We begin this reflection with the premise that the place we are trying to go
is improved medical education. There are, of course, many paths one might
take to get to this place but the path we will discuss is that which gets to
improved medical education via more widespread use of computer-assisted
instruction (CAI). We also start with an assumption that CAI will ultimately
have a greater value and yield if the programs developed are utilized. Much
work has been done to apply computer technology to medical education but,
unfortunately, CAI remains underutilized in medical education overall, and
in clinical education in particular. Many CAI programs have been developed
over the last two decades, but the majority of these either never achieved a
significant level of use or are no longer in use. We will discuss what we believe
are the most important barriers on the path to increased CAI use and suggest
ways to bypass these barriers, based on some recent signs of a successful
path. Finally, assuming that this roadmap will allow more of us to follow this
path of CAI use, we will discuss the unique roles that CAI can play in clinical
education.