As long as there has been technology, there has been the debate as to whether it improves our quality of life and to what extent. We suggest that perhaps a more productive way to deal with this controversy is not to ask whether or not technology makes our lives better but to see it as providing us with an increasing number of choices. Whether or not technology can or will improve psychiatric education depends on our ability as psychiatric educators to make good choices. As such, the most important aspect of this issue of Academic Psychiatry is to inform its readers so that they can make good decisions about which technology to apply to our work. This issue not only does an excellent job of describing the current "state of the art" of possible technology for psychiatric education, but it provides information and methodology for educators to make judgments about its relative merits.
The use of technology in any context is completely dependent upon the ease with which it can be accepted. All of the great technological revolutions in human history have taken place not at the point at which the technology was developed but at the point at which it could be made available, usable, and understandable to large numbers of people. There are several articles in this issue that address the problems of acceptance, both in terms of what has been written about the general psychological issues that involve technological change and in terms of hard survey data about the feelings of people who actually utilize the technology. Ignoring whether and to what extent a new technology will be embraced has often resulted in a tremendous waste of time, money, and energy.
There are some themes here that are worthy of mention. The first is the ability to make possible what was previously impossible. One of the great chronic problems of any kind of clinical education, but perhaps particularly difficult for psychiatric education, is the issue of "luck of the draw" for both clinical experience and clinical examinations. The papers included here offer some potential solutions to this. The use of personal digital assistants in clinical medicine has provided an enormous amount of information resources at the point of service, but for trainees it provides the opportunity to track their experiences at the point of service with patient and clinical experience logs and then be able to evaluate the extent to which their experiences were adequately educational.
Evaluating how much or how well technology is adopted or infused into medical education is an important first step. Very little has been published in the literature about the perceptions of technology by medical students and residents, including their comfort level, proficiency, and learning styles. A survey of medical trainees in two teaching institutions represents a first effort in this area. It was interesting to see how these "tech-savvy" participants managed technology in pursuit of their education.
Other papers discuss the utility of virtual reality for medical education and computer-driven simulations to perform clinical examinations. The idea of using standardized patients has been explored over the years, but with the addition of virtual environments and computer-driven simulations, the dynamics and depth of pathology can add to the complexity and realism. This will ultimately offer a better assessment of skills.
Perhaps the greatest change brought about by technology is access to information. Put succinctly, we are living in an age in which we no longer have to go anywhere to get information. Pretty much anywhere that we might practice or teach, the wisdom of the world is available to us in a constantly and consistently updated form. In academic psychiatry, this means considerably more than just having access to clinical information wherever and whenever we want. Some of the papers in this issue point out how technology can be used to foster research and other academic collaboration over the Internet, how courses can be taught online, how students can be assessed online, how practitioners can sustain their commitment to lifelong learning online, and how faculty and students can keep portfolios of their accomplishments online. Once again, this technology not only provides the opportunity to simplify various academic activities, but it makes it possible to do them virtually anywhere at any time.
It is the job of any academic journal to inform its readers about the most current scientific advances in their field. Scientific advances in the process of education, particularly psychiatric education, can be nebulous, subjective, and often of questionable value. This journal has historically risen above these problems and provided its readers with timely information, allowing them to stay current in the field of psychiatric education. This issue continues that tradition by making sure that the readership is informed about use of current and future information technology, and we applaud its depth and breadth.
As we look toward the future of technology in psychiatric education, we realize that the revolution has taken place. Marshall McLuhan pointed out that "the future is already here." Next is the continuing evolution. These Academic Psychiatry articles have shown that a convergence of technology and media has brought about new forms of learning with new ways to reshape our educational experiences. And just as we learn from our students, we also learn from our exploration into these new technologies.