Comprehensive, Technology-Based Clinical Education:
The "Virtual Practicum"

By Joseph V. Henderson, MD

This article first appeared in the International Journal of Psychiatry in Medicine, Vol 28(1), 1998; 41-79.

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This paper discusses the application of technology to promote more comprehensive clinical education in the biopsychosocial aspects of primary care. Comprehensive refers to the inclusion, in addition to scientific and technical knowledge, of knowledge that is less easily characterized, quantified, and taught: empathy, intuition, the demonstration of artistry. Clinical education will be increasingly facilitated by the proliferation of computers capable of displaying combinations of text, graphics, video, and sound; broadband networks capable of delivering these multiple media to the home or office; and new methods for using these technologies for education and training. However, current models for technology-based learning are limiting, lagging behind the rapid technological evolution driving our entry into the Information Age. Some recent educational model (Schön's reflection-in-action and reflective practicums, Boisot's E-space, Kolb's learning cycle) provide for a more comprehensive and complete view of health professional education. This paper describes these models in depth and proposes a new model for technology-based clinical training, the "Virtual Practicum," based on them. The Virtual Practicum is illustrated with a new interactive CD-ROM program, dealing with primary care of patients with HIV/AIDS. The concepts presented here are generally useful in thinking about clinical education, regardless of the means used.