Scaling-up Undergraduate Medical Education: Enabling Virtual Mobility by Online Elective Courses

Scaling-up of undergraduate medical education can be defined as a process of reaching a large number of medical students over a wide geographical area (1). It may be achieved by introducing effective online-based learning programs and enabling virtual mobility of both students and teachers. Due to today’s technology, educational opportunities are no longer location-dependent, but allow for collaboration among students and teachers in different regions, bringing more quality benefits to more students more rapidly, more fairly, and more tenably (1). Online-based learning is especially advantageous for those not able to participate in physical exchange programs, because it allows them to benefit educationally and culturally from the experience offered by other universities (2). In addition, virtual mobility can play an important role in reaching the Bologna objectives in an effective and innovative way, although distance education is not currently incorporated in the Bologna process (3). Virtual mobility can motivate institutions to readjust and develop further their pedagogical models, because changes in learning tools and content delivery methods call for the introduction of new pedagogical and didactic models, such as guided self-study, problem-based learning, and project-based learning. Because the virtual web space allows the use of different intelligence modes – abstract, textual, visual, social, audial, and kinesthetic, the teachers are challenged to create new learning environments that use the potential of the web to exploit the natural ways in which humans learn. In short, virtual learning environments demand pedagogical shifts from the teachers controlling the teaching to the students controlling the learning (4). These modern pedagogical models based on socio-constructivist learning theory (5) perceive students as active participants who share ideas, use various information sources to solve problems, and collaborate to create synergy that results in the construction of new knowledge and produces better outcomes than those resulting from individual work. Virtual mobility courses designed in rich virtual learning environments are useful because they can help students develop team collaboration skills. The capacity for and understanding of teamwork, along with critical thinking, adaptability, and self-evaluation, is a generic skill that should be fostered by university education (6). Consequently, to fit the changing educational models and make the learning experience meaningful to net-generation students (7), medical teachers need to re-evaluate and revise their undergraduate medical curricula and take account of modern educational theory and research, in addition to making use of modern technologies where evidence shows that these are effective (8). Although mobility and collaboration of students and teachers are at the core of the Bologna process (3) and ever more important for European education policy makers, physical mobility of students is still rather marginal in Europe (2) and even more so in relatively disadvantaged transition countries like Croatia (9). During the past three years, all four Croatian medical schools have collaborated on harmonization of their teaching programs to allow for mutual accreditation and mobility of students. Croatian medical schools have discipline-based curricula and mostly use traditional teaching methods without much vertical or horizontal integration (10). There is little evidence on online learning shared among students of medical schools in different regions. This article presents a model of collaboration among higher education institutions incorporating information communication technologies (ICT) in their current working practice and deploying online learning across the country in a unifying way. The virtual mobility pilot project intended for Croatian medical students and teachers was developed and implemented as part of the Standardization in Teaching of Medicine project funded within the framework of the Trans-European mobility scheme for university studies (Tempus) program (11).