Medical Education is undergoing a revolutionary change as we challenge the dogma of traditional teaching and try to innovate to improve both the learner experience and clinical outcomes for patients.

Some have declared that textbooks are dead and point to online media as the future of medical education.


The movement for free, open access medical education has lead to an explosion of online resources like podcasts, study guides, and other great learning tools.

Creating these tools requires a certain level of technical expertise, raising the barrier to entry for those that want to create content.

As someone invested in improving medical education, I was thrilled when Apple released iBooks Author. This free software allows anyone with the right hardware to create an interactive iBook: a polished learning tool with well integrated multimedia. When compared to standard iBooks, the “interactive iBooks” can contain widgets with review questions, 3-D images, and other components that engage readers.

For example, I recently reviewed two excellent interactive iBooks for medical professionals: The Heart and Introduction to Bedside Ultrasound.

Creating an iBook takes about the same technologic skill as writing a PowerPoint presentation. By lowering the barrier to entry, medical educators can now use this software to easily create their own sophisticated resources for their students.

Unfortunately, this technology comes with crippling and unnecessary restrictions that limit its practical application to medical education.

The interactive iBooks format only functions on an iPad running iOS 5 (generation 2 and above or iPad mini), and can only be written using iBooks Author on a Mac computer. These tools don’t work on iPhones or on personal computers. iBooks can be exported as pdfs, but they lose all their interactive components.

It would seem that Apple created this software to showcase the iPad, with no intention of granting access to those without that device. Apple may think these restrictions give them a competitive advantage in a growing tablet market, however, I would argue that instead it paralyzes their ability to use interactive iBooks to impact higher education.

These proprietary limitations are annoying for consumers, but they are especially constraining for educators. For an educator to spend considerable time developing new content for an interactive iBook, those new resources must be accessible to a large audience of learners, regardless of what type of hardware they own.

This strategy is in direct contrast to that used by Amazon. Books sold through the Kindle store can also be read on virtually any other device, a fact that Amazon actively advertises.

To be fair, Kindle books do not contain the extensive multimedia components that interactive iBooks do, so I would expect that it would be much more difficult to create reading apps for other device platforms.

However, the fact that Apple doesn’t even allow users to read interactive iBooks on a Mac personal computer makes me doubt that the device restrictions are only based on technological limitations, and are instead a deliberate attempt to convince more customers and educational institutions to buy iPads.

Thanks to a generous graduation gift, I do have an iPad, so I’ve been looking forward to reading medically oriented interactive iBooks. Though the software was released about a year ago, only a few textbooks on medical topics have been produced in this format.

Disappointingly, it is tremendously difficult to find medically focused interactive iBooks on iTunes. Textbooks are divided by topic, but The Heart isn’t categorized under life science, instead ending up in a miscellaneous section. There is no medical textbook section, so Introduction to Bedside Ultrasound is listed in the general health and medical section of the iBooks store. There’s no way to narrow down a search in that section for a specific subcategory like Emergency Medicine or for health care providers.

Instead, users must wade through self-help diet books to find content directed at medical professionals.

Interactive iBooks are mixed in with regular content in iTunes. There is a section devoted to interactive iBooks, but there’s no way to search for content in a specific subcategory like medicine.

In order to make this technology appealing to health care providers, iTunes needs to organize content so that it is appropriately visible. Apple already has a section with Apps for Healthcare Professionals. They should include relevant iBooks in this section, or create a similar page in the iBookstore.

In addition, customers should be able to easily sort out interactive iBooks from those books without enhanced multimedia.

Final Thoughts:

  • Interactive iBooks are a potential game changer for medical educators; however, Apple’s stringent hardware restrictions and poor organization and dissemination of these tools through iTunes severely limits their practical applications.
  • A severe limitation to using interactive iBooks in education is that they can only be viewed on an iPad. That makes this technology irrelevant to learners who only have personal computers or a different brand of tablet. For interactive iBooks to make an impact in higher education, they must be readable on a larger variety of devices. Even making these tools readable on Mac personal computers would be a significant improvement.
  • Those interactive iBooks currently in existence should be well catalogued and searchable in iTunes so that they can reach their intended audience.
  • Until those changes are made, interactive iBooks will only be a good idea, not the revolutionary educational tool that they have the potential to be.


Lex, J. “International EM Education Efforts and E-Learning” talk at the New York Symposium on International Emergency Medicine. 8/2012. Link.
3D4 Medical. “The Heart.” Version 1.0. 6/2012. Link.
Dawson, M; Malin, M. “Introduction to Bedside Ultrasound.” Volume 1. 10/2012. Link