Evolving models for medical physics education and training: a global perspective
P Sprawls, PhD
Sprawls Educational Foundation, Montreat, North Carolina, United States
Abstract
There is a significant need for high-quality medical
physics education and training in all countries to support effective and safe
use of modern medical technology for both diagnostic and treatment purposes. This
is, and will continue to be, achieved using appropriate technology to increase
both the effectiveness and efficiency of educational activities everywhere in
the world. While the applications of technology to education and training are
relatively new, the successful applications are based on theories and
principles of the learning process developed by two pioneers in the field,
Robert Gagne and Edgar Dale.
The work of Gagne defines the different levels of learning
that can occur and is used to show the types and levels of learning that are
required for the application of physics and engineering principles to achieve
appropriate diagnostic and therapeutic results from modern technology. The
learning outcomes are determined by the effectiveness of the learning activity or
experience. The extensive work of Dale as formulated in his Cone of Experience
relates the effectiveness to the efficiency of educational activities. A major
challenge in education is the development and conduction of learning activities
(classroom discussions, laboratory and applied experiences, individual study,
etc) that provide an optimum balance between effectiveness and efficiency. New
and evolving models of the educational process use technology as the
infrastructure to support education that is both more effective and efficient.
The goal is to use technology to enhance human performance
for both learners (students) and learning facilitators (teachers). A major
contribution to global education is the trend in the development of shared
educational resources. Two models of programs to support this effort with open
and free shared resources are Physical Principles of Medical Imaging Online (http://www.sprawls.org/resources)
and AAPM Continuing Education Courses (http://www.aapm.org/international). © 2008
Biomedical Imaging and Intervention Journal. All rights reserved.
Keywords: Effective education, efficient learning activities,
technology enhanced education, shared resources
Introduction
Medical practice and healthcare facilities in most
countries are becoming increasingly effective in diagnosing and treating many
diseases, thanks to advances in science and technology for both diagnostic and
therapeutic applications. In order for these advances to benefit citizens anywhere
in the world, the medical technology has to be available and accessible, and
highly-educated and trained medical professionals have to be able to utilise
the technology for maximum effectiveness.
Medical physicists have the knowledge to ensure optimum
and safe utilisation of modern medical equipment for the benefit of all
patients. This is achieved through applied clinical activities such as
treatment planning and imaging procedure optimisation, education and training
of other medical professionals such as physicians and technologists, evaluation
of equipment performance, risk analysis, and management of quality and safety
activities.
There are two specific dynamics that have an impact on the
effectiveness of education and training activities in a specific geographic
region. One is the many rapid advances in the science and technology that
require almost constant updating of knowledge, experience, and educational
materials on a local basis. The other is the need to transfer knowledge from
the few centres of experience with new technologies and methods to the many
worldwide locations for clinical application. These needs will only be met by
transiting to new models of the education and training process where
state-of-the-art technology is used to enhance human performance of both learners
(students) and learning facilitators (teachers). The goal is to produce
enriched learning environments on a global basis to support highly effective
learning activities.
We will now review the characteristics of learning
environments, especially with respect to their effectiveness and efficiency,
as described by two of the major pioneers in the educational process and then
analyse two models that are making major contributions on a global basis.
Effective Learning
In order to contribute to improved healthcare, the
knowledge of medical physics must be applied in the clinical environment to
plan and optimise procedures, analyse performance, solve problems, and other
creative activities. This requires a higher level of learning than might be
required for adequate performance on many written examinations.
Robert Gagne, introduced in Figure 1, provides an analysis
of the learning process which defines the different types of learning.
Gagne's Principles Applied to Medical Physics Education
A major contribution of Gagne that applies to medical
physics education is the formulation of the hierarchy and levels of learning as
illustrated in Figure 2.
Not all learning activities result in achieving the same
abilities to perform specific functions. The application of medical physics in
the clinical environment generally requires the higher levels of learning as
illustrated above.
The level of learning achieved and the ability to perform
specific functions depends on the effectiveness of the learning
activity. While it is desirable for a learning activity, such as a classroom
discussion, to be highly effective there is a major compromise that must be
considered. That is the efficiency of the learning activity in terms of
required resources such as personnel time and effort, institutional facilities,
and financial costs as illustrated below.
Relationship of Effectiveness and Efficiency of Learning Activities
This significant relationship between effectiveness and
efficiency of learning activities was formulated by Edgar Dale and described
with the Cone of Experience which has been published in different forms as
illustrated in Figure 3.
Dale's Cone of Experience
Dale's cone of experience is shown in more detail in
Figure 4.
As one can see, the cone of experience organises learning
experiences and activities in terms of their effectiveness in producing
learning outcomes.
The learning outcomes that are crucial to clinical medical
physics (analyse, create, evaluate, problem-solve, etc.) are best developed by
experiences and learning outcomes at the base of the cone.
The Cone of Experience Applied to Medical Physics Education
The concept of the cone of experience applied more
specifically to medical physics education is shown in Figure 5.
Relationship of the Cone of Experience to Effectiveness and Efficiency
A major question is why a specific type of learning
activity is selected and used. The answer is found when the characteristic of
efficiency is added to the cone as shown in Figure 6.
Efficiency of Educational Activities
Many factors that have an effect on efficiency are
illustrated in Figure 7.
Any learning activity requires resources and it is this
overall requirement that determines the efficiency of the activity. As has been
observed above, learning activities that can be highly effective with outcomes
to support applied clinical medical physics (the lower section of the Cone
of Experience) require significant resources, and are therefore not the
most efficient when compared to some other educational methods.
