Introduction and Concepts in Distance learning

What is distance learning

Explanation of Various Terms.

Glossary of Web Based learning


Practical self experience with Distance Learning?

Difference between Distance Education and Correspondence Courses

 Can skill oriented courses be covered by DE?

Technologies used in distant education

Instructional Qualities for Web Based Learning

Challenges of Web-based Learning

DE in providing medical education to non traditional students

Teacher and student qualities for distance education

Assignment - Preparation of Distance Learning Module

Evaluation of Distance Learning

Advantages and Disadvantages of e-Learning

Famous quotes

Discussion end- Compliments from Sir & Friends

Summary - Distance Learning


Can skill oriented courses be covered by DE?

Praveen Singh
  Yes skill oriented courses can be covered by DE. An example of this is being highlighted below.
But we have to be clear about the additional things required for this like; In between participation in skills at local/nearby/regional places.
Online Continuing Professional Education in Clinical Embryology and Andrology
In the early days of assisted reproductive technology ( ART ), there was a huge demand for training in laboratory and clinical skills such as IVF, embryo culture, cryopreservation, oocyte retrieval and embryo transfer. When micromanipulation techniques such as ICSI and embryo biopsy for PGD emerged in the 1990s, another wave of training efforts began. As a pioneer in the field of ART, the Jones Institute at the Eastern Virginia Medical School became a training destination for embryologists, physicians, and researchers from around the globe. Most of these skills can be learned without traveling to Norfolk or other centers of excellence.

Now continuing education to update knowledge and skills has become a priority. The explosion of knowledge and technology in reproductive science and medicine, together with the power of the new genetics, requires practitioners of ART to keep abreast of developments so that they can provide the best laboratory practice and patient care. As regulations governing ART tighten, an advanced degree will become essential.

In 2003, we launched a new master's degree program to meet the needs of continuing education for:
• Clinical embryologists
• Clinical andrologists
• Physicians specializing in reproductive medicine
• Nurse practitioners
• Laboratory scientists in the field of human reproduction and genetics
• Others who seek to deepen their knowledge of the field without needing to apply it clinically

  Barathi Subramaniam 
As you have quoted DE courses not only abroad,in our country various courses offered by IGNOU has hands on training in regional centres and hospitals earmarked for the said training programme. This includes post basic nursing,postgraduate diploma in maternal and child health and also certificate course in rural surgery..all of which gives practical/clinical exposure upto a c ertain clock hours duly certified by the faculty under whom the candidate is posted

When a candidate works under supervision, would that course still be called DE--- I am referring to the rural surgery course. How many of you would like to be operated by a surgeon who has been trained by DE?Is there any role of DE in learning psychomotor skills?

Will the surgeons on this forum tell me can laparoscopic surgery be learnt online. Any simulators etc available?

  Dr. Tejinder Singh
I would- if I was in a village, suffering from acute appendicitis and had no other option available.
Just to clarify- rural surgery is not some sort of quackery- the candidates are already trained (PG degree) in some surgical branch. A orthopedic surgeon is also taught how to do a LSCS- for example. This training happens in well established centers. The basic objective is to meet the shortage of trained surgeons of all specialties at all PHCs. After all what is wrong, if a Gynecologist performs an appendicectomy in an emergency?
Now tell me, would you get operated, if required?

Yes, I got the point when I went through Praveen's mail. Initially I was sceptical of a 'well read' surgeon who had not honed his surgical skills-- but I now understand that it means practical training plus additional distance education.
We have started DNB rural surgery here in our institute so I was familiar with this concept. Just the DL bit which was confusing.

 Navneet kaur
As far as my Knowledge goes, the Surgical skills labs have trainers of laparoscopic surgery of various levels. The advanced simulators provide a kind of a virtual operating enviornment ( just like a video game or a virtual flight training experience) where a learners picks up the operating skills. (They are kind of a net practice before an actual match is played). But these trainers are not a substitute for the hands on training on patients
Besides once, one has mastered the basic skills of laparoscopic dissection, knotting and endo suturing, the skills for various procedures can be just be learned fron VCD / DVD or online sources
So one can say that to a certain extent, laparoscopic surgery can be learnt online

Navneet please visit the following link and give your comment:

 Even MBBS doctors perform many surgeries in rural areas. In interior areas, it is considered a luxury to have a trained doctor. So, of course gynecologists... can perform appendicetomies in cases of emergencies

Hello barathi, yes I visited the site and it provides beautiful presentations on many laparoscopic surgical procedures.
But one has to be trained in basic endosurgical skills, such as hand eye coordination, dissection and endosuturing etc. to benefit most from these presentations

Navneet I endorse your comments
What emerged from the discussion is that distance learning is also applicable for the domains of skilful & psychomotor learning with a word of caution in the sense that a person has adequate clinical exposure or that training is adds on.


