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PubMed2004

[Online bedside teaching: multimedia, interactive and case-based teaching scenarios in dermatology].

The MeduMobile project or Mobiler Campus Charité was started in the beginning of 2003 to evaluate new, multimedia supported teaching and learning scenarios. The project focuses especially on acute and rare diseases to which students usually have are very limited access. During the teaching sessions the MeduOnCall team and the academic teacher communicate with the students who are equipped with individual notebooks through a wireless net. In dermatology the MeduMobile project focused in summer 2003 and winter 2003/2004 on bedside teaching. Despite some technical difficulties in the beginning the project was well received by teachers and students. The possibility of simultaneous online searches by Internet as well as the possibility to include photographs depicting the course of the skin disease was felt to be one of the main advantages of this project. Based on these positive experiences an attempt will be made to integrate the project further into the regular teaching of the Charite.

Case-Control Studies↗
PubMed1999

A multimedia intervention on cardiopulmonary resuscitation and advance directives.

OBJECTIVE: To assess the effects of a multimedia educational intervention about advance directives (ADs) and cardiopulmonary resuscitation (CPR) on the knowledge, attitude and activity toward ADs and life-sustaining treatments of elderly veterans. DESIGN: Prospective randomized controlled, single blind study of educational interventions. SETTING: General medicine clinic of a university-affiliated Veterans Affairs Medical Center (VAMC). PARTICIPANTS: One hundred seventeen Veterans, 70 years of age or older, deemed able to make medical care decisions. INTERVENTION: The control group (n = 55) received a handout about ADs in use at the VAMC. The experimental group (n = 62) received the same handout, with an additional handout describing procedural aspects and outcomes of CPR, and they watched a videotape about ADs. MEASUREMENTS AND MAIN RESULTS: Patients' attitudes and actions toward ADs, CPR and life-sustaining treatments were recorded before the intervention, after it, and 2 to 4 weeks after the intervention through self-administered questionnaires. Only 27.8% of subjects stated that they knew what an AD is in the preintervention questionnaire. This proportion improved in both the experimental and control (87.2% experimental, 52.5% control) subject groups, but stated knowledge of what an AD is was higher in the experimental group (odds ratio = 6.18, p <.001) and this effect, although diminished, persisted in the follow-up questionnaire (OR = 3.92, p =. 003). Prior to any intervention, 15% of subjects correctly estimated the likelihood of survival after CPR. This improved after the intervention in the experimental group (OR = 4.27, p =.004), but did not persist at follow-up. In the postintervention questionnaire, few subjects in either group stated that they discussed CPR or ADs with their physician on that day (OR = 0.97, p = NS). CONCLUSION: We developed a convenient means of educating elderly male patients regarding CPR and advance directives that improved short-term knowledge but did not stimulate advance care planning.

Advance Directives↗
PubMed2000

The effects of multimedia communication technology on non-collocated teams: a case study.

Collaborative teams are becoming increasingly important for industry, both within and across companies. There is a need for communication technology to support teams because many teams are non-collocated, or 'virtual'. Two automotive supply chain teams were observed while they were experimenting with multimedia conferencing in order to determine what support non-collocated teams need and the potential effects of introducing technologies on their group processes. The observations included meeting recordings and other sources that show the organizational factors affecting teams. Working in teams requires very close collaboration. Communication technology can help teams if it is used to foster close and relatively informal person-to-person interaction. Organizational constraints on how the technology is introduced favour high-technology, special-purpose installations, but teams can best be supported using relatively modest equipment with desktop access.

Ergonomics↗
PubMedDate not supplied

Limitations on the uses of multimedia exposure measurements for multipathway exposure assessment--Part II: Effects of missing data and imprecision.

Multimedia data from two probability-based exposure studies were investigated in terms of how missing data and measurement-error imprecision affected estimation of population parameters and associations. Missing data resulted mainly from individuals'refusing to participate in certain measurement activities, rather than from field or laboratory problems; it suggests that future studies should focus on methods for maximizing participation rates. Measurement error variances computed from duplicate-sample data were small relative to the inherent variation in the populations; consequently, adjustments in nonparametric percentile estimates to account for measurement imprecision were small. Methods of adjustment based on lognormality assumptions, however, appeared to perform poorly.