The Role of Digital Technology
The long-standing challenge between the efficiency
and effectiveness of education activities is now being reduced through
the availability of state-of-the-art digital technology. One of its
contributions that relates to the cone of experience and the levels of learning
is illustrated in Figure 8.
Technology is now making a major contribution to more
effective medical physics education by providing high-quality visual
representations to enrich the learning environments and move the learners
closer to the physical reality that they are studying.
High-quality visuals have the capability of ‘making the
invisible now visible’ (radiation, atomic structures, etc.), showing
relationships and interactions, and illustrating virtually all aspects of medical
imaging.
The increased efficiency comes from the sharing of the
digitised resources so that local learning facilitators (teachers) and learners
(students) can devote their time and effort to a more productive learning
process.
The Traditional Classroom Learning Environment Model
For centuries, the usual learning environment has been the
classroom as illustrated in Figure 9.
While the traditional classroom process continues to be
useful for many topics, especially those that are conveyed through audio media
(music, languages, etc.), it presents a major challenge for effective medical
physics education for both the learners and the learning facilitators as
illustrated in Figure 10.
The production of high-quality visuals that can connect
the learner to the physical world (medical physics) about which they are
learning requires extensive time, talent, knowledge, experience, and technical
resources that are not generally available to the traditional classroom
teacher.
Because of the rapid advances in medical physics and the
associated technology for both imaging and therapy, and the migration of these
around the world, the local learning facilitator is challenged with having to
keep ‘up-to-date’ through continuing education and lifelong learning.
The Learner in the Traditional Classroom Model
The learner in the traditional classroom model is first
challenged with the necessity of recording, in written form, both the visuals
and spoken words and then using the materials later for effective learning as
illustrated in Figure 11.
Technology Enhanced Education
Many of the challenges and short-comings of traditional
education methods, especially in medical physics, are being reduced by
innovative applications of technology.
The desired role of technology is not to replace the
learning facilitator/teacher but to enhance human performance, through
increased effectiveness and efficiency, of both the learner/student and the
learning facilitator/teacher.
This is, and will continue to be, achieved through
evolving models of the educational process that combine the advantages and
values of both technology and humans. Figure 12 shows how this is achieved in a
variety of medical physics academic courses and for continuing education.
When high-quality visuals are available from an online
resource, the local learning facilitator can devote time to guiding and leading
the learning process with their personal knowledge and experience. This can be
a highly effective learning activity producing the desired outcomes for clinical
medical physics applications because it combines high-quality visuals to enrich
the learning environment with the experience of the local learning facilitator.
It is also very efficient for the learning facilitators because their effort
can be directed to engaging the learner and guiding the learning process rather
than having to produce visuals and other related materials.
The learner is now "seeing" much of the
physical universe rather than hearing it described in words, which results in a
much more effective learning experience and higher levels of learning. When the
visuals and related descriptive materials are also available to the learner for
later study and review, the total learning activity becomes much more
efficient.
Enriching the Learning Environment with Shared Resources
One of the greatest needs in medical physics education and
training is to enrich the local learning environments everywhere in the world
with the up-to-date experience associated with the developments in science and
technology. A model of how this can be achieved is illustrated below.
The requirement is that physicists, other scientists, and
medical professionals who have the experience with the various technologies and
applications transfer their knowledge into digital resources that are shared
with both learners and learning facilitators on a global basis as illustrated
in Figure 13.
We will now consider a model for each of these
applications.
The Physical Principles of Medical Imaging Online
The Physical Principles of Medical Imaging Online
(PPMI) is a multifaceted shared resource as illustrated in Figure 14.
The purpose of PPMI Online is to support and enrich each
step in the integrated learning process of the physics of medical imaging for
medical physicists, radiologists, and other medical imaging professionals. In
most applications it is integrated into, and used as a resource for, courses
provided by institutions under the direction of the local medical physics
faculty.
Open Resources for Medical Physics Continuing Education
The American Association of Medical Physicists (AAPM)
provides many continuing education activities each year. These include
approximately 50 courses presented during each AAPM Annual Meeting and also the
Summer School devoted to a specific topic of interest each year. These courses
and the proceedings of the Summer School are now available through the online
Virtual Library as illustrated in Figure 15.
In addition to being available to AAPM members, the
courses are now available at no cost to all medical physicists in developing countries
who register to be an AAPM Developing Country Educational Associate (DCEA)
through the international portal web site (http://www.aapm.org/international/).
Summary and Conclusions
There is a significant need for high-quality medical
physics education and training in all countries to support effective and safe
use of modern medical technology for both diagnostic and treatment purposes.
This is, and will continue to be, achieved using
appropriate technology to increase both the effectiveness and efficiency of
educational activities everywhere in the world. While the applications of
technology to education and training are relatively new, the successful
applications are based on theories and principles of the learning process
developed by two pioneers in the field, Robert Gagne and Edgar Dale.
The appropriate goal is to use technology to enhance human
performance for both learners (students) and learning facilitators (teachers).
Two models of programs to support this effort with open
and free shared resources are:
Physical Principles of Medical Imaging Online at: http://www.sprawls.org/resources
AAPM Continuing Education Courses available through:
http://www.aapm.org/international
Received 21 December 2007; accepted 5 February 2008
Correspondence: Director, Sprawls Educational Foundation, PO Box 1208, Montreat, NC 28757, United States. E-mail: sprawls@emory.edu (Perry Sprawls).
Please cite as: Sprawls P,
Evolving models for medical physics education and training: a global perspective, Biomed Imaging Interv J 2008; 4(1):e16
<URL: http://www.biij.org/2008/1/e16/>
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