The INSURRECT project uses the SuperJANET network to link six sites in the UK for interactive teaching and learning in surgery, an area of higher education where visual information is critical to the learning process. Collaboration between the six universities allows students access to a larger pool of surgical expertise and case studies than any single institution could provide. The project expects to improve the time that medical students can devote to surgery by up to 50%, by providing both supervised and unsupervised access to important visual information and case studies. Finally, the reduction in student numbers in operating theatres should reduce the infection risk to patients. A key component of the project is the central image resource, located in London, but allowing students and surgeons access from anywhere on the network. This paper describes the development of the interactive surgical teaching system and our experience with it during the first 18 months. One subjective observation, noticed after just one term's teaching, was the improved quality of the teaching.

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The INSURRECT project began in 1993 as a collaboration between six UK universities in distance teaching of undergraduate surgery. The first year was spent in testing the network and preparing the course material. This was followed by a two-year pilot teaching course. During this phase, 108 teaching sessions were conducted, involving more than 1300 students in all. It was found that successful teaching depended on increasing the amount of audience interaction was much as possible and transmitting high-quality video pictures. Although the time taken to deliver material by interactive video was greater than for conventional lectures, both students and teachers responded favourably to the project.

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