Dr.Sanjay Bedi brought in the concept of Medical University and gave a list of various websites which could be accessed to gather all important information.

  Dr Sanjay Bedi
This is one Virtual Medical University which has online courses. I
worked for some time in this from 1997 as content creator for
Pathology when Dr Mahender Bhandari was Vice Chancellor. He was the original Mentor I had luckily .The concept is good but has not been fully exploited so far due to some reasons. Gradually the concept is blooming with reduction in costs and changing managements and technology. A similar concept can be included public sector as well.

 S. Ziaur Rahman
Do you have any idea - how many virtual medical university exist in India?
Its a new concept!!  
  Dr. Sanjay Bedi
There are a lot of speciality specific groups in India which help in updating yourself and connecting with your fraternity.
For Anatomy it is
Forensic Medicine-
It will be nice if we can add to the list.


  Dr. Sanjay Bedi
Carngie Melon University I considered are model though not in Medical courses. Engineering, Statistics, French etc are taught.


  Dr. Sanjay Bedi
Just In Time Education: a new paradigm?
A new paradigm called Just In Time Education which become possible in 21st Century with the use of Web based Education. I remember during SARS outbreak I was secretary Computerisation of Indian Medical Association Punjab State Branch and we emailed presentation on SARS to IMA members with full X-rays picture and other education materials very quickly.
Just in Time is a concept from Business in Supply Chain Management where raw materials are delivered Just in Time to Cut down downtime costs of materials. This concept is coming in Education also with the learner learn Just in time what he needs to solve a problem rather than pre conceived course materials with lot of flexibility.
Sending a link and an article on the topic.

Revised Medical curriculum?
Sending the revised Medical curriculum received from DGHS.  A lot of e-learning component is there in  many subjects.
REVISED (1144.4 KB)


Paraclincal and Precilinical?
Sending para-clinical and preclinical s available in CD
ABC of Web Based Learning and teaching from BMJ?
2 attachment(s) (202.7 KB), (150.9 KB)


M.B.B.S. by Distance Learning

  Suman Singh
I was just going through the net and found interesting news article to share with you all.

MBBS degree through Distance mode likely to get MCI approval

New Delhi: A new concept in medical education i.e. through distance mode would be possible soon in India by the joint effort of Max Healthcare and the US-based Ocenia University of Medicine. The proposal is under consideration at the Medical Council of India (MCI) and is likely to get the approval before the coming academic session.

If the proposal gets the government's nod, students would be offered MBBS programme through distance mode of education.
According to MCI sources, Max Healthcare and US-based Ocenia University are in regular touch with the MCI for the approval of distance MBBS programme. The proposal is in the final stage of approval.
According to Pervez Ahmed, Executive Director of medical operations, Max Healthcare - "the course and curriculum that Max plans to offer would be as per MCI guidelines and the mode of delivery would be similar to the Ocenia University programmes. The theory part would be conducted in distance mode with interactive Internet tools. The practical classes would be conducted on campus at various functional and upcoming Max Healthcare hospitals."

Welcoming the Max Healthcare's move of imparting medical education through distance mode, Anil Kohli, president of Dental Council of India said, "This would definitely be a major boost to medical education and will make it within the reach of more students. Currently, private medical courses are very costly and not properly monitored.''
Till date, in India, medical education through distance mode has not been approved by the MCI. Only few paramedical programmes are on offer by several open universities including IGNOU. Since MBBS courses need a lot of hands-on training, distance courses were thought to be unviable.
So in near future it may be distance learning all around


  S. Ziaur Rahman
It is new news!! as of now no medical course i.e. MBBS or MD/MS or DNB being offered in India through distance learning. However, few postgraduate diplomas and certificates courses are being offered by private institutes (cf my presentation).
USA has largest medical colleges that are offering medical course through distance education.

 The importance of Distance education is reflecting on our rich discussion. The concept of MBBS through distance education was unheard off! 

