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Table of Contents    
NI FEATURE - COMMENTARY: TIMELESS REVERBERATIONS
Year : 2015  |  Volume : 63  |  Issue : 3  |  Page : 298-299

Neurosciences Education: From 'Gurukul' to e-Learning


Professor Emeritus, Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication5-Jun-2015

Correspondence Address:
Vijay Kak
Professor Emeritus, Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.158149

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How to cite this article:
Kak V. Neurosciences Education: From 'Gurukul' to e-Learning. Neurol India 2015;63:298-9

How to cite this URL:
Kak V. Neurosciences Education: From 'Gurukul' to e-Learning. Neurol India [serial online] 2015 [cited 2019 Nov 14];63:298-9. Available from: http://www.neurologyindia.com/text.asp?2015/63/3/298/158149


Medicine in Ancient India was based on the practical experience and careful methods pursued by sages in olden days. Ayurveda and Siddha, the all pervasive health sciences, were developed indigenously, and were based on the theory of Tridosh. The third system of medicine, Unani, was introduced when Mohammedans came from Arabia and Persia. This included blood as the fourth humor. The educational system of ancient India was based on a personal relationship between the pupil and the teacher. Medical education was being imparted at the Universities of Taxila and Kasi (Banaras), with Atreya and Sushruta as heads of medical sections. The course of training extended over a period of seven years, at the end of which the student had a thorough and severe test of his knowledge before he went into practice.

There was neither a trained neurosurgeon nor any department of neurosurgery in India at the time of independence. The credit for starting Neurosurgery as an independent speciality goes to Jacob Chandy, followed by B Ramamurthi, ST Narasimhan and RG Ginde. Neurosciences training in India started with a structured programme at Vellore and KV Mathai was the first trainee in neurosurgery, passing out in 1961. Gradually more and more universities and institutions started training courses for MCh (Neurosurgery) adhering to the strict guidelines laid down by the pioneers. The course duration, initially for a period of two years after MS (Surgery), was later increased to three years. A National Board of Examinations was created over 20 years back to conduct Diplomate of National Board (DNB) examinations in various branches of medicine. DNB (Neurosurgery) training (three years after MS or DNB in surgery) was also started at several institutions with adequate faculty and training facilities. Later, at some institutions, a five year direct training programme (after MBBS) for MCh was also started, and the DNB also followed suit with a similar five year direct stream. The Neurological Society of India (NSI) actively took up the curriculum development for training in neurosurgery and neurology at the instance of NH Wadia, and resolutions regarding the maintenance of a uniform standard of examination in neurological sciences throughout the country were approved. It also recommended enhancement of the training period from 2 to 3 years.

Delivery of medical education has changed beyond recognition, due to the rapid cultural, social and economic strides in information technology and scientific knowledge. Education is now defined as an activity leading to a discernible change in the behaviour of the learner. It has now changed from a teacher oriented to a learner oriented model. Current healthcare delivery and finance systems are threatening medical education. Changing needs of the society, advances in scientific knowledge, and innovations in educational technology have resulted in modifications in the medical curricula. Medical education in India continues in traditional didactic teaching and watertight departmental instructions. The National Health Policy (1983) and Medical Council of India Regulations on Graduate Medical Education (1997) were a step in the right direction. We need visionary medical educators to convince diehard departmental heads to changeover to Problem Based Learning (PBL) model. This would facilitate instructional approaches that cultivate self-directed learning, relying on techniques that include small groups and case studies. Trainees must become proficient in technology, and the educators should open up classrooms to online participation. We should train the students to become lifelong learners and critical thinkers. Assessment methods need to change with introduction of formative and summative assessments, and Objective Structured Clinical Examination (OSCE) and Objective Structured Practical Examination (OSPE). The current neurosurgeon is expected to practice Evidence Based Medicine, Telemedicine, and keep his knowledge upto date by attending regular Continuing Medical Education (CME) programmes. The NSI took an active interest in the development of these training programmes, and has been instrumental in starting and running CME programmes since 1977.

E-learning is defined as learning mediated by technology, such as the World Wide Web. Traditional medical education included didactic lectures, case discussions, and assisting and performing surgery. However, changing times demanded newer curricular contents, innovative instructional methods, and creative approaches to assessment. Gone are the days when we spent hours in the library searching and reading literature, with online availability of almost all literature and e-books.

A wide range of e-learning modalities have been widely integrated in medical education. The future of e-learning in medical education is heavily influenced by the rapid adoption of information technology in medical education, a need for competency-based patient-oriented training, and the rapidly changing scenario of therapeutic possibilities and patient expectations. Simulation technology could possibly replace the operative exercise (at centres where it is held). Synchronous learning delivery and video conferencing for patient based training would also improve the quality of instructions.

While digital literacy is not yet a part of the core curricula in medical schools, it is beginning to appear more regularly and more formally as extracurricular learning. Medical education represents a unique setting for advanced digital skills development. Contemporary medicine has been transformed by the ability to collect massive amounts of information from diagnostic devices and to build accurate and predictive models for diagnosis and treatment. These same systems enable the production of simulations of medical crises that can be solved in a variety of ways, giving medical personnel opportunities for rehearsal and practice in risk-free environments. They also build an expectation for translating large amounts of digital data to create easy-to-understand visual representations that make it easier to compare results. This recognition of the importance of discipline expertise combined with advanced digital communication skills expertise has led to the emergence of fields of study such as informatics and medical imaging within medical education.

Having come up through an unstructured training in neurosurgery and having trained several abler and more competent 'youngsters', I hope that the younger educators in neuroscience will take up the challenge of integrating advancing technology in neuroscience education in developing e-learning modules and virtual laboratories to produce digital 'avatar' neurosurgeons and patients. India awaits a digital revolution and let us not be found lagging behind!




 

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