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Learning, the Web's Potential


A&E, the documentary TV channel, chose Johannes Gutenberg as top man of the millennium for his invention of the printing press. Why? We as a society place high value on access to information. Sharing knowledge is the most expedient route to enlightenment and is a major factor in creating cohesiveness, regionally and globally.

Our current Gutenberg is the internet. But the potential of this new medium has, thus far, been offset by an emphasis on Web sites designed first and foremost as IPOs. As a friend of mine who is a very successful venture capitalist in Silicon Valley said, "We used to get excited by companies that had the potential to be valued at $10M, but we wouldn't even look at one now if the upside wasn't at least $100M—and preferably $1B." Healthcare e-commerce alone, it is estimated, will be worth $370 billion by 2004.

As a result of this new Web-based, gold-rush economy, I don't believe the true power of the 'net is being developed for professional and lay education. On the one hand, some 15,000 health sites currently exist, 45% of online consumers access the internet for health information, and 19% of physicians earn CME electronically. But disinformation abounds, and few sites have advanced much beyond the "shovelware" stage.

Gutenberg invented the printing press for the mass transcription of quality literary and religious works that had been accessible to only a privileged few. Why don't we have a similar goal? Is it our intent to allow the development of the internet to be directed by commercial interests? Or can we find ways to use sound principles of "knowledge engineering"—and investment—to best benefit various groups within society?

As a physician, professor, and editor, I'm naturally interested in the Web's role in physician education. Starting now, we need to think of the Web as a new printing press—one with far more power and capability. But who is going to develop user-centric, multimedia, interactive teaching if it is not of immediate commercial interest? I doubt universities and colleges will do this. Although they have the content experts, they don't have the technical and business savvy. Publishers alone lack the content expertise. It's clear that partnerships are needed in this new venture—partnerships that respect the importance of quality learning and content, want to develop new methods of teaching, and recognize the role of commercial interests.

Current limitations: (1) Bandwidth. (Given the current speed of change, this won't be a problem for long). (2) Access. (For physicians in developed countries, this is a diminishing obstacle.) (3) Facility with knowledge engineering for the medium. (We're all experimenting.) (4) Resources—money, time, and minds.

The last limitation may be the hardest. The tremendous opportunity to make money has influenced even prestigious people, organizations, and journals to produce something far less than what they could in their rush to get on the frenzied bandwagon. We have a means to increase learning, but we are at risk of its getting a bad name before the real quality appears. Somehow we have to bring real needs—such as sports medicine education—in line with adequate resources.

I believe that in the long run, usefulness, appropriate packaging of information, and quality of content will win out. And I'm content (for a few weeks, anyway) to sit back and think about how best to approach our goals—and what part The Physician and Sportsmedicine can play in advancing knowledge.

In the meantime, please share your thoughts with me via [email protected].

Gordon O. Matheson, MD, PhD

PS. This month we offer a special section: e.MD will help you navigate the burgeoning field of medical informatics. Technology will change your life and practice, so read up.