摘要：E-learning in healthcare professional education still seems like it is a new innovation but the reality is that e-learning has been around for as long as the internet has been around. This is approximately twenty years and so it is probably appropriate to now take stock and consider what the future of e-learning in healthcare professional education might be. One likely occurrence is that there will be more formats, more interactive technology, and sometimes game-based learning. Another future of healthcare professional educa- tion will likely be in simulation. Like other forms of technology outside of medicine, the cost of e-learning in healthcare professional education will fall rapidly. E-learning will also become more adaptive in the future and so will deliver educational content based on learners' exact needs. The future of e-learning will also be mobile. Increasingly in the future e-learning will be blended with face to face education. var currentpos,timer; function initialize() { timer=setInterval("scrollwindow()",10);} function sc(){clearInterval(timer); }function scrollwindow() { currentpos=document.body.scrollTop; window.scroll(0,++currentpos); if (currentpos != document.body.scrollTop) sc();} document.onmousedown=scdocument.ondblclick=initialize 310 T he fuTure of e - learning in healThcare professional educaTion teract with realistic scenarios and to learn clinical and communication skills – and integrate these [5]. They can also practise and rehearse as often as they like – un- like in the real life environment where patients will get tired or in a physical simulation suite which will rarely be open at all the times that the learner wants to learn. The pace of development will also continue to be very fast – there is already a tool where you can learn resus- citation skills via the accelerometer on an ipad. Like other forms of technology outside of medicine, the cost of e-learning in healthcare professional education will fall rapidly. Healthcare professional education is expensive and so providers and consumers of education will be keen to ensure that they get maximum value from any invest- ment in e-learning [6, 7]. It is likely that value for money will come from e-learning (saving money on everything that goes with face to face education) and from sharing e-learning resources between institutions [8, 9]. E-learning will also become more adaptive in the fu- ture and so will deliver educational content based on learners' exact needs. Learning that is based on learner needs is more likely to be effective and so software that recognises learners' needs and adapts its provision ac- cordingly will be more efficient from a learning and time perspective [10]. In e-learning packages of the future, we can look forward to scenario based content where modules become more difficult as learners develop ex- pertise and where modules contain branched narratives that allow users to fully experience the consequences of their actions. This will result in a more personal experi- ence for each individual user and will therefore make the experience more compelling. The future of e-learning will also be mobile [11]. The ubiquity of mobile devices will mean that e-learning will always be available to the medical learner. And provid- ers of e-learning will in turn modify their content so that it is more suitable for mobile devices and so that it can provide an instant learning experience at the point of care. In future, medical education will be about learn- ing some core knowledge but then learning knowledge- searching skills, and learning the places to find reliable up-to-date evidence based knowledge. In the future doctors will be saying "I don't know – but I will look it up" – and they will have constant access to point-of-care decision support tools via mobile devices. Will this brave new world of e-learning make face to face education a thing of the past. This is unlikely to happen. In the future we will use different formats that help us achieve different outcomes: Evidence based learning resources to help doctors develop excellent ap- plied knowledge; interactive case histories to help them develop problem solving skills; and multimedia or simu- lation based resources to engender healthy attitudes and professional behaviours. Face to face education will continue – in the form of interactive lectures and networking events - and so a blend of learning resources will help us develop healthcare professionals with the right balance of knowledge, skills, and behaviours. There will undoubtedly be more high users of e-learning but there will also be those who prefer face to face edu- cation and who will make strategic learning choices as to the formats that they prefer in different contexts and at different times [12, 13]. Attempting to predict the future is never a complete- ly straightforward exercise – but in the case of e-learn- ing the trends over the past ten years will very likely continue for some time to come. It will be up to us as healthcare professionals to ensure that we use e-learn- ing wisely and harness its many advantages to help use deliver better care for patients and populations [14]. Accepted on 24 November 2014. 1. Walsh K, Dillner L. Launching BMJ Learning. BMJ 2003;327:1064. DOI: 10.1136/bmj.327.7423.1064 2. Begg M. Leveraging game-informed healthcare education. Med Teach 2008;30(2):155-8. DOI: 10.1080/01421590701874041 3. Dewhurst D, Borgstein E, Grant ME, Begg M. Online vir- tual patients - A driver for change in medical and healthcare professional education in developing countries. Med Teach 2009;31(8):721-4. DOI: 10.1080/01421590903124732 4. Bradley PP. The history of simulation in medical educa- tion and possible future directions. Medical Education, 2006;40:254-62. DOI: 10.1111/j.1365-2929.2006.02394.x 5. Cook DA, Hatala R, Brydges R, et al. Technology-en- hanced simulation for health professions education: a systematic review and meta-analysis. Journal of the Ameri- can Medical Association 2011;306:978-88. DOI: 10.1001/ jama.2011.1234 6. Sandars J. Cost-effective e-learning in medical education. In: Walsh K (Ed). Cost effectiveness in medical education. Radcliffe: Abingdon; 2010. 7. Sandars J, Walsh K. A consumer guide to the world of e- learning. BMJ Career Focus 2005;330:96-7 8. Walsh K, Rutherford A, Richardson J, Moore P. NICE medical education modules: an analysis of cost-effective- ness. Educ Prim Care 2010;21(6):396-8. 9. Walsh K, Jaye P. Cost and value in medical education. Educ Prim Care 2013;24(6):391-3. 10. Walsh K. How to assess your learning needs. J R Soc Med 2006;99:29-31. DOI: 10.1258/jrsm.99.1.29 11. So HJ, Kim IS, Looi CK. Seamless mobile learning: pos- sibilities and challenges arising from the Singapore experi- ence. Educational Technology International 2008;9:97‐121. 12. Sandars J, Walsh K, Homer M. High users of online continuing medical education: A questionnaire survey of choice and approach to learning. Med Teach 2010;32:83-5. DOI: 10.3109/01421590903199171 13. Hande S. Strengths weaknesses opportunities and threats of blended learning: students' perceptions. Ann Med Health Sci Res 2014;4(3):336-9. DOI: 10.4103/2141- 9248.133455 14. Wutoh R, Boren SA, Balas EA. eLearning: A review of Internet-based continuing medical education. Journal of Continuing Education in the Health Professions 2004;24:20- 30. DOI: 10.1002/chp.1340240105 RefeRences
关键词：e-learning ; . medical education ; . simulation
