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Joshua Jacobs

Publications and source records attributed to Joshua Jacobs.

8 recordsLinked to original sources
PubMed2005

Implementing an online curriculum management database in a problem-based learning curriculum.

Managing a medical school curriculum is a difficult challenge. The body of knowledge is large, diverse, and changing. Continuous oversight is required to ensure the proper balance of learning opportunities, to eliminate redundancies, and to fill in gaps. Within the context of the integrated problem-based learning curriculum at the University of Hawaii John A. Burns School of Medicine (JABSOM), the authors describe a 2003 transition from a paper-based method of curriculum tracking to an online international database. The tool chosen, the Curriculum Management and Information Tool (CurrMIT), allows for myriad ways of entering data and structuring the curriculum, but presents unique challenges as well. The authors describe how this new tool was implemented at JABSOM, which included initial data entry by course directors, who provided close scrutiny of course content and took the opportunity to more closely align course objectives with course content. A keyword meta-data strategy was adopted to tag each curriculum element. Despite some difficulties, the resulting ease and accuracy of report generation has produced significant benefit to course directors and to the curriculum oversight committee, and has allowed even further improvement in the educational process. This strategy has been successfully adopted and adapted by other institutions.

Adult↗
PubMed2004

Distributed interactive virtual environments for collaborative experiential learning and training independent of distance over Internet2.

Medical knowledge and skills essential for tomorrow's healthcare professionals continue to change faster than ever before creating new demands in medical education. Project TOUCH (Telehealth Outreach for Unified Community Health) has been developing methods to enhance learning by coupling innovations in medical education with advanced technology in high performance computing and next generation Internet2 embedded in virtual reality environments (VRE), artificial intelligence and experiential active learning. Simulations have been used in education and training to allow learners to make mistakes safely in lieu of real-life situations, learn from those mistakes and ultimately improve performance by subsequent avoidance of those mistakes. Distributed virtual interactive environments are used over distance to enable learning and participation in dynamic, problem-based, clinical, artificial intelligence rules-based, virtual simulations. The virtual reality patient is programmed to dynamically change over time and respond to the manipulations by the learner. Participants are fully immersed within the VRE platform using a head-mounted display and tracker system. Navigation, locomotion and handling of objects are accomplished using a joy-wand. Distribution is managed via the Internet2 Access Grid using point-to-point or multi-casting connectivity through which the participants can interact. Medical students in Hawaii and New Mexico (NM) participated collaboratively in problem solving and managing of a simulated patient with a closed head injury in VRE; dividing tasks, handing off objects, and functioning as a team. Students stated that opportunities to make mistakes and repeat actions in the VRE were extremely helpful in learning specific principles. VRE created higher performance expectations and some anxiety among VRE users. VRE orientation was adequate but students needed time to adapt and practice in order to improve efficiency. This was also demonstrated successfully between Western Australia and UNM. We successfully demonstrated the ability to fully immerse participants in a distributed virtual environment independent of distance for collaborative team interaction in medical simulation designed for education and training. The ability to make mistakes in a safe environment is well received by students and has a positive impact on their understanding, as well as memory of the principles involved in correcting those mistakes. Bringing people together as virtual teams for interactive experiential learning and collaborative training, independent of distance, provides a platform for distributed "just-in-time" training, performance assessment and credentialing. Further validation is necessary to determine the potential value of the distributed VRE in knowledge transfer, improved future performance and should entail training participants to competence in using these tools.

Computer Simulation↗
PubMed2003

Integration of advanced technologies to enhance problem-based learning over distance: Project TOUCH.

Distance education delivery has increased dramatically in recent years as a result of the rapid advancement of communication technology. The National Computational Science Alliance's Access Grid represents a significant advancement in communication technology with potential for distance medical education. The purpose of this study is to provide an overview of the TOUCH project (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) with special emphasis on the process of problem-based learning case development for distribution over the Access Grid. The objective of the TOUCH project is to use emerging Internet-based technology to overcome geographic barriers for delivery of tutorial sessions to medical students pursuing rotations at remote sites. The TOUCH project also is aimed at developing a patient simulation engine and an immersive virtual reality environment to achieve a realistic health care scenario enhancing the learning experience. A traumatic head injury case is developed and distributed over the Access Grid as a demonstration of the TOUCH system. Project TOUCH serves as an example of a computer-based learning system for developing and implementing problem-based learning cases within the medical curriculum, but this system should be easily applied to other educational environments and disciplines involving functional and clinical anatomy. Future phases will explore PC versions of the TOUCH cases for increased distribution.