Child↗
PubMedDate not supplied

Limitations on the uses of multimedia exposure measurements for multipathway exposure assessment--Part I: Handling observations below detection limits.

Multimedia data from two probability-based exposure studies were investigated in terms of how censoring of nondetects affected estimation of population parameters and associations. Appropriate methods for handling censored below-detection-limit(BDL)values in this context were unclear since sampling weights were involved and since bivariate associations/measures were of interest. Both simple substitution(e.g., using 1/2 or 2/3 of the detection limit(DL)for BDL values)and truncation-based strategies were investigated by creating some artificial DLs and comparing resultant estimates with the original studies'uncensored results. The substitution methods generally outperformed the truncation methods, with the(2/3)DL substitution generally performing best.

Child↗
PubMed2005

Audiometric testing and hearing protection training through multimedia technology.

The purpose of this paper is to present the development process of a computer-based audiometric testing and tailored intervention program, and assess its feasibility by obtaining users' feedback. The program was implemented for 397 operating engineers at their union training center, and its feasibility was evaluated by obtaining quantitative and qualitative feedback from the participants through a survey and focus group. Over 96% of the participants indicated they liked receiving a hearing test by computer; the computer-based test worked smoothly; and the computer-based training was well organized, effective and held their interests. Almost all (more than 99%) said they would recommend this program to other workers. This project is considered as one of the first ones incorporating multimedia computer technology with self-administered audiometric testing and tailored training. Participants' favorable feedback strongly supported the continued utilization of this approach for designing and developing health screening and intervention to promote healthy behaviors.

Adult↗
PubMed2004

Working it out: development and testing of a multimedia, vocational education program.

A self-administered, CD-ROM-based, interactive multimedia psychoeducational intervention, called Working It Out, was developed to improve employment functioning for clients in substance dependency treatment. The computer-based, program's effectiveness was tested in comparison with printed material. During 2000--2001 194 clients with employment concerns in six treatment programs were randomly assigned to a CD-ROM or print material condition and evaluated at baseline and 6 months later. A main effect for improvement was observed on employment indices, but there was no condition-by-time interaction. Results suggest that clients are willing and able to use vocational rehabilitation information presented in any format, although the CD-ROM-based program received significantly better satisfaction ratings than did the print material.

Adult↗
PubMed2002

Usability of multimedia technology to help caregivers prepare for a crisis.

The objective of the research was to evaluate the usability of a multimedia software application that provides information on coping with difficult situations, dealing with everyday caring problems, and first aid for emergency situations. Casual users (family caregivers, professional caregivers, and older people) were invited to use the software application and complete a questionnaire measuring quality and efficiency in utility and usability. Quantitative data were analyzed using the Statistical Package for the Social Sciences (SPSS) and qualitative data were analyzed by content analysis. Findings indicated the software application to have high global usability, correspond to user expectations, respond quickly, and be visually pleasant and easily understood. The authors conclude that software applications of this type have the potential to increase the quality of life of family caregivers, enhance their coping capacity, and enable them to continue for a longer period in their caring role.

Caregivers↗
PubMed1999

A tailored multimedia nutrition education pilot program for low-income women receiving food assistance.

This article describes the development and pilot evaluation of a tailored multimedia program to improve dietary behavior among 378 low-income women enrolled in the Food Stamp program in Durham, North Carolina. After randomization to intervention or control groups, participants completed a baseline survey and were resurveyed 1-3 months post-intervention. Measures included dietary fat intake assessed using a brief food-frequency questionnaire, stage of change, knowledge of low-fat foods, self-efficacy and eating behavior questions. The computer-based intervention consisted of a tailored soap opera and interactive 'info-mercials' that provided individualized feedback about dietary fat intake, knowledge and strategies for lowering fat based on stage of change. At follow-up, intervention group participants had improved significantly in knowledge (P < 0.001), stage of change (P < 0.05) and certain eating behaviors (P < 0.05) compared to the control group. Both study groups had lowered their reported fat intake markedly at follow-up (P < 0.001), but did not differ significantly from each other. A majority of participants rated the program as very helpful and were interested in using a similar program in the future. The findings of this pilot study suggest that computerized tailored self-help health promotion programs may be effective educational interventions for lower income and minority populations.

