Background. Postgraduate surgical training is limited in Malawi, one of the world’s poorest countries, and doctors who pursue further training abroad may fail to return. One solution is to deliver education online, allowing trainees to complement their in-the-workplace learning. Objective. To evaluate the perceived effectiveness of an online MSc in Surgical Sciences programme for trainees continuing to train and work full time in their Malawian clinical environment. Methods. Twenty-four Malawian surgical trainees enrolled on the programme since 2010. Students’ perspectives regarding the MSc were explored by questionnaires, and Malawian student performance was measured using a variety of metrics and compared with that of other students in their year. Training programme supervisors in Malawi were surveyed on their opinions of the effectiveness of the programme. Results. Feedback revealed that students valued the structured presentation of the basic sciences integrated into interactive virtual patients, the access to e-journals and the opportunity for discussion with international surgical colleagues. Academic performance of Malawian trainees was comparable with that of the cohort average in the first 2 years of the programme. Attitudes of students and supervisors regarding the educational benefits of the programme were positive. Conclusions. The MSc in Surgical Sciences provides a culture of studying and sharing knowledge with peers and mentors globally, and has increased the academic support network for Malawian trainees from a few dedicated surgeons in the country to an international network. This innovative approach can serve as a model in other developing countries with critical shortages of healthcare workers.

The new repository will support pharmacology practical teaching by promoting the sharing and re-use of existing pharmacology resources

Objectives: To assess the impact of a surgical sciences e-learning programme in supporting the academic development of surgical trainees during their preparation for professional examination.Background: In 2007, a 3-year online part-time Master of Surgical Sciences (MSc) degree programme was launched, utilizing an innovative platform with virtual case scenarios based on common surgical conditions addressed by the curriculum relating to the Membership Examination of the Royal Colleges of Surgeons (MRCS). Multiple-choice questions with feedback and discussion boards facilitated by expert clinical tutors provided formative assessment. Summative assessment comprised written examination at the end of each of the first 2 years (equivalent to MRCS level), culminating in submission of a research dissertation in year 3 toward an MSc.Methods: Students' age, gender, and level at entry to the programme were documented. Anonymized student feedback from 2008 to 2012 was examined using online questionnaires, and performance in the MSc programme was compared to MRCS examination outcomes for students who had consented to release of their results.Results: A total of 517 surgical trainees from 40 countries were recruited over the 6-year period, and 116 MSc students have graduated to date. Of 368 students, 279 (76%) were foundation doctors (interns) and had not commenced formal surgical training on enrolling in the MSc programme. However, level at entry did not influence performance (P > 0.05 across all 3 years). Average pass rates since the programme launched, for those students completing all of the required assessments, were 84% +/- 11% in year 1, 85% +/- 10% in year 2, and 88% +/- 7% in year 3 of the MSc programme. MSc students had significantly higher MRCS pass rates than nonenrolled trainees (67% vs 51%, P < 0.01, n = 352). There was a significant correlation between MRCS examination performance and overall performance in the MSc (R-2 = 58%; P < 0.01, n = 37). Of 248 respondents, 202 (81%) considered that the MSc would improve their chances of gaining a surgical training post, and 224 (90%) would recommend the programme to their peers.Conclusions: The online MSc programme supports academic development of trainees in the early years of surgical training, is well received by students, and is associated with improved success in their professional examination.

The aims of this study were to explore the use of animals in teaching and the implementation of innovative technology-based teaching practices across a small sample of universities in Eastern Europe. The research methods used were a questionnaire circulated four weeks before a workshop took place (in October 2009, in Belgrade, Serbia), as well as focused, face-to-face group discussions, led by one of the authors during the workshop. Twenty-two faculty (physiologists and pharmacologists), from 13 Eastern European countries, attended the meeting. Fourteen of the eighteen schools represented at the workshop were making use of animals, in some instances in quite large numbers, for their teaching. For example, a single department at a Romanian university used over 250 animals per annum, and at least 1130 animals were used, per annum, across all of the institutions. The species used in largest numbers were the rat (34%), frog/toad (29%), mouse (22%), rabbit (10%), guinea-pig (4%) and dog (1%). None of the universities sampled had implemented institution-wide virtual learning environments (VLEs), although there were isolated instances of local use of VLEs. There was relatively little current use of technology-based teaching and learning resources, but there was considerable enthusiasm to modernise teaching and to introduce innovative learning and teaching methods. The major perceived barrier to the introduction of replacement alternatives was the lack of versions in local languages. There was a consensus view that developing local language exemplars and evaluating their usefulness was likely to have the greatest impact on animal use, at least in the short-term.

