| Continuing medical education, required by law in most states as a condition for professional license renewal of physicians and increasingly so for nurses, has always been problematic for a variety of reasons--time away from family, lost practice income, considerable travel expense for specialty conferences which may be located in other regions of the country, and, frequently, considerable tuition costs. However, computers and computer-based communications technologies suddenly have created new and exciting opportunities for learning through distance education. The success of these programs presumes the willingness to use them along with the requisite computer skills which make them accessible.; This study examines the predecessors of distance learning, the current state of computer-based distance learning in emergency medicine, and explores the potential for a promising future in a virtual reality environment. Physicians and nurses actively engaged in the practice of emergency medicine in a variety of clinical settings and from diverse geographical locations participated in this study. Attitudinal factors which appear to influence the acceptance and utilization of this instructional technology among nurses and physicians are identified and explored by means of survey research and statistical analyses, using Chi-Square tests of independence, Kruskal-Wallis One-Way ANOVA, Mann Whitney U Test, and the Kendall Correlation Coefficient.; Among nurses and physicians who participated in this study, over 85% are computer literate. Forty-seven percent of physicians and almost 30% of nurses use computers on a daily basis. However, modem skills are problematic for both groups. Greater than 90% of respondents indicate willingness to engage in on-line computer-based continuing medical education programs, particularly those meeting state licensing board criteria for credit toward license renewal. Between the two groups, clear user preferences emerge for various on-line services, such as real time consultations. Nurses and physicians perceive computers as enhancing professional skills and development--clearly learner preferences which demand consideration in educational planning and research.; The apparent vitality and viability of computer-based distance learning in emergency medicine presents a clear challenge to medical educators to lead the way to the communications superhighway of the 21st century--the Internet--or be supplanted by entrepreneurs who will. An eight point plan of action is proposed as a beginning strategy for implementing and promoting computer-based learning among nurses and physicians engaged in the practice of emergency medicine. |