 Suman Singh
E MBBS is a great and a revolutionary plan to execute in INDIA. However, a proper monitoring mechanism would be inevitable to its actual success of the said programme but sounds facinating and can change the health scenario of india if monitored.
Soon, get online MBBS degrees
26 Nov 2007, 0051 hrs IST, Manash Pratim Gohain,TNN

NEW DELHI: Next year, if you fail to make it to a prestigious medical college, don't lose hope of studying medicine. A leading hospital chain is all set to offer India's first MBBS programme through distance education.

According to sources in the Medical Council of India which regulates medical education in the country, Max Healthcare and US-based Ocenia University have been in regular touch with MCI over the distance MBBS programme and their proposal is in the final stage of approval. Ocenia University offers online and distance medical programmes in the US and will help Max structure the course.

So far, only a few distance paramedical programmes are on offer in India by open universities like IGNOU as MCI is yet to approve online and distance programme in medicine. Since MBBS courses need a lot of hands-on training, distance courses were thought to be unviable.

Pervez Ahmed, executive director of medical operations at Max Healthcare, told TOI that the course and curriculum that Max plans to offer would be as per MCI guidelines and the mode of delivery would be similar to the Ocenia University programmes. "The theory part would be conducted in distance mode with interactive Internet tools. The practicals would be conducted on campus at various functional and upcoming Max Healthcare hospitals," he said.

Max Healthcare would be upgrading its six hospitals in the National Capital Region to 4,000 beds within three years, sources said. Anil Kohli, president of Dental Council of India, welcomed the plan for distance MBBS courses.

"This would definitely be a major boost to medical education and will make it within the reach of more students.

Currently, private medical courses are very costly and not properly monitored." According to Ahmed, the fees of the distance MBBS course would be "competitive."


One thing that appears is that Distance Education is a more or less universal set and all others appear atleast partly to be a subset of it. Sir, what is your comment on MBBS through distance education?

Idea is good but will the pass outs have equal opportunities as those passing MBBS by conventional education?

  Dr.Tejinder Singh

Do not see DE as a replacement for conventional education; see it as a complement to existing system to address the areas which are not covered by conventional system.
Given the ideal situations, there is no reason why medicine can not be taught by distance mode. Look at some of IGNOU programs- computers, engineering, water management etc are as skill oriented as medicine is. In fact, it will make teaching more standard as compared to opportunistic now. Moreover, DE does not mean that teacher and student never come face to face. (Keegan defines DE as a mode of instruction which does not primarily depend on face to face teaching- the emphasis is on primarily). Only issue is that as educators, we have to convince the society that DE is not a second rate mode! It will require a lot of effort to produce quality material and lot of money to create a virtual reality.
(Come to think of it, even now, a good number of students come to classes just for sake of attendance.)

IGNOU has post basic and masters in nursing.
Medicine can be taught by DE, more contact classes for hands on training is required, acceptance by peers and society on par with conventional training is needed as TS sir points out this can be an adjunct.
Students attendance and performance are not necessarily proportional


I also do agree to your questioning the effectiveness of distant learning as opposed to traditional system. I feel that it may be more of supplementary type as a top up to your knowledge but cannot be totally complementary. Even you must have noticed the most courses offered by IGNOU using such system add extra classes and particularly practical which is mandatory to attend. Also as mentioned by Suman P that MCI is approving the e-MBBS course, some provision for actual but not virtual classes must have been arranged.


With regard to IGNOU courses and Practicals, Hands on training is good but in some centres the distance learners are treated as outcastes. Moreover MCI has never bothered to recognise in spite of GOI recognising various PG diplomas offered by IGNOU


Just read on an online forum that a medical school in Nepal takes two kinds of students in their first MBBS- 50% seats are for students pursuing science stream like us, while 50% seats are reserved for students who have previously done paramedical branches. This system was initially criticized by the 'medically qualified superiors' and attempts made to curtail entry of the paramedical graduates into MBBS. However in the long run, it has been noticed that doctors largely practicing in rural areas and serving the underprivileged areas were largely from this cadre. That has made them rethink their policy.
I was wondering if we in India need to replicate what our close neighbours are doing. And isn't a modified version of this training via distance education a viable solution to the lack of doctors in rural areas. After all what incentive do we give to our health care workers professionally? If they are worth it, can we have defined specific courses so that they are not labelled quacks and can handle basic health care? It will mean getting down from our 'thrones' and sharing our 'superior knowledge'. In any case they have the interest in staying there where we are reluctant. Or will extra knowledge turn them into city mongers too? Any ideas?