Medical educational opportunities and resources are considerably limited in the developing world. The expansion of computing and Internet access means that there exists a potential to provide education to students through distance learning programmes. This study investigated the feasibility of providing distance learning course in surgery in Malawi. The study investigated the user requirements, technical requirements and Internet connections in two teaching hospitals in Malawi. In addition the appropriateness of current course material from the Edinburgh Surgical Sciences Qualification to Malawi trainees was assessed. The study found a high degree of interest from Malawian trainees in distance learning. The provision of basic science modules such as anatomy and physiology and the ability to access journals were considered highly desirable. The current ESSQ course would require extensive re-modelling to make it suitable to an African trainee's requirements. Internet speeds remain slow and access is currently expensive. There is considerable interest in distance learning programmes in Malawi but access to them is limited partly because of slow and expensive Internet access. Understanding the needs of trainees in countries such as Malawi will allow better direction of educational aid and resources to support surgical training.

The development of online virtual patients has proved to be an effective vehicle for pedagogical and technological skills transfer and capacity building for medical and healthcare educators in Malawi. A project between the University of Edinburgh and the University of Malawi has delivered more than 20 collaboratively developed, virtual patients, contextualised for in-country medical and healthcare education and, more significantly, a cadre of healthcare professionals skilled in developing digital resources and integrating these into their emerging curricula. The process of engaging with new approaches to teaching and delivering personalised, context sensitive content via a game-informed, technology-supported process has contributed to the ability of healthcare educators in Malawi to drive pedagogical change, meet the substantial challenges of delivering new curricula, cope with increasing student numbers and promote teacher professional development. This initial phase of the project has laid the foundation for a broader second phase that focuses on promoting curriculum change, developing educational infrastructure and in-country capacity to create, and integrate digital resources into education and training across multi-professional groups and across educational levels.

Balkan universities use a substantial number of small mammals and amphibians in the teaching of physiology and pharmacology. This project investigated whether making computer-based alternatives readily available, and combining this availability with a staff development workshop focusing on methods of integrating such resources into undergraduate curricula, would have any effect on animal use. Teachers from 20 Institutes (from five Balkan countries) participated in the workshop. They presented information about animal use in teaching in their universities, and agreed to introduce at least one computer-based alternative into their teaching in the following year. They were surveyed by questionnaire before, during, and one year after, attending the workshop, in order to estimate any changes in animal use. The results showed a significant ( P < 0.01) reduction in animal use and a high level of implementation of the alternatives provided at the workshop. Teachers recognised the potential benefits of using computers to support their teaching. They lacked knowledge about what computer-based alternatives are available and how to find information about them, including published evidence of their educational effectiveness. In this pilot study, a combination of staff development and making alternatives readily available to teachers had a significant impact on animal use in the teaching of physiology and pharmacology.

In this paper, recent developments of the HFVE vision-substitution system are described; and the initial results of a trial of the "Silooet" software are reported. The system uses audiotactile methods to present features of visual images to blind people. Included are details of presenting objects found in prepared media and live images; object-related layouts and moving effects (including symbolic paths); and minor enhancements that make the system more practical to use. Initial results are reported from a pilot study that tests the system with untrained users.

