, all day and all night. They can be provided freely, with or without registration. Once produced, the materials cost almost nothing to maintain.

This revolutionary change is not just making textbooks available online for the student to read.

An entire course can be made available online ( e.g. Nursing Fundamentals I ).

An entire clinical rotation can be simulated online ( e.g. OBGYN Morning Rounds )

A technical skill can be taught online, with only some hands-on practice under supervision needed to close the training loop. ( e.g. Measuring Blood Pressure )

A patient interaction can be presented, requiring the student to engage, review the history and physical findings, and then begin making decisions. The student gets immediate feedback, is allowed to make mistakes, and no one is hurt. ( e.g. Stephanie Haggerty’s Breast Lump ).

Through online discussion groups and social media interactions, students can work in teams and receive group support for their learning. Interaction with their professor can be similarly structured.

Providing training online is much less expensive than in the traditional methods. It is more efficient in its’ use of student time and focus. It provides a consistently excellent level of training for each student, regardless of where the student is located, or who their professor might be.

The obvious drawback to online training is the lack of actual hands-on experience. This experience is essential to the training, but can be accomplished in relatively small amounts of time, if the student is otherwise fully trained in the academic aspects of the clinical skill.

Most medical schools in the U.S. are still following the outline of the Flexner Report, now more than 100 years old. Many of the modifications of that curriculum still rely on the essential content of the report. Most medical schools still use classroom lectures provided by professors for the “pre-clinical” training, and hospital based “clinical” training by physicians, taking about 4 years.

I believe that in 20 years or less, that model will rarely be found anywhere. It’s too expensive, inefficient, and time-consuming.

• Employing online training techniques, most of the “pre-clinical” material will be covered by students watching and listening to screens, in a structured, highly-efficient arrangement.
• Online training will be used to provide most of the didactic training, and some of the experiential training for the “clinical” material.

If I’m right about this, the change will be substantial and will have important teaching and financial consequences for students and teachers in medical training institutions.

While I’m less knowledgeable about training in Nursing and the Allied Health Professions, I suspect the same dynamics are at work, and the consequences will be similar.