The advanced technologies

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Abstract

The improvements and as well as the advanced technologies in the field of the information technology from the past two decades has helped to create some new set of learning models, but when we take the traditional educational systems these education systems are fixed for providing a standard learning platform for the subject enthusiasts, teachers and well as the students which allows them to access to their subjects freely wherever they may be for example they may be in school, home or somewhere else, which also helps to share their opinions, comments and questions. The e-learning tools also help to gain the knowledge, skills and also help easily to renew their performances. The implementation and designing of e-learning in the medical education has several challenges. These challenges are faced by the students and as well as the instructors due to the lack of the knowledge in the information technology. And one more challenge is that the data which is available in this system is diverse in nature. This research paper carries out its work on tools and technologies that are used in the e- medical system, from this research paper one can find the useful information about the advanced tools and technologies that are used in e-learning medical education.

1. Introduction

The education system in recent years was entirely different when it is compared to today's education system the knowledge gained from the lectures was assessed through the examinations and various tests. The system of the education was based on the skills, information achieved from the professors and form books or the instructions given by the instructor, but these traditional education systems never assessed the differences like the capabilities of the learner and his learning skills. The tremendous growth in the field of information technology and as well as the communication has led the development of the e-learning systems, these e-learning systems use the internet, networking multimedia and other type of applications which helps to modify the education process.(Albarrak 2005).The e-learning system mainly focuses on the capabilities of the student rather than on the content. The aim of the system is to allow the students to gain knowledge on a particular subject according to their motivation and their interest in the subject. It also helps in communicating with their friends, peers and as well as professors with the use of the discussion forums and through multimedia conferencing which help them to access themselves through the online exams and they can also find the stuff what they require. It helps the student to have the flexible mode of the education independent of the time and the location. The E-learning system in the today's world is growing more and more with the increase level of the internet and also the availability of the resources. And in the today's world as the infrastructure of the information technology is becoming more and more available more advanced learning standards are expected, and with the help of the virtual classrooms one can easily understand the various complex topics easily, and also more and more practical work can be done with the higher level of the flexibility which helps the student to go through the learning process at any time whenever to wants to learn.(Academic Medicine, 2006).

In the today's industry which means the e-learning industry in the worldwide is around 56 billion Euros and which is going to be increased rapidly in the recent years. It is estimated that by the end of the year 2010 nearly for about 5.6 million students are enrolled in various online programs in the various US universities, as we know in some of the universities in the world wide there are online degrees and PhDs and the number is going to be increased in the upcoming years. The report given by the Sloan says us that the students are very much satisfied with the online courses as much they are satisfied by the traditional classes. And in the upcoming years many of the universities are going to be involved in the online learning systems because it reduces the cost and as well as it gives effective way of learning (Wikipedia, 21/04/2009).

1.1. BACKGROUND

Increasingly e-learning is being offered as an option of the Professional development for the physicians and the medical practitioners. This quantitative study involves in finding the solution for the physicians, medical practitioners and students who are doing their bachelors or masters degree in medical sciences. We are also listing out the identified benefits of the implementing a e-learning portal.

The use of the computers in the medical education is increasing these days. Since computers are a truly an interactive medium, Computers are replacing the use of the text books. The computers are presenting reliable and reusable content in the format convenient to the learner.

Learning is the sharing of information between the two parties. Today knowledge transfer is increased to the hi-tech level. Traditionally people used to learn by listening to the lecturers in the class room which is integrated with labs where they are implemented. The complications exists due to the practitioner poorly attending the lectures or cancelled lectures. The complications may also exits due to un predictable lectures. In these situations the theory of the effective knowledge transfer will fails.

E-learning portals can help the practitioners in solving the knowledge deficiency problem. If utilized well this can fulfill all the needs of the practitioners. E-learning portals enables the students and the practitioners to access the lectures and information when ever they are most attentive. The users can also review the material to a degree they fell necessary.

2. LITERATURE Review

The E-learning system is the use of the technologies which helps us to build a internet based learning or a computer assisted instruction. The E-Learning tools help the learners to have their grip on the contents on which they are going to take their instructions such as the time, media and the learning pace. The E-learning system can be considered as the effective way for the traditional instructional methods but it should be considered as the compliment to the traditional methods instead of treating as the replacement.

