The dependence of educational infrastructure on clinical infrastructure.

The Albert Einstein College of Medicine needed to assess the growth of its infrastructure for educational computing as a first step to determining if student needs were being met. Included in computing infrastructure are space, equipment, software, and computing services. The infrastructure was assessed by reviewing purchasing and support logs for a six year period from 1992 to 1998. This included equipment, software, and e-mail accounts provided to students and to faculty for educational purposes. Student space has grown at a constant rate (averaging 14% increase each year respectively). Student equipment on campus has grown by a constant amount each year (average 8.3 computers each year). Student infrastructure off campus and educational support of faculty has not kept pace. It has either declined or remained level over the six year period. The availability of electronic mail clearly demonstrates this with accounts being used by 99% of students, 78% of Basic Science Course Leaders, 38% of Clerkship Directors, 18% of Clerkship Site Directors, and 8% of Clinical Elective Directors. The collection of the initial descriptive infrastructure data has revealed problems that may generalize to other medical schools. The discrepancy between infrastructure available to students and faculty on campus and students and faculty off campus creates a setting where students perceive a paradoxical declining support for computer use as they progress through medical school. While clinical infrastructure may be growing, it is at the expense of educational infrastructure at affiliate hospitals.