LAUSR

I was extremely pleased to be reading the recent research report by Van Nuland and Rogers (2017) regarding the use of e-learning tools in anatomy teaching. As an avid student of clinical anatomy myself, I feel that the rise of e-learning and its implications are something which are currently unaddressed in medical schools. Technology is heralded as being the making of our generation. It has been integrated into almost every aspect of daily life and education is not an exception. The use of electronic resources has exploded in recent years and its use within all educational spheres has on the whole been enjoyed and accepted. Benefits include reduced space needed for practical tasks, the ability to return to difficult topics after the original teaching session has finished, as well as the facility to informally assess your own learning via apps. I do not question the huge benefits of increased technology within education, but I do question why technology is replacing, hands on, face to face teaching in some aspects of medical school as reported by Van Nuland and Rogers (2017). Personally, I have been lucky enough to attend a medical school where prosections and models are used regularly in anatomy teaching for first and second year students. Through a Masters in Research Surgical Anatomy module, I was even able to dissect a cadaver myself. This experience was invaluable and fueled my interest in anatomy and surgery. However, I appreciate this is not the case for all. Many medical schools are abandoning anatomy teaching using dissections and prosections and turning to electronic computer models and online teaching resources. In the United Kingdom now, there is a dearth of dissection as a teaching method with only a small percentage using cadavers in this way. This article highlights the damage that this could be having on the education of future doctors. The fact that the education of students with poor spatial awareness, lack of technological experience, or kinesthetic learners may be compromised by the move to e-learning tools is very concerning. Medicine has always been a specialty which attracts a wide range of minds and people. It is therefore necessary for medical school education to cater for all. Even at my medical school we learn histology via online learning modules and computer sessions. While I appreciate the difficulty in maintaining high quality histology specimens, I personally feel that histology teaching via computers is not an accurate representation of the skills or understanding of the tissues necessary for work in pathology. It is important to have a true appreciation of this so that we can make informed decisions about our career paths. Medical school is not only a place where students learn knowledge relevant to diagnosis and management of disease. It is also a place where we can experience aspects of the profession which we are about to enter into. Just as it does not follow that learning histology via a computer allows understanding of the work of a pathologist, learning anatomy without the ability to get hands on with models or cadavers does not allow understanding of the work of a surgeon or physician. The point which resonates with me most from the Van Nuland and Rogers (2017) article is that e-learning is shown to give no advantage to students yet is so heavily relied upon by their educational institutes. Without doubt, new technology within education represents an exciting prospect owing to the ability to reduce space, monetary, and time constraints, however this needs to be taken hand in hand with improved learning. Van Nuland and Rogers (2017) state that “one of the biggest challenges in education is to assume that new technologies are as effective, if not more so, than traditionally salient teaching practices.” Surely, it is vital to ensure that technology is not being introduced without proper reason and with evidence to support its utility. An article by Frehywot et al. (2013) discussed how one such place in which this could be an issue is in resource-limited countries. There is no doubt that elearning could be a benefit here, especially where there may be a lacking in teaching or medical infrastructure or political disruption. However, the article highlights how it is necessary to ensure that the technology is implemented in a place where resources are at least at a level to enable the e-learning to be used to its full potential, that is, internet access and electronic devices. Frehywot et al. (2013) conclude their article stating that “only when the appropriateness, feasibility and true costs of e-learning tools and methodologies are understood can their impact upon the health of country populations be realized.” This is something which is not only relevant for low-resources countries, but also for those with vast resource, to ensure they are being used in the most appropriate and fruitful ways. Overall, it seems there is a great breadth of knowledge and interest in the future and potential of e-learning and this is something which should be encouraged. Personally, I find it very reassuring the benefits and drawbacks of e-learning are being discussed and that it is not assumed, as Van Nuland and Rogers (2017) say that “one size fits all.” It is important for those with the resources, such as researchers and academics to show these findings and raise awareness of the issue, *Correspondence to: Ms. Abigail Lowe, Newcastle Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, United Kingdom. E-mail: [email protected]