The E-learning system is the web based internet based learning, this help us to go through various materials which can be given through the CD-ROM/DVD which are given through the LAN network or can be given through the internet. Basically there are two kinds of ways for the E-learning education which can be known as the e-learning practices they are distance education and the other one is computer assisted instructions. Mainly the distance education is for the learners who are at remote locations but this is carried through the central location, the delivery can be of any type such as it may through real class rooms sessions through the VSAT (satellite technology) or through multimedia streaming through the instructions. And one more aspect is the computer assisted instruction which involves the usage of the computers which allows us to deliver the standalone multimedia packages for learning and as well as teaching, these two can be integrated through the internet.

The E-learning education comes in many different forms, they can be given as the instructional which means it is pure of instructions which means no face to face interactions, another type is the blended e-learning which is involved of both which can be given as pure instructions and as well as the face to face interactions. There are two types of learning in the medical e-learning education they are synchronous learning and Asynchronous learning, the synchronous learning in the one which involves the student participating in the real time classroom sessions and where as the Asynchronous learning involves the student taking the instructions after the classroom session is recorded and which is distributed at the later time. There are some other types of the E-learning they can be given as web based, computer based, led groups and video/audio media. There are more and more delivery methods they can be also known as different delivery methods such as print that is via e-books, e-magazines etc, and the other methods are through the videos such as the streaming videos, video tapes and also the satellites, and also through the audios like the audio tapes and the streaming audios. And finally the reviews and the exams can be through the electronic, interactive and the paper based and this can be done asynchronously through the weblogs, email and also synchronously through the video and the audio conferencing.

2.1. Synchronous E-Learning

The interaction oriented learning and scheduled instruction learning is known as synchronous E-learning, and it is known as real time and live education. It mainly takes through the electronic media, and the synchronous E-learning is entirely separated from the Asynchronous E-learning because it is mostly live and it may involve some procedures such as the pre registering and the diagnostic technical checks. Here in the synchronous E-learning the learning experience is real time, and this type of the learning can be blended.

With traditional and asynchronous learning and form this new blended learning systems can be developed which can be live and also real-time and this learning can be self paced. In most of the universities and the institutions this synchronous E-learning is growing rapidly and fastly. And according to the reports given by the e-learning guild research that 90% of the students are interested in the synchronous e-learning.. Because of rapid technological advancements e-learning is trying to use the best practices but there is still uncertainty in planning, designing and delivering in this system. And it also got some different types of modes which can be given as web casting, e-learning, Virtual learning, web conferencing, video conferencing, live meetings etc.

The Synchronous e-learning means it is all about achieving the effective training and also education by utilizing the tools.

The Synchronous e-learning can be given as:

  • Teleconferencing is the one which involves audio and video conferencing
  • Gaming.
  • Web casts.
  • Web conference.

2.1.1. Teleconferencing:

The Teleconferencing can be classified into two types they can be given as

  • Audio conferencing.
  • Video conferencing.

Audio Conferencing:

The Audio conferencing is also known as the conference call which can be a call over the telephone or the internet call. And this is the tool that can be used for the knowledge sharing and as well as the project updates and it is known as the synchronous tool since in this discussions are live and these can be recorded for the future use and for the references. (Synchronous E-Learning Book, 2005, p.3).This helps us to give the instant feedback and helps us to assess the knowledge acquired. This technology can also be used with the other means which helps us to make effective when used for the presentation slides and materials through the messengers and the virtual classrooms.

Video Conferencing:

The type of the E-learning in the medical education gives a great potential for the students, because it is almost a point to point or multi point broadcast of video and audio simultaneously. It gives us the real time experience because it gives us the face to face interactive sessions on the full screen. And there are also many ways for going on with this video conferencing they can be web cam driven communication and the ISDN to IP conferencing which allows user friendly environment with the desktop. This technology is very useful for the training when there is need of the training in two different locations at the same time where class rooms can be broadcasted live through satellites or through desktop integration.

2.1.2. Web Casting:

The web casting is nothing but it is the reference to the internet technologies which has the ability to transmit the audio and the video also, and it is usually helpful in broadcasting the content over the web and also helps for the streaming media which helps in transmitting the audio/video very efficiently over the internet, and these streams can be encoded and decoded using the formats that are supported by the systems such as the real media, windows media and Quick Time(Synchronous E-Learning Book, 2005, p.4).And this web casting can be used in the unidirectional such as the point to point or point to multipoint broadcasting and it is mainly based on streaming the media over the internet. These web casts are useful for the larger volume of the learners and they can be also used for the presentation style learning.

