Peder Saether Symposium (March 9-10, 2000)
Professor Knut Lundby Presentation
Prof. Knut Lundby, Director, InterMedia, University of Oslo, Norway
Changing Roles in Changing Learning Environments: Distributed Problem Based Learning in Medical Education, University of Oslo
I will be discussing the roles of the teacher and the learner as my entry into this session, using the case of medical education at the University at Oslo as an example for this discussion.
I would also like to give credit to all those people who have been doing this work; I’m just reporting it and researching it. But there is quite a team behind this work.
We have developed at the University of Oslo what we call ‘Oslo 96,’ which is a complete turnaround of problem-based learning in the medical school. That was quite a change to go through. And the idea behind it is that students have to seek the information, the knowledge, themselves, rather than to rely on lectures. There is an increased focus on evidence-based medicine, in order to seek those skills relevant to the roles they will play. Behind the whole thing is the move towards life-long learning, which will be the future.
The vision of this change in the medical program at the University of Oslo is that when we use ICT, the students should have 24-hour access to the information dedicated to them, including the kind of databases they need, in which the lectures, curriculum, etc. will be stored. They should be able to access this information whenever and wherever they want, at the pace which suits them. They should also be able to have the kind of discussions with the other students and teachers they would like, as part of this problem-based approach. So we tried to create this so-called distributed learning environment, while still maintaining the patient contact and the focus on the patient during clinical teaching.
There are various digital elements in this approach. This is established as distributed learning--I will come back to that more in detail--using sound, video, text. We build a digital curriculum which is then made available to the students. We also have multimedia learning programs for work on practical procedures, and problem-based learning is used in groups when it goes on the Net.
Distributed learning, then, is the idea. These students, as part of their study, are being placed in different hospitals over a rather large area. As I said, there are very few lectures, but they are important and they should be continued. There is a need for distance education, even with hospitals quite close to each other geographically. We have a pilot project that connects hospitals, one kilometer from each other, using a 155-megabit network, broad band. We are working with a partner in Sweden, the University of Umea.
The digital curriculum is being made available to the students. That means the handouts are digital, they’re made as references, with video sequences of the lectures on the server. Multimedia programs, examinations, and operations are also made available as part of this digital curriculum.
Students, as well as graduates, feel poorly prepared for a practical working career. For that reason, multimedia learning programs, the practical procedures which could be learned with some multimedia help, are being introduced. That is part of this "Oslo96" perspective.
The students will have access to skills labs, where they can work on the multimedia procedures themselves. For example, they can work on a program like this over and over again to teach themselves and groups the kind of practical procedures needed.
This is another example, which includes a video. It has been quite successful.
A problem-based learning groupware has also been developed, since the problem-based approach with students in small groups has been quite successful. What happens, then, when this is taken onto to the Net? In the problem-based approach, there is a need for interaction between those involved in the teams, be they students or teachers. How could that be accomplished on the Net? Could we do it by using asynchronous communication, by finding the right groupware for that? Could we add effects by using video conference facilities? We are looking into these various options.
How can we integrate all these various elements into such an environment? We have developed a World Wide Web platform, which, translated, is called the Learning Web. There is the curriculum database, which shows all the lectures and the schedule for the whole study. We also have electronic classrooms.
The Learning Web aims to develop services and technological solutions which support the social interaction of the PBL process. This should facilitate practical solutions for the production, organization, and use of digital media in a learning environment like this, and should be made available to others through a digital library.
The curriculum database is quite big. References to some 16,000 lectures, throughout the study program, are being stored in that database, so that students can enter the database before going to class. They have one screen that comes up to say where and when, and what kind of references the teacher will provide on that topic, with links to the Medline bases, to previous publications of that teacher, and so on. This saves a lot of time for the administrative staff, potentially changing their roles. It also provides for a better use of personnel, a more efficient system for handling lecture hall reservations and so on.
Then we have applied electronic classrooms. We’re actually starting up two electronic classrooms in two main hospitals this month. We will use these electronic classrooms for problem-based group sessions, as well as for clinical sessions with patients, and for some of those key lectures. It is actually quite difficult to gather all the students for those few key lectures. They may have to travel too much, there may be no lecture hall for them, and so on. So that will be done on the Net, synchronously.
What are the new roles for learners and teachers that are arising? Will these changes arise from the problem-based approach, or to the use of digital media or ICT? I would like to play with an ‘e’ for the learner. The learner is self becoming an educator because the problem-based approach is self-activity. The learner is becoming an explorer into new situations to try out, test. In a way, the learner is becoming an e-lender, getting onto the Net, lending from the Net into the group, into the social learning environment. Maybe we have enthusiasts here. They are excavating, digging out materials, solutions which could be given to the group and given to the social study environment. They are actually becoming experts, experts at least on the Net and the digital medium.
Then there's ‘c’ for the teacher. The teacher becomes the coach, the supervisor of the lecture. But still the teacher will be the connection to the medical tradition, a guide with a better overview, of course, than the student can have. The teacher could also develop into a kind of ‘cybrarian,’ able to sort out all of this material, which is being gathered by the students in the problem-based learning. The teacher should be able to be the critic and remind students of pitfalls, difficulties, and so on. He or she could also be the constructor, to help the students put elements together which might not otherwise be quite meaningful. The question, then, is whether the teachers will remain coaches or really go into the Net. In Oslo, the staff at the Medical school truly joined in the problem-based approach, but will they also really join in the ICT-based approach? That remains to be seen.
What are the impacts on the learner and the teacher, then? If you first look at the impact of the problem-based approach, the single roads are undermined. Students have to work in teams, and professors have to relate to these teams. So interaction becomes a key word, interaction between these roads. As far as possible impacts on the learner and the teacher of the use of ICT, more roles are involved than just the learner and the teacher, and, in that way, the title of this session is quite misleading. But a lot of other people or other roles are necessarily involved: IT system people, those constructing the core systems, and so on. Interaction, again, becomes a key word, including interaction between roles and the system. Those many roles, more than just the learner and the teacher, and the interaction between the various roles and the system become key. But we should remember that old roles, even if you think of them as simply the learner and the teacher, are also part of a system. So actually we are seeing a shift from system to system, or we could say an institutional shift, as is quite obvious to us after this day of presentations.
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