While educators and policymakers talk about e-learning, the medical profession is doing it.

Elliott Masie,1 a technology and training expert, saw this first-hand when he was invited to see what he calls "a truly breakthrough example of e-learning."

Imagine a conference hall with 7,000 cardiologists watching and interacting with surgeons conducting heart surgery simultaneously in 3 countries around the world. Six patients were prepared for cutting-edge heart procedures in operating rooms in Israel, Italy, and New York City. Each operating room had 3 to 8 TV cameras and scanning equipment to show these operations live and give internal imaging views.

The cardiologists in each operating room were pushing the edge of current practice, doing very complicated procedures that were far more advanced than standard approaches. Several of the patients had quite complicated and serious conditions, but all had signed consent agreements, and, in fact, were awake and respondent during much of the procedure.

A satellite feed and connection allowed the viewers to communicate live and interact with the doctors during the process, as well as track various instrument read-outs. A "reaction panel" comprised of top cardiologists expressed different views and opinions about the procedures underway. The doctors in the audience used response keypads to vote in real time on what procedure they would do or whether they would continue or stop an action. As voting was underway, four screens filled with real-time data that helped the group place what was happening into context.

"It was a deeply powerful learning experience," Masie reported. "The process supports very rapid dissemination of medical information and knowledge, quite faster than the normal medical publishing process." Masie said that the virtual operating room allowed approved trials to be witnessed in real time and disseminated instantly.

"The group process fostered an incredible amount of discussion and conflict that brought forth a level of intellectual dialogue on best practices that I have rarely seen in other professions," he said. "The group voting process seemed scary to me at first, but actually gave some feedback to the doctors in the operating rooms and placed the learner's risk-taking process in perspective. The intensity of side-dialogues was amazing, as we watched and reacted in small peer conversations alongside the real time group interaction."

Masie added, "The international perspective gave a global element to the entire learning experience and we were able to see very different attitudes toward similar innovations in diverse cultures . . . The use of research to frame the discussion was powerful, as we were seeing a multi-dimensional view of the points of conflict."

Did the patients mind? Masie reports that the outcomes and survival rates for this process are higher than normal procedures. Do all doctors approve of this model of medical knowledge transfer? No, there are some that are quite opposed. Was the live element necessary?

"I think it added greater levels of learner attention and made the experience quite real versus simulated," he said. "I was jealous. I wondered when the learning and training profession would have this level of an open and intense discussion about what actually works and does not work in each e-learning genre."

1. http://www.masie.com