2.1.3. Games and Simulation based Learning:

The Games and simulation based learning comes under synchronous e-learning and this is still in infancy. But as the new technologies came into existence with the field of information technology we can say that the simulation based learning is emerging, and with the help of these virtual campuses are being established. This Gaming and simulation based learning has spread to sophisticated areas such as medicine, aviation, military and financial services where real time representation can be simulated on the desktop or on web (Synchronous E-Learning Book, 2005, p.5).

2.1.4. Web Conferencing:

The web conferencing and the webcasting technologies are totally different. The web conferencing is highly interactive and also it is myriad of the internet application which helps us to provide a rich set of tools such as the audio/video from the instructors and learners, polling, chats, white boards, discussions threads, website tours, chats etc. It can provide a highly collaborative and as well as interactive online learning. The web conferencing is suited for the small classes to the level of large group of learners. In the academic session it helps to form basis for the virtual class rooms. It helps the learners to discuss the issues and share the views and experiences and also to follow up the questions and as well as the practice sessions such as the exercise and the case studies. It also helps in building the social networking and as well as the communities and to build a high order skills paving way for the mutual understanding and for the sharing of the knowledge which doesn't interfere with ethics and cultural backgrounds of the individuals and the instructors (Synchronous E-Learning Book, 2005, p.6).

2.2. Asynchronous Learning Systems:

These types of the learning systems are self paced; they are independent learning methodology which has the intermittent access or the collaboration. This is not the real time and the live scenario. And in these learning systems the contents and also the materials and recorded that means they are reproduced and these are available by means of the web and the electronic media such as the CD/DVD and also the tapes. And the learners can interact with each other through the emails, discussions forums.

2.3. Advantages of E-Learning

There are many advantages in the E-learning environment, and few of them can be given as follows

  1. The E-learning helps the student to learn the course according to his capabilities.
  2. The E-learning environment is self -directed.
  3. It helps the student in choosing their contents according to their skills and their interests.
  4. In the E-learning system the students have the chance to take the instructions from anywhere, which means that there are no geographical barriers.
  5. These helps the students to save their time and as well as their costs for the courses.
  6. It helps to increase the co-ordination between the students and as well as the teachers.
  7. And for example the E-learning helps us to increase the global opportunities a student form the UK can take the courses from the universities in USA, which helps him to save the cost of the education in terms of the residence.
  8. And the students also have the flexibility to take up the courses according to their schedules.
  9. When compared to that of the traditional education system the E-learning helps to introduce the new technologies constantly into the education system.
  10. And finally we can say that the E-learning can be integrated with the traditional education systems with the help of these new results and continuous improvements in the medical field can be achieved.

2.4. Disadvantages of E-Learning

The E-learning is especially for the students who have the good skills in the computer and as well as the internet skills, as it is based on the information technology. The students should take on their own this means they should be like to read, write and also self directed. The students should be independent and they should undertake any task, and also some times the e-learning degrees may also take some longer times than that of the traditional degrees.

2.5. Virtual Learning

It is the software program; it helps for automating creating course content and also for tracking the performance of the student. This type of the learning environment can be called as learning management system and also course management system. It also helps the educators to provide a standard method of delivery of the course through the internet according to the needs of the students, and these type of the systems gives an approach to divide the course material into the units and also the modules, which helps the student to progress at their own pace. These virtual learning systems can be divided into two types they can be given as proprietary and open source systems. And the first virtual learning system have the products which are commercial and these need to be purchased by the organizations that is form the vendors the examples can be given as WebCT and Blackboard. And the second type of the virtual learning systems are made by the developers the example of this type of learning system is Moodle ,these type of the learning system are free they don't cost any money but they need the technical skills in order to maintain the software..

2.6. Overview of different virtual Environments

2.6.1. WebCT

The Web CT was actually developed in the year 1997.This software helped the students to gain the access to various websites which consisted the instruction material. The user using the WebCT needs the login which allows them to go through the course materials and this access will be based on the privileges that the user or the student gets. It also allows us to export the questions, assessments and other contents from the other Web CT modules. And there are some disadvantages in using this one of them is the lack of the structured format which has made the instructors to take time in adding the modules to the system.