Craniocerebral Trauma↗
PubMed2003

Anatomy and the access grid: exploiting plastinated brain sections for use in distributed medical education.

Computerized animation is becoming an increasingly popular method to provide dynamic presentation of anatomical concepts. However, most animations use artistic renderings as the base illustrations that are subsequently altered to depict movement. In most cases, the artistic rendering is a schematic that lacks realism. Plastinated sections provide a useful alternative to artistic renderings to serve as a base image for animation. The purpose of this study is to describe a method for developing animations by using plastinated sections. This application is used in Project TOUCH as a supplemental learning tool for a problem-based learning case distributed over the National Computational Science Alliance's Access Grid. The case involves traumatic head injury that results in an epidural hematoma with transtentorial uncal herniation. In addition, a subdural hematoma is animated permitting the student to contrast the two processes for a better understanding of dural hematomas, in general. The method outlined uses P40 plastinated coronal brain sections that are digitized and to which contiguous anatomical structures are rendered. The base illustration is rendered, interpolated, and viewed while audio narration describes the event. This method demonstrates how realistic anatomical animations can be generated quickly and inexpensively for medical education purposes by using plastinated brain sections.

Anatomy, Cross-Sectional↗
PubMed2003

Virtual patient simulator for distributed collaborative medical education.

Project TOUCH (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) investigates the feasibility of using advanced technologies to enhance education in an innovative problem-based learning format currently being used in medical school curricula, applying specific clinical case models, and deploying to remote sites/workstations. The University of New Mexico's School of Medicine and the John A. Burns School of Medicine at the University of Hawai'i face similar health care challenges in providing and delivering services and training to remote and rural areas. Recognizing that health care needs are local and require local solutions, both states are committed to improving health care delivery to their unique populations by sharing information and experiences through emerging telehealth technologies by using high-performance computing and communications resources. The purpose of this study is to describe the deployment of a problem-based learning case distributed over the National Computational Science Alliance's Access Grid. Emphasis is placed on the underlying technical components of the TOUCH project, including the virtual reality development tool Flatland, the artificial intelligence-based simulation engine, the Access Grid, high-performance computing platforms, and the software that connects them all. In addition, educational and technical challenges for Project TOUCH are identified.

Artificial Intelligence↗
PubMed2003

Comparison of two and three-dimensional computerized polyethylene wear analysis after total hip arthroplasty.

BACKGROUND: The accurate determination of acetabular polyethylene wear in vivo is necessary to assess the clinical performance of the bearing surfaces of total hip replacements. Our objective in this study was to determine the clinical performance of two and three-dimensional computerized wear analysis and to assess the implications of this performance on requirements for patient enrollment in studies designed to detect wear of total hip prostheses. METHODS: Two and three-dimensional digital computerized analyses of acetabular polyethylene wear were performed on 153 hips in 140 patients. The acetabular components consisted of a polyethylene insert in a titanium shell, articulating with a 28-mm cobalt-chromium femoral component. The average duration of radiographic follow-up was 8.4 years. The correlation coefficient for two-dimensional versus three-dimensional analysis was calculated, as was the difference between the wear detected by the two techniques. The same observer analyzed each image twice, allowing an assessment of the repeatability of the two-dimensional and three-dimensional analyses. The impact of the clinical performance of each technique on the sample size needed for adequate power in prospective studies was evaluated. RESULTS: There was a high correlation between two-dimensional and three-dimensional wear analysis (r (2) = 0.933). In thirty-one (5.2%) of 595 observations, the wear values derived with the two-dimensional and three-dimensional techniques were not consistent. Logistic regression demonstrated that acetabular anteversion had a significant effect on the likelihood of such inconsistency occurring. The two-dimensional technique detected 90.1% of the total linear wear subsequently detected by the three-dimensional analysis. The average wear value was 1.09 mm as detected by two-dimensional analysis and 1.21 mm as detected by three-dimensional analysis. The two-dimensional technique was four times more repeatable than the three-dimensional technique. Power analysis indicated that up to 1.4 times more patients need to be enrolled if the three-dimensional technique is used for wear analysis. CONCLUSIONS: While three-dimensional analysis detected 10% more wear, its repeatability was four times worse than that of the two-dimensional technique and, as a consequence, patient enrollment requirements for wear detection were higher. The poor quality of the lateral radiographs contributed to the decrease in the repeatability of the three-dimensional analysis. Three-dimensional analysis may be useful for highly anteverted cups, but the limited improvement in wear detection achieved with that technique, coupled with its inferior repeatability, limits its clinical value.

Arthroplasty, Replacement, Hip↗