Adult↗
PubMed2005

Pilot study in the development of an interactive multimedia learning environment for sexual health interventions: a focus group approach.

In the UK there are high rates of sexually transmitted infections and unintended pregnancies amongst young people. There is limited and contradictory evidence that current sexual health education interventions are effective or that they improve access to appropriate sexual health services. This paper describes the outcome of focus group work with young people that was undertaken to inform the design of an Interactive Multimedia Learning Environment that incorporates message framing, intended for use in sexual health promotion. The focus group work addressed sexual attitudes, behaviour, risk perception, and knowledge of sexual health and sexual health services in Nottingham. The results provided new insights into young peoples' sexual behaviour, and their diversity of knowledge and beliefs. Common themes expressed regarding sexual health services included concerns about confidentiality, lack of confidence to access services and fear of the unknown. The results showed that while the adolescents are reasonably knowledgeable about infection, they do not know as much about the relevant services to treat it. This work emphasizes the need for user involvement throughout the design and development of a sexual health intervention, and will form the basis of the next part of the project.

Focus Groups↗
PubMed2000

Four-day multimedia diet records underestimate energy needs in middle-aged and elderly women as determined by doubly-labeled water.

Systematic problems exist in the quantification of food intake in populations using traditional self-reported measures. The objective of this study was to determine the effectiveness of an innovative multimedia diet record (MMDR) for dietary energy intake assessment. Dietary intake was estimated by combining the use of a microcassette tape recorder and 35-mm camera in 53 women whose ages ranged from 50 to 93 y (64.9 +/- 11.3 y), with body weights of 62.4 +/- 12.2 kg and body mass indexes (BMI) of 24.4 +/- 4.0 kg/m(2). Using household measures, subjects voice-recorded and photographed all food and beverages consumed for four consecutive days. A two-point doubly-labeled water (DLW) method was used over 13 d to calculate carbon dioxide production, total body water, and subsequently, total energy expenditure (TEE) through the use of a food quotient. Mean body weight did not change between d 1 and 14. TEE and reported energy intake were compared using MMDR. Mean reported energy intakes 7.5 +/- 1.9 MJ/d (1774 +/- 476 kcal/d) were lower (P < 0.01) than TEE by 10.4 +/- 3.1 MJ/d (2477 +/- 736 kcal/d), indicating underreporting of food intake. Reporting accuracy (reported energy intake/TEE' 100%) was 76.0 +/- 22.9%. Mean energy expenditure (MJ/d), as determined by doubly-labeled water, was higher (P < 0.01) in each stratified age range when compared to reported energy intake by MMDR. There were no significant differences in reporting accuracy among the stratified age groups. Using the MMDR method, this population of weight-stable women underreported their food intakes compared to their determined energy expenditure estimated by DLW.

Aged↗
PubMed1997

Multimedia image display: a view to the future.

The development of multimedia image review stations offers the cardiologist the ability to review multiple image sets in a single setting rather than moving from one review station to another. To accomplish this goal there are three essential barriers: 1) memory requirements for digital images; 2) standardization of data format; and 3) practical user interfaces. Image compression algorithms can be used to overcome the digital barrier; however, these must be used cautiously so as to not adversely affect image quality. The lack of standardization is being addressed by the implementation of the Digital Communication in Medicine (DICOM) standard, and practical user interfaces are being developed every day with the widespread implementation of World Wide Web technology. These solutions will allow the clinician to review all of a patient's image data in one location, such as in the office, on the nursing unit, or at home.

Computer Communication Networks↗
PubMed1999

Implementation of a four-year multimedia computer curriculum in cardiology at six medical schools.