2.6.2. Blackboard

It is the learning management system. It has the strong capabilities in giving the instructions, communication and assessment.(Beatty & Ulasewica, 2006: 37).This can be exclusively used in the educational institutions which helps them to create the online courses and also helps them to provide the learning materials for the traditional classroom instruction. Blackboard allows us to import and as well as to export the documents, from the development of an institution-wide learning object repository and the collaboration among instructors to develop new learning objects (Blackboard, 2005: This system has a more structured format when compared to that of the WebCT which helps us to decrease the flexibility and it is interoperable legacy WebCT systems.

2.6.3. Desire2Learn

It helps us by providing the eLearning management suite and it also has some separate software applications for the course management, learning object repositories and communications tools. This product is so tailored to provide instructors with the ability to develop and use different learning paths for the same course presentation. The main drawback of this Desire2Learn system is the need for institutions to purchase software offered by the company to develop a fully functional online learning environment. The firm has been sued by Blackboard for patent infringement, which raises the possibility that institutions using the product may also face legal or financial liability (Carnevale, 2006: A30).

2.6.4. ATutor

A Tutor is the software which is available free of cost and it is free open source learning software developed by one of the university known as Toronto university. This has the same features to that of the proprietary systems and it provides horizontal communication to the students and also vertical communication to the instructors in the course management and assessment tools. And this is fully XHTML complaint virtual learning environment and this can be downloaded and it can be integrated to the virtual learning environments (A Tutor, n.d. 1).

2.6.5. Moodle

The Moodle is the one which stands for the student assumption that the student has an inquiry and discovery for taking up the course and the instructors can modify the materials according to the needs of the students. This type of the software can be used with different types of the operating systems but it also needs a strong SQL support. It also has the minimal features when it is compared to that of the commercial legacy soft ware's. But it is very helpful for the institution and organizations for modular object oriented dynamic learning environment and is a free open source virtual e-learning environment (Brandt, 2005).

2.6.7. Sakai Project

Sakai is another open source virtual learning environment developed with the collaboration among several universities and offered to the education institutions who are participating in this project. It offers same tools as in other systems for online education including learning management communications and assessment (Angelo, 2005: 21). It has several difficulties with automated content integration from outside sources. There is an annual fee charged to the institutions who are participating in this project.

3. Methods

3.1. RESEARCH METHODOLOGY

Major amount of time was consumed in selecting the best research methodology which suits this thesis. Although there are many practices came into existence each one has its own significance.

The methodology is defined as a highly intellectual human activity used in investigation of nature and matter in which data is collected, analyzed and interpreted. A research topic is a unsolved or unanswered question, concern, query or a statement of enquiry.

There are some of the limitations encountered when doing or thinking of doing a research project. The time constraints since it includes continuous study of the alternatives more study consume more time. Financial considerations are also some of the major limitations since research study incurs more cost due to search for a material, availability of material and travel in search of materials.Limitations anticipating and avoiding problems Limitations due to Equipment. There may be an situation where required to work on a rare equipment the researcher must required to utilize the equipment more carefully and limitedly. Human resource limitations many occur since the availability of the support team for the information gathering. There are two more considerations like "Out box thinking" and "In box thinking" if the data for there two are very vast the proper solution may not be received.

A systematic review of available resources is called the Literature Review. This includes the theoretical and conceptual concepts to be reviewed. We also required to identify the independent and dependent variables owing to the research. We also required measuring the operational definitions. Although there are many research techniques are available selection of the appropriate research technique will help in completing the process very soon. The review must also follow the sampling the strategy where the samples are taken and observed for findings. A statistical technique is required to be followed since the findings must be measured and to be proved statistically. There is also provision to study the findings and conclusions of the similar studies. The most sources of information in the literature review are Books, Journals that are published by societies, Internet as a major resource for the knowledge, Databases although not available for free of cost this resource may require special permissions from the administrators, Archives can be gathered from the libraries or book stores, Interviews taken from the persons of that are specific to the topic, Observations from the experiments done, Reports from the previous researches, Records of the previous research.

There are three forms of research Exploratory Research, Constructive Research and Empirical Research. Whenever a problem is not clearly defined then Exploratory research is conducted. Exploratory research determines best research design data collection method and subject selection. In computer science based researches constructive method is used. In this method conclusions are objectively argued and defined. Since it constructs new objectives it is named like that. Where as empirical research tests the feasibility of a solution using empirical evidence.

