This project contributed to our understanding of several concepts:

• How to employ technology-based learning to provide interactive, individualized, continuing education to health care providers, at any time or place
• How emerging broadband networks can be used for that purpose
• The use of satellite-based Internet access for delivery of on-demand educational services to individuals in rural settings
• The methods, performance, acceptability, benefits, and costs of this type of system

The chief benefit of this knowledge is to improve the delivery of continuing education services to rural health care providers. Currently, the predominant model for delivery of distance learning is videoconferencing. This method has the distinct advantage of delivering good information to a potentially large audience at a distance. However, videoconferencing has a relatively rigid format: it cannot be tailored to the interests and learning styles of the individual learner, and it lacks interactivity (other than limited opportunities to ask questions). Further, active participation in a videoconference, however limited, requires that the individual be at a particular place at a particular time; i.e., it must be done synchronously. The alternative is to view the videoconference passively at a later time, as one views any instructional videotape.

This project expands on videoconferencing models and methods for distance learning in these important ways:

• The format of the Virtual Practicum model is highly flexible.
• It is tailorable to the interests and learning style preferences of the learner.
• It is interactive, allowing the learner to participate in a variety of learning experiences including simulated cases, lectures, computer-based activities, interviews with patients and clinicians, and case discussions, all under the "virtual mentorship" of a world-class practitioner and teacher.
• Delivery via broadband Internet permits asynchronous learning by individuals, allowing them to access educational content according to their schedules.
• Delivery via a satellite service such as DirecPC permits shifting from an economic model in which a provider of educational services pays a high, per-event rate to one where numerous individual service recipients pay for general Internet access on a per-month basis; advantages are that any information provider can provide information at a fixed, relatively low cost for Internet access, while recipients gain access to a variety of Internet-based services at a fixed, relatively low cost.

Program Description

This program, developed by the Interactive Media Lab and the Columbia School of Nursing, focuses on training health care providers and medical students to care for HIV patients. The program offers the user a chance to play the long-term physician, and gives a first hand sense of the emotional impact of HIV/AIDS on individual patients.

The interactive video, sound, and graphics move the user through a "virtual clinic" that includes an orientation, a learning resources room, and encounters with a "virtual patient," a 20-year-old student named Laurie Matthews. Users interact with this patient extensively: prior to the diagnosis, soon afterwards, and years later. The patient's responses vary, depending on which questions are asked by the user, as well as how the user answers questions posed by the patient herself. For example, users can ask about the patient's sexual practices, or, based on cues from the patient, ask about her thoughts on having children. The learning resources room includes lectures and activities, as well as interviews with real patients from different walks of life.

To learn more about this program, you can view the HIV Virtual Clinic Page on the IML Website.