Correspondence

Continuity in Clinical Education

N Engl J Med 2007; 356:2650June 21, 2007

Article

To the Editor:

I was glad to learn of the pilot project in longitudinally integrated clinical education for third-year medical students at Harvard Medical School and the Cambridge Health Alliance, as reported by Hirsh et al. (Feb. 22 issue).1 It will be interesting to see whether outcome data from this and other efforts to reform undergraduate medical education by increasing continuity of care, curriculum, and supervision confirm the reasonable expectation of the authors that “enhanced learning, greater patient satisfaction, and more efficient and effective medical care” will result.

Cavin P. Leeman, M.D.
State University of New York Downstate Medical Center, Brooklyn, NY 11203
cpl@cpleeman.net

1 References

1. 1

   Hirsh DA, Ogur B, Thibault GE, Cox M. “Continuity” as an organizing principle for clinical education reform. N Engl J Med 2007;356:858-866
   Full Text | Web of Science | Medline

To the Editor:

We studied the effect of an “e-learning” tutorial, on reading electrocardiograms (ECGs); the tutorial, held in October 2006, was for third-year medical students at Imperial College London. One group of 83 students was told that the tutorial was compulsory, whereas a second group of 263 students was simply encouraged to use it. Participation rates were 97.5% in the first group and 64.6% in the second. A quiz about ECGs was administered 3 months later; the mean score in the first group was 75.1%, as compared with 60.1% in group 2.

E-learning encourages a deeper approach to learning,1 and it can be used by students in distant clinical placements to supplement knowledge obtained on the wards. High-quality interactive e-learning will help lessen the discrepancy in knowledge due to different learning opportunities at different sites.2

Dean J. Noimark, M.R.C.P.
Karim Meeran, F.R.C.P.
Imperial College London Medical School, London SW7 2AZ, United Kingdom
zcham11@hotmail.com

2 References

1. 1

   Masiello I, Ramberg R, Lonka K. Learning in a Web-based system in medical education. Med Teach 2005;27:561-563
   Web of Science | Medline

2. 2

   Cook DA. Web-based learning: pros, cons and controversies. Clin Med 2007;7:37-42
   Web of Science | Medline

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