Selecting the appropriate methodology is based on the nature of the problem being investigated. Checking weather the problem is subjective or objective. Subjective problems required a study on the specific subject and objective problems are done by investigating the available options. There are four types of research methods

  • Qualitative
  • Quantitative
  • Qualitative and Quantitative (Mixed)
  • Critical and Action Oriented.

3.1.1. Qualitative methodology

Qualitative methodology is based on the Surveys. Generally used to survey based on the referenced. This methodology is longitudinal in nature. It implements cross-sectional correlation. This methodology is experimental a number of experiments are conducted on the domain space based on the experiments the system solution is founded. This is Exposit facto research.

3.1.2. Quantitative methodology

Quantitative methodology is biographical in nature which involves in the study of a single thing in depth. It is also phenomenological i.e based on the experience of the building materials and their sensory properties. This also involves in finding the fullest possible context about the subject. This is also based on the case studies.

We are proposed to used the mixed approach of the qualitative and quantitative approaches for our research due to their benefits when mixed we can find the perfect solution.

The process in collection of the data is as follows at the first level nominal observation can be coded. We also observer the ordinal observations that can be ranked, identify the observation that can be counted or measured. And finally mix all the observations and prepare a matrix for identification.

We proposed to collect the data in the four ways. Observations are done by observing the existing web portals that are intended for the learning for medical domain. Interviews are conducted with the people who are practicing the medicine as well as studying by using the learning portals. By developing the reports and observing the records that are previously done in the same domain.

Data analysis is planned to be done in three ways by considering the type of data collected. The available data is separated by identifying the categorical, continuous and mixed.

Tests are conducted on the categorical data Chi-squared test-to determine the relationship between the variables, Fishers-test to compare two unpaired groups, McNemars Test to analyze the matched case-control study. Kappa to quantify interafter agreement. Wilcox test-to compare one group to a hypothetical value, Kruskal-wallis test-to compare three or more groups Spearman test to compare association between variables.

Continuous data can be tested using T-Test to compare one or two groups, ANOVA to compare three or more groups, Pearson test to compare the association between variables.

Drawing the conclusions from the data is based on the graphical presentation of the data, using the statistical analysis, Sharing data among the colleagues and receiving constructive feedback, Critically analyzing the data and results.

The research findings can be presented by a table of matrix representing variables. Figures- Visual organization of data like pictures, pie charts, line charts, bar charts, flow charts, organizational charts, cartogram charts, Gantt charts, scatter plot charts

3.2.Web survey of different medical websites

3.2.1.Zoomerang:

In the field of medical education it is very useful for the students and as well as for the medical organizations by doing some research and also online web surveys, here we can give some web surveys which will be useful for anyone who goes through this topic for further developments.

The medical research surveys can be conducted for improving the health, these surveys helps the students a lot who are taking their medical education through the E-learning system, these online surveys helps them to know about the feedback of the hospitals, small medical offices and it is also useful for conducting medical industry research. With the help of the surveys tools like zoomerang we can conduct surveys on the women's health research or we can collect health statistics. In order to make web survey we need to use a survey panel which helps us to reach the participants that we need to interview. The zoomerang is the one which has the panel participants more than 3 millions which is very helpful for conducting the online surveys. The zoomerang helps us to create and deploy fast and quick medical research questionnaires. It also gives the tools for better understanding of the medical research surveys. It also has some thousand of satisfied customers some of them are Johnson and johnson, the American medical association, children's hospitals and more. It also gives us the tools to maintain privacy about the patient's details.

There are many reasons for using the Zoomerang for the Medical research surveys

More than 97% of the students and customers are very much satisfied with the Zommerang. Many of the leading schools and the medical organizations use the Zommerang reports are given very clearly so that everyone can understand them.

