No one can predict which patients might be in the hospital at any one time, nor what their clinical issues might be. There could be several patients with the same disease, but no patients with other important diseases. Consequently, the breadth of student clinical exposure is limited.

Didactic Lectures. Some are good, some not so good. Some are missed by lecturers or by students. Lecturers and topics are sometimes selected more on the basis of tradition, availability, and academic hierarchy than the needs of the students. Even good lectures are often an inefficient use of student time…an hour lecture could be covered by a scripted and recorded lecture in 1/3 the time, and if played back at 2x speed, could be covered in 1/6th the time.

The style and most of the content of this traditional training continue to be based on medical care and medical education paradigms that are more than 100 years old (Following the Flexner Report). During the last 100 years, massive changes in healthcare have occurred. Among these are:

 – Shift from hospital based care to ambulatory care

 – Shift from solo providers to institutional and group practice

 – Improved management, rendering older methods obsolete

 – Internet / digital resources for patients and providers

 – Changes in finance  (Insurance, Government)

 – Explosive growth in research funding

 – Specialization and sub-specialization

 – Growth of full-time faculty (research funded)

 – Changing role of voluntary (teaching) faculty.

Despite these sea changes, it struck me that medical students were still being taught the mostly the same material, in mostly the same way, as when I was in medical school.

The high cost to the student of medical education. When I graduated from medical school in 1974, annual tuition for me was $2500 ($12,775 in 2016 dollars). If I were attending the same school in 2016, my tuition would be $49,318, a four-fold increase. It’s not clear whether my students of today are getting a four-fold increase in the quality or quantity of their medical education compared to mine.

So I developed this simulation for my students, to address these shortcomings. I won’t claim that someone who goes through the entire simulation will be qualified to pass through to the next stage of training. There still must be hands-on experience and close interaction with supervising physicians through accredited institutions. But I do believe that the simulation will provide great support to the students who use it, enhancing their knowledge in ways that are certainly different, and may be superior in some respects to what they are otherwise experiencing.

I’m persuaded that online  education and medical simulation is the future of medical education. I’m confident that my small venture into online medical education soon will be joined by others, and probably replaced by even better simulations and better training.

About half the visitors to my websites arrive using mobile devices (tablets and smart phones).  I’ve tried to make this simulation as usable on a mobile platform (tablet, smart phone) as it is on a desktop or laptop computer. I’ve been successful, but for the Outpatient Clinic simulation which relies of Flash programming that is generally not functional on mobile devices. I hope to soon have them converted to make them mobile friendly.

I’ve also tried to make use of all of the science of how students best learn off screens. This is more complicated than it would seem, and there is a learning curve to addressing these needs. My later efforts are much better than my earlier efforts. I intend to continually improve in this area.

Having gone to the effort to develop this simulation, I wanted to make it readily available to everyone. So I’ve posted it openly on the internet. I hope you find it useful.

I believe that 21st Century Medical Education is:

• Effective
• Efficient
• Free

Dr. Hughey

---

About Dr. Hughey

I received my AB in biochemistry from Princeton University in 1970 and my MD from Loyola University Medical School in 1974. I completed my residency in OB-GYN in 1978 at Northwestern University, where I joined the Medical School Faculty.

For over 30 years, I was in general OBGYN clinical practice and actively engaged in teaching medical school undergraduates, residents, post-graduates, and students in related health professions. My current clinical privileges are as a Senior Attending Physician, NorthShore University Hospital, Evanston, IL.

I spent 14 years in the U.S. Navy Reserve, reaching the rank of Captain in the Medical Corps. My primary focus with the Navy was in education and training of professionals providing women’s healthcare in isolated settings, and in operational medicine. For my work, I received two Meritorious Service medals, and the Navy Commendation Medal.

My current positions include:

• Associate Professor of Clinical Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine in Chicago
• Adjunct Associate Professor of Obstetrics & Gynecology, Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda Maryland.
• Senior Clinician Educator at the University of Chicago Pritzker School of Medicine.
• Associate Director of Undergraduate Medical Education, Department of Obstetrics & Gynecology, NorthShore University HealthSystem

I’m the author of 18 peer-reviewed research papers, 7 books, and 7 textbook chapters.

Separately, I’ve reported my experiences as The Reluctant Forester, and posted my Uncle Tom Cartmell’s WWII wartime experiences in A Young Man Went Off to War – 2LT Thomas E. Cartmell, USAAF. In your free time, you may enjoy reading these adventures.

My current focus is on medical training through computer-based resources. My company, the Brookside Associates, produces electronic textbooks, videos, and other educational resources in support of professional training.

I can be contacted at doc@obgyned.com