Your idea sounds very interesting. May be we cannot make people move out in the periphery but through distance education we can surely strengthen the base of so-called quakes. May be if MCI approves eMBBS and make it compulsory for the so-called doctors in the villages to clear it, it can solve our health related issues. But looking into the sincerity of MCI inspectors, if they cannot assure faith in working of conventional medical schools then who will give assurance about the quality of e Medical Schools?


You are very right in questioning the sanctity of MCI. Because the custodian role of MCI in maintaining the standard of medical education in our country is continuously under scanner due to overt flouting of rules and norms both in private as well as government sector. These being overlooked in existing medical colleges any one can be anxious about the standard of e-course; particularly given the fact that medical education is gradually being engulfed by the consumerism and commercial values. Moreover, is it really feasible to network remote places through such distant learning system so as to reach the target mass in real rural setup? Particularly these doctors are not supposed to be theoretical academician but we expect them to deliver health care by executing their practical skill. How far a distant education be applicable to impart practical skill? Personally, I feel worried about mushrooming of health care education since quantity at the cost of quality is the most imminent outcome.
Distant education/ e-learning are good options to be reserved mainly to enrich the existing knowledge but its role in basic education is still questionable unless we have real interactive network solutions and supporting infrastructure at the grass root level.


  Ziaur Rehman
It’s a general belief amongst medical colleges that MCI has become sort of bias and unfair in most of the decision and in maintaining the standard of medical education. In such situation there must be another accreditation review agency. How about organization like International Association of Medical Colleges (

As mentioned, “IAOMC is committed to peer evaluation of the education provided by individual medical schools anywhere in the world. It is a non-stock, not for profit association. Its goal is to serve society and those with an interest in the evaluation of quality of undergraduate medical education to enhance that education. The standards and process will be transparent and the evaluation results available to the public to inspire confidence in integrity of the process and findings.”

This organization shares the vision of independent, democratic, openness and transparent accreditation and affiliation of medical colleges including e-MBBS. This is also recognized by International Association of Medical Regulatory Authorities. ( 


Thanks for the information and it is appearing such international forum may be more sensible and trustworthy to be used as a watch dog over MCI. However, leaving aside side issues like MCI activity monitoring, I would like to come to the main topic related area. It is nice to know that the course like e-MBBS will also be  accredited by such agency.

Actually there should be clear guidelines and objectives for any of such distant education courses. It is also imperative to clarify that which type of study materials it covers and after completion of such course up to what level these students can cater the health care need. Generally and quite unfortunately we see that many a times this decision limit is somewhat blurred. Instances are many, so this is to be taken seriously and not only setting some criteria will do but actual implementation seems to be more crucial. Otherwise, particularly at peripheral level where public consciousness is less and lack of facility is dire there is ample chance of misuse of such licence for vested commercial benefit. Structured course with stringent guidelines and monitoring the products of such course may be needed, otherwise the system which has ample potential will crash into a failure.


  Ziaur Rehman
Most of the answers of your query could be found from the website of the IAOMC. I agree that there should be a body above the MCI more sensible and trustworthy.

Distance learning is increasingly being looked to by many institutions as an economical way of expanding their activities, widening opportunities for students around the world, and making effective use of the new technologies which are rapidly emerging. Are their some standard guidelines that must be followed by all institutions involved in distant education?


Seeing scope of distance learning in medical education, it seems that the following are some of the prominent points.

1) C.M.E. can be utilised as a mode  of distance eucation which is being done at many places and is one of the prominent utilisation in distance learning
2) Use of medical library services towards medical education
3) Telemedicine, Telepathology
4) some of the disciplines and components of postgraduate teaching

An example of an article quoting this is given below:

Feasibility of a Web-Based Continuing Medical Education Program in Dermatology: The DermoFAD Experience in Italy
Luigi Naldia, Roberto Manfrinib, Leigh Martina, Christian Deligantb, Pietro Drib

aCentro Studi GISED, Ospedali Riuniti di Bergamo, Bergamo, and
bZadig, Scientific Publisher, Milan, Italy
Dermatology 2006;213:6-11 (DOI: 10.1159/000092830)

Background: Web-based systems are increasingly being considered for medical education. A draft legislation on distance-learning programs was licensed in Italy by the National Commission for Continuous Education in November 2003. A series of pilot studies were developed, among these the DermoFAD project, based on five simulated clinical cases of acne and a systematic appraisal of the evidence for their clinical management. From July 1 to August 27, 2004, a total of 500 medical doctors participated in a free of charge evaluation program of the project. Observations: Users were distributed all over Italy. Two hundred and eighty-one (56.2%) were primary care physicians, 83 (16.6%) dermatologists, and 136 (27.2%) other medical specialists. A wide range of connecting times was observed. The pass rate of each individual case, at first attempt, ranged from 44 to 77%. When asked to assess the overall distance-learning experience, 98% of the doctors considered it to be enjoyable. A total of 2,152 continuing medical education (CME) credits were awarded. Over 50% of the users stated they would still use the system if they had to pay for it. Conclusions: Our experience shows that distance learning is feasible and is well accepted by physicians. The DermoFAD program was an efficient means of delivering CME to the Italian medical community at large.