3.2.2. Medical Web Use Survey for Patients created by students with the help of the E-learning Medical education

With the help of the E-learning tools in the medical education the student can create the online web surveys which will be very helpful and useful for the patients and these surveys given by the patients can be used as the research for the students for their education. These surveys also help the medical organizations to evaluate the standards of the healthcare and for the government to see that what type of health requirements it is providing to the people. The surveys questionnaire which is created online which is helpful for the E-learning medical education can be given as follows

3.2.3. A new approach the use of the Web 2.0 technologies for undergraduate and postgraduate students in medical education:

The main aim of the web survey was use of the Web 2.0 technologies and to identify its familiarity and also it should be used by the medical students and as well as the medical practitioners and also its use for the E-learning medical education. And the method was a semi-structured online questionnaire survey and almost for about 3000 medical students and as well as 3000 medical practitioners were participated in it. And the results were all the groups had the high familiarity but there was less use of the podcasts, and the use of the digital media players were high by the medical students. But the use of the Web 2.0 technologies was somewhat low due to the lack of the skills and as well as the knowledge and also they don't know how to use the technology, but there was a high usage of instant messaging and also the social networking by the medical students.

And overall there was good response by both the groups for the use of the new web 2.0 technologies but this can be used clearly and it can be brought into use for the medical education if necessary education and skills and also the training is provided how to use this new type of technologies.

3.2.4. BOSTON MEDICAL CENTER (BMC):

The BMC known as Boston medical center is famous for its online surveys on healthcare, it is an extra ordinary medical center and as well as community for the healthcare, and its online site is www.bmc.org and its mission is to provide exceptional care without exception. This medical center conducts online surveys about the patients to know about the healthcare system and these are very useful for the e-learning medical students for developing their knowledge about the outside world and to gain practical knowledge. The Mission of the BMC is to provide excellent health services and accessible health services to all of them who are in need of care regardless of their creed, community and status. The vision of the BMC is to provide the health needs to the people of Boston and also for its surrounding communities by providing a high quality of the healthcare. And it has some values such as respect, commitment, diversity, competence, education, and research and cost effectiveness. The surveys conducted by the BMC take place less than one minute or less.

3.2.5. e-Lime

(Jottings on e-learning and on its application to medical education)

The VLE/PLE debate and medicaleducation

In the field of the medical education in the e-learning process now a days there are going on debates and sessions between the great professors in the institutions.beacuse there are certain disadvantages in the use of the advanced technologies from the side of the students and the skills and the knowledge should be taught to them. According to the recent debates in the field of the medical education, the famous learner Steve wheeler says that it is inevitable that the personal web will have a win over the VLE .He says that the use of the personal web is to support the own personal development and he says there are two main reasons for this

The use of the WEB 2.0 tools is very low which supports teaching and learning which will be among the best students and teachers.

And the other one is the firewall issues in the NHS which will be prohibiting the use of the number of personal web tools which supports the teaching and learning.

3.2.6.Undergraduate medical education in emergency medical care: A nationwide survey at German medical schools

From the year of the 2002 , there were some revised regulations in the Germany which says that the emergency medical care as an interdisciplinary subject in the medical education and the emergency treatment should be given importance, and on this basis a online survey was conducted for the undergraduate medical education students for evaluating the surveys from the students. Based on this a standard questionnaire was implemented and all the medical students and the medical faculties in Germany were asked to answer for this questions with concerning the issues like teaching and assessment methods, representation of disciplines, instructors, qualifications and as well as evaluating the procedures. The results were the data from the 35 out of the 38 medical schools in Germany were analyzed. In 35 of the medical faculties the 32 medical faculties, their local departments of Anesthesiology was responsible to teach the student of emergency medical care; but in the two faculties, emergency medicine was supposed to be taught by the Department of Surgery and in the other by Internal Medicine. And the Lectures, seminars and also the practical training sessions were scheduled in different composition at 97% of the locations.

3.2.7. SCIENCE VISION:

Science vision is a company that delivers its services to the e-learning medical education. The science vision helps for the online education and as well as its online services for the healthcare systems. And there are different technologies that it offers for the students and as well as for the others such as the

  • E-learning courseware
  • Interactive physician learning
  • Webcast services
  • Website centre
  • Resource centers
  • Online news letters
  • Online surveys

This company or the organization helps to use the advanced technologies in order to know more and more about the advanced world in medical field and as well as to teach skills and to give more and more information for the people and to make them use of the available technologies.

3.2.8.Use of information and communication technology by medical students' survey of VSS Medical College, Burla, India

In the year of 2005 there was new impact of the technology in the medical education which has brought some tremendous changes in the medical education field, and these made to undergo some changes (Harden, 2002; Davis and Harden, 2001).The medical schools in the developed countries were interested in the ICT information and communication technology which was helpful to improve the quality of the education and also the helpful to improve quality of the health service. And in the developing countries like India where there were the scarcity of the human resources in the health sector was a serious problem and the ICT-mediated education was certainly the beneficiary one, and there were problems for the students who are in the medical education due to lack of the resources and the information was not available so the ICT tool was the best at that time in the medical education to provide students some knowledge along with the developed countries to reach at their targets and to known about the advanced medical procedures.