The pressures of a changing health care system are making inroads on the commitment and effort that both basic science and clinical faculty can give to medical education. A tool that has the potential to compensate for decreased faculty time and thereby to improve medical education is multimedia computer instruction that is applicable at all levels of medical education, developed according to instructional design principles, and supported by evidence of effectiveness. The authors describe the experiences of six medical schools in implementing a comprehensive computer-based four-year curriculum in bedside cardiology developed by a consortium of university cardiologists and educational professionals. The curriculum consisted of ten interactive, patient-centered, case-based modules focused on the history, physical examination, laboratory data, diagnosis, and treatment. While an optimal implementation plan was recommended, each institution determined its own strategy. Major goals of the project, which took place from July 1996 to June 1997, were to identify and solve problems of implementation and to assess learners' and instructors' acceptance of the system and their views of its value. A total of 1,586 students used individual modules of the curriculum 6,131 times. Over 80% of students rated all aspects of the system highly, especially its clarity and educational value compared with traditional lectures. The authors discuss the aspects of the curriculum that worked, problems that occurred (such as difficulties in scheduling use of the modules in the third year), barriers to change and ways to overcome them (such as the type of team needed to win acceptance for and oversee implementation of this type of curriculum), and the need in succeeding years to formally assess the educational effectiveness of this and similar kinds of computer-based curricula.

Attitude to Computers↗
PubMed2004

Validity of scores generated by a web-based multimedia simulated patient case software: a pilot study.

PURPOSE: The value of multimedia simulated patient cases (MSPCs) in medical education remains unclear. The authors conducted a pilot study to assess the validity of automated scores of diagnostic reasoning ability provided by DxR Clinician, a widely available Web-based MSPC software. METHOD: In 2002-03, all 89 students enrolled in a required third-year primary care clerkship at the University of California, Davis, School of Medicine were assigned to complete four MSPCs. The authors determined the degree of correlation between the Clinical Reasoning Score (CRS) and Level of Diagnostic Performance (LDP) generated by the MSPC software and subscale scores from a validated measure of diagnostic reasoning sophistication, the Diagnostic Thinking Inventory (DTI). RESULTS: Of 356 completed case events, instructor override of automated scoring was required in 206 (58%) to obtain an accurate LDP and CRS. Mean DTI subscale scores improved significantly from the beginning to the end of the year (p <.0001, Wilcoxon signed rank test). However, there were no significant correlations between CRS or LDP scores on any of the four cases and either of the two DTI subscale scores. CONCLUSION: Automated diagnostic reasoning scores generated by one widely available MSPC software appear to lack criterion validity. The validity of automated diagnostic reasoning scores generated by MSPCs should be established before such cases can be confidently employed as educational tools.

Clinical Clerkship↗
PubMed2005

The effectiveness of picture-fading techniques in a multimedia learning system for teaching Chinese word recognition to students with multiple disabilities.

The purpose of the study was to examine the effectiveness of picture-fading techniques in a multimedia learning system for Chinese word-recognition instruction. A single-subject, multiple-probe baseline design across participants was used. Three first-grade students with multiple disabilities participated in this study. The three participants received word-recognition instruction with picture-fading techniques to identify four Chinese printed words. The results of this study demonstrated that all participants could identify the four printed words correctly without the presence of known pictorial prompts. In conclusion, the use of picture-fading techniques in word-recognition instruction can function as a bridge between pictorial prompts and printed words.

Child↗
PubMed1997

Programmable ultrasound imaging using multimedia technologies: a next-generation ultrasound machine.

High computational and throughput requirements in modern ultrasound machines have restricted their internal design to algorithm-specific hardware with limited programmability. We have architected a programmable ultrasound processing system, Programmable Ultrasound Image Processor (PUIP), to facilitate engineering and clinical ultrasound innovations. Multiple high-performance multimedia processors were used to provide a computing power of 4 billion operations per second. Flexibility was achieved by making our system programmable and multimodal, e.g., B-mode, color flow, cine and Doppler data can be processed. We have successfully designed and implemented the PUIP to fit within an ultrasound machine. It provides a platform for rapid testing of new concepts in ultrasound processing and enables software upgrades for future technologies. Current and future clinical applications include extended fields of view, quantitative measurements, three-dimensional ultrasound reconstruction and visualization, adaptive persistence, speckle reduction, edge enhancement, image segmentation, and motion analysis. The PUIP is a significant step in the evolution of ultrasound machines toward more flexible and generalized systems bridging the gap between many innovative ideas and their clinical use in ultrasound machines.

Algorithms↗