Can we discuss these and other scopes available in medical education.

Distance learning is really a blessing in disguise for those students who stay far away from cities. These students can undergo postal/ internet based teaching for exams like CAT, IIT, PMT ...and shines at par with city students who have the luxury of coaching classes to get through competitive entrance exams.

Barathi Subramaniam
I agree with you that distance learning is really a blessing in
disguise for those students who stay far away from cities. But to what extent the facilities are used by students from remote villages and hamlets?


Here is an ERIC document myth.pdf that deals with myths and realities of DL.
Although published in 1998 most of the things discussed here seems to be relevant to our online discussion. There are good references too.

Dear friends,  I am mailing abstracts of interesting articles on distance learning.


J Am Med Inform Assoc. 2001;8:570-584. DOI .
© 2001
American Medical Informatics Association

Application of Information Technology
Implementation and Evaluation of a Medical Informatics Distance Education Program

William R. Hersh, MD, Katherine Junium, MS, Mark Mailhot, MD and Patricia Tidmarsh, JD

Affiliation of the authors: Oregon Health and Science University, Portland, Oregon.
Correspondence and reprints: William Hersh, MD, Associate Professor and Chief, Division of Medical Informatics and Outcomes Research, School of Medicine, Oregon Health and Science UniversiHersh tor="ty, BICC, 3181 SW Sam Jackson Park Road, Portland, OR 97201; e-mail: < >.
Received for publication: 02/19/01; accepted for publication: 06/01/01.

Objective: Given the need for continuing education in medical informatics for mid-career professionals, the authors aimed to implement and evaluate distance learning courses in this area.

Design: The authors performed a needs assessment, content and technology planning, implementation, and student evaluation.

Measurements: The needs assessment and student evaluations were assessed using a combination of Likert scale and free-form questions.

Results: The needs assessment indicated much interest in a medical informatics distance learning program, with electronic medical records and outcome research the subject areas of most interest. The courses were implemented by means of streaming audio plus slides for lectures and threaded discussion boards for student interaction. Students were assessed by multiple-choice tests, a term paper, and a take-home final examination. In their course evaluations, student expressed strong satisfaction with the teaching modalities, course content, and system performance. Although not assessed experimentally, the performance of distance learning students was superior to that of on-campus students.

Conclusion: Medical informatics education can be successfully implemented by means of distance learning technologies, with favorable student satisfaction and demonstrated learning. A graduate certificate program is now being implemented.

Experimenting with new paradigms for medical education and the emergence of a distance learning degree using the internet:

Teaching evidence-based medicine

Authors: Marius Fieschi a;  G rard Soula b;  Roch Giorgi b;  Joanny Gouvernet b;  Dominique Fieschi b;  Genevi ve Botti b;  Fran oise Volot b; Yvon Berland
Informatics for Health and Social Care, Volume 27, Issue 1 January 2002 , pages 1 - 11
Subjects: Allied Health; Computers in Medicine;

This paper is focused on designing and developing a teaching environment associated with an introductory course in evidence-based medicine designed for undergraduates. Attempting to break away from the traditional educational model based on acquisition of factual knowledge, we developed a software tool centred on content management, student assessment and feedback. We ran this course on an educational website, using chat rooms and electronic mail for trainer-trainee communication over one academic year. The website served as a repository for knowledge and information and presented freestanding web-based interactive study modules and a non-interactive degree course. Trainers and trainees responded favourably to the computer applications and the Internet. This project demonstrated the feasibility of computer-aided learning and the advantages of distance teaching over the Internet.


 What appeared from the discussion was that any course can be offered as distance education but with a fact that DE acts as an adjunct or supplement and if required more amount of contacts can be arranged wherever the situation demands.
Second thing that emerged was that whatever agency is providing such courses should have some proper accreditation if possible both national & international.