3.2.9 AN ANALYSIS ABOUT THE WEBMD WEBSITE:

The WEBMD is an website which helps the students and as well as the medical practioners to known about the advanced news and to know about the healthcare systems and also to know about the advanced technologies in the medical field for example to know about the diseases like AIDS and its symptoms and also to know about the nutrient diet and health food to have and also guidance to maintain a good health care of our body. The WEBMD website gives the information for all the people about the health system a-z and also it helps to maintain good health care systems by using online resources by the e medical students this type of information can be known and their skills can be developed.

10. Office of Medical Education Faculty Development

The Boston university school of medicine OME faculty development has developed a medical web site it was developed by the medicine office of medical education faculty development program it was developed in order to assist the faculty and staff in order to increase the effectiveness in their teaching by providing a central location for the use of the medical education information , self paced quick tutorials on teaching and educational career development strategies. This helps them a lot increase the teaching standards and to provide the students the advanced skills and the use of the new developed tools in the medical education by which the students can also developed their skills solely which means indivually.

4.Evaluation and Analysis

From the researches and the information available from the research papers from the medical field tells us that the implementation of the e-learning in the field of the medical education is the most effective virtual learning environment. In the present generation the students have the independency in gaining the vast knowledge and they also learn a lot of things in the medical field since it is evolving and also the new things can be added to the curriculum. The online universities evaluate that that the E-learning in the medical education system is more effective and also it meets the needs of the institutions and as well as the students which is similar to that of the general proprietary systems such as the blackboard learning systems. (Stewart et al, 2007: 1). These evaluations were based on the objective criteria which are established by the university which includes the cost of the implementation, usability, of the student and as well as the instructor and assessment protocols. And the implementation of the e-education systems in to the present medical curriculum this is not the easy task so there will be a need of devising plan which includes trainings, assessments and the final outcomes and decisions in order to use e-learning. Some of the universities have tried to use e-learning systems as the standalone systems for expanding their curriculum but it is the body to be with the strategy that should consider benefits of the blending learning. In the medical field the E-learning can be applied in different ways in the undergraduate medical education it offers the contents such as the self learning or with the collaboration of just normal E-learning tools, But where as in the case of the post graduate education the content of e-learning can be divided ,these can be divided depending on the competencies and they can be effectively utilized in the field of the education and for the educators such as the students and the resident doctors by replacing the traditional lecturing systems (Academic Medicine, 2006).And when is the requirement is high and the hours are limited the system of asynchronous e-learning can be utilized effectively. And thus in final we can conclude that the physicians can also attend their conferences through the new model of the e-education systems in the form of the e-conference from one place with the daily medical obligations.

5.Future Enhancements:

5.1.Recommendations of the Appropriate design for an online E-Learning in Medical Education

The amount of the research work in the E-learning environment can be increased by focusing on the flexibility and also the adaptability of the content (Arroyo & Mizoguchi, 2004: 366). In the point of the current use of the tools the authoring tools are effective in the specific domain they are being used but they have low functionality in the domains or else they may have high cross-functionality but they have low effectiveness in the individual domains. This problem has risen due to the absence of the standard philosophy for the content of the authoring process in the virtual learning environments, with each of the system which helps in developing a separate philosophy which is not compatible with that philosophy which is used by the other systems. As this the result may occur as the same processes used for authoring the content in one E-learning this may not function well in the another E-learning environment, to the further coming generations there will be a great scope of developing this environment in greater degrees of the standards which allows the ability to author and as well as to extract the contents form the external sources which can be used in the virtual learning environment.

And there can be also a research in involving the use of the knowledge maps or the e-maps as the method which helps in organizing and also in sequencing the course materials (Ruffini, 2004: 383). This helps us to develop the approaches for developing the graphical representation of the way from the student can process information and also the way of learning occurs. And the content of the course can be structured in accordance to the map with the level that the map tool can be embedded in the course management component of the virtual e-learning environment software, and to this the map can be linked to the knowledge objects that are available in the repository. And the use of the map helps us for the identification of the learning objects that are suitable for the usage when we are developing courses.