Animal use for education and training in university teaching is small compared to that for research but it is still significant, and often unnecessary for many students. Pharmacology is the discipline which uses most animals. A wide range of 'proven' non-animal models already exist and there is good evidence that they can be both educationally and cost effective. To further reduce animal use in education it is important to convince and persuade faculty who are the curriculum 'change agents' and efforts should be directed towards this through awareness raising, publishing evidence of successful use of non-animal methods in other universities, providing assistance with integration of alternatives into mainstream teaching, and developing new technological approaches to creating the resources which enable faculty to modify content and educational approach and avoid technological redundancy. Laboratory-based practical classes, in which students conduct experiments on animals or animal tissue, are a central feature of bio/medical degree courses in most countries. Computer-based learning programs, which simulate such experiments, offer a virtual laboratory experience which may meet the great majority of the learning objectives for most students. Faculty need to be made more aware of the possibilities that alternatives afford, and they need to be convinced of the their viability. They also frequently express the desire to be able to modify the computer programs to meet local educational needs and this is something that developers of alternatives need to take into consideration. There is now significant evidence that alternatives are able to meet many of the learning objectives though generic and specific laboratory and surgical skills cannot be adequately taught in this way.

Most of our students complete most of their written assignments using a word processor, but they are still asked to handwrite responses in an examination. It could be argued that they have not practiced this task and the validity of the assessment could thus be questioned. This paper explores the possibility of bringing computers into the traditional essay-examination context, describes an appropriate hardware and software configuration, and provides feedback from initial evaluations with students and their reactions to the idea. Some of the implications and equity concerns that need to be considered before a decision can be made to use computers in essay exams are also discussed.

This paper describes "work-in-progress" on "HiFiVE" (Heard & Felt Visual Effects), an experimental vision-substitution system that uses verbally-orientated audiotactile methods to present certain features of visual images to blind people.

A cornerstone of professional education is the practicum, setting designed for the task of learning a practice. In a context that approximates a practice world, students learn. . . by undertaking projects that simulate and simplify practice; or they take on real-world projects under close supervision (Schon 1987, 37). In the healthcare professions, one of the ways the practicum is reified is in the form of internship programs in which students gain real-life clinical experience through structured interactions with doctors and their patients. However, student clinical experience has become ever more problematic for numerous reasons. Advances in clinical techniques and therapies have led to less invasive procedures, leading in turn to a significant reduction in the time spent by patients in the hospital. In addition, many countries are introducing directives limiting physicians' traditionally long working hours, and this—along with growing concerns over the liabilities associated with allowing unlicensed (and therefore less accountable) students in the clinical workplace—is exacerbating the problem further. Moreover, in light of widespread requirements for more assured core skills and experiences on the part of healthcare workers, even the traditional approach to internships can leave too many holes in an individual's education (General Medical Council 2003). These various factors result in a dichotomy whereby the healthcare practicum is increasingly problematic in real hospital settings even as greater numbers of fully qualified healthcare workers are needed.

Many thousands of animals are still used annually in tertiary education despite efforts by enthusiastic teachers to reduce this number by developing and making available to their colleagues a range of alternatives. Technology-based alternatives which support replacement and reduction are at the forefront of these efforts. Persuading teachers to use them is critical and strategies to raise awareness and support the integration of the alternatives into teaching are described. Many of the existing computer-based alternatives were developed in the early 1990s and rapid changes in the technologies used to deliver them have rendered them difficult to use and in some cases obsolete despite the fact that their content and educational design are still valid. A project, using a learning object approach to development, which aims to preserve the content and educational design, improve the flexibilty of delivery and enable teachers to edit the content, is also described.

Learning technologies are becoming a common, and in many cases essential, component of the contemporary learning environment. As such, those who design, implement and control these encompassing technologies have emerged as major contributors to the success (or otherwise) of such systems. This article considers the power and responsibilities of learning technologists and the ways that they affect the teaching and learning environments around them. It does this by investigating, through semi-structured interview, the praxis of a learning technology group at the University of Edinburgh and relating this to professional issues for learning technologists in general. The article goes on to develop a typology of learning technology service provision based on the relationship between the learning technologist and the context in which their work is to be used. This is compared with interviews with practitioners, and a series of principles and recommendations is then developed. The thrust of these is that direct participation in the learning community is essential for learning technologists and that common codes of practice for learning technologists are required, both as a benchmark and as a framework by which professional practice can be measured and developed.