There are some difficulties with the knowledge object repositories in the current virtual learning systems and one of which is having potential large number of objects and with particular fine granularity. The inclusion of the learning objects in a course becomes more and more difficult because of the reason that the instructor may not be aware of the object and whether the object exist in the system or not. The e- map is very useful in providing support for the functions such as internal search with the abilities like retrieving the learning objects in response to the query of the instructor which may be suitable for inclusion in the curse materials. (Jansen, 2006: 72).And with the development of the XML functions such as the search functions it is easily possible to automate the selection process of the content which are based on the query parameters which are established by the instructor. For these results the contents of the course should be customized for the needs of the individuals. The students have benefits such as gaining the ability to draw the additional contents from the internal and external knowledge repository which helps them in understanding the subject and to gain more and more knowledge and skills. There are many trends emerging from the research work in the virtual learning environments which is the development of the wider range of the tools. The approaches for the virtual learning environment software in the today e-world are based on the traditional models in which the instructors can develop the curriculum which are from the presentations with some online medium which helps them to transmit to the students. Now a days the method of the content delivery is online and it give us the opportunity to develop the learning approaches, and these approaches are based on the issue how the online media operates. And here we can give an example of this type of the collaborative approaches is to research the effectiveness of using the Wikis as the part of the learning process (Bold, 2006: 6). A Wiki is nothing but it is the collaborative document which is posted on the website where all the members of a certain community can be able to view and edit it. And here we can state that each Wiki page can be devoted or allotted to a specific subject and it contains knowledge all about the project. And here the collaborative tool is used for the assessments and helps in identifying the contribution of the each student for the development of the Wiki. And it helps in creating the opportunities more and more for a greater amount of self-directed learning and this can be more and more effective in learning more advanced subjects. And finally all of these can be easily implemented in the field of Medical education by using the VLE and we can also use 3D VLE which shows us the real practical sessions using the ICT.

6. CONCLUSION:

The E-learning education is the well known online education or the distance education which refers to the usage of the internet and as well as the communication technologies which helps us to broadcast a wide range of learning methodologies which helps the students to developed their knowledge, skills and also their level of performance. And when we compare the cases this is very similar to the concept e-learning in the medical education. The implementation of the e-learning in the other fields and existing fields has brought a change in the learners and as well as its implementation in the field of medical education. As all of us know that this stream is very large field and it's mandatory to maintain record and information about this field for the use of the students and as well as learners. There were lots of challenges too in this field technically and as well as skill based. The faculties in the medical education should be given training on technologies, tools and skills for using the contents. The students should be educated how to use these tools and technologies, and thus finally the integration of e- learning in the medical education is really a great advancement in all levels of education whether it may be undergraduate, postgraduate or else the returning doctors who want to have the information till date in this modern advancement world, and also the skills, knowledge, technologies, tools

About the advanced medical world, which helps to make a great future and way for the adult education too?

Personal Experience:

I have always found this 'research' is very interesting enjoyable and more approachable for me. There are so many pro's and cons while doing this research, why because its totally different from other fields and it is not that much easy to gather the information and do the research in this topic that to medical field, I can't able to get the websites for the medical survey I can't found particular sites for the web survey,I think I spent a lot of time to do the survey, I came to know more about the surveys in medical field and I feel that all those are great moments which I spend lonely sometimes with listening to music inorder to not get bored, all those discovery and achievements make worthwhile to me.

I have finished this research on time its because of my supervisor Frances Slack ,she given me more confidence for me to do this research, and she suggested me so many things about this research I feel free and more comfort while doing dissertation under her supervision. Everything she explains clearly and the way she encourages the student to do the best of their research by conducting the dissertation workshops that makes my project more easier to me, workshop shows us how to do and what to mention in every chapters everything I learnt a lot from the workshop, I feel its so worthwhile for the students who are doing there research. so that I had finished my task early on time, her words and her suggestions make my project more beneficial for me to complete on time. She not only gives me the suggestions about the topic but i also had so many things learnt from her supervision. During the appointments time i used to discuss everything about my career plans and I used to take a lot of suggestions from her. She used to guide the students in a positive way; I am very much impressed with her support and nature.

I know that no need to mention all these things in conclusion but just I want to say special thanks to Frances Slack.

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