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Videodisc has established a niche in education. The combination of exceptional sound and picture quality with near-instantaneous frame addressability has transformed the medium of interactive video, i.e. the notion of communicating with a video programme. Any good system can be used by the most technophobic, but choosing one is rather less simple.
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We are developing a tool for matching physically impaired people with suitable technical aids;w this tool will also provide specific and comprehensive information to users. According to the user's physical abilities and situations (indicated when using a "mouse"), specific instructions with dynamic images are displayed on the screen. The hardware of this system will be constructed with the laser¿disk system (Pioneer Laser Active, CLD¿A100). The software for drawing dynamic images is a two dimensional animation software (Animation Stand). The difficulties of developing this system are (1) Collecting every possible pattern without exclusion and constructing the comprehensive information frame for providing specific advises, and (2) Drawing a large number of dynamic animations. The merits of this tool are (1) High quality image and quick response time, (2) Excellent presentation ability, (3) A user friendly interface.
This demonstration will present the key modules from an innovative videodisc-based program that was designed as an educational tool for health care professionals. It provides a resource for learning to deal with patients and families regarding the increasing problematic area of end-of-life-decisions. Tough Choices: Ethics, the Elderly, and Life-Sustaining Technologies is an interactive program that combines abstract ethical approaches with the realistic drama of a critical care setting. The format integrates scientific facts about the patient with value questions regarding the utilization of life-sustaining technologies. The unique program provides health care personnel with strategies on how to guide family decision-making as well as examples of the various interventions. This interactive multimedia program opens up an opportunity for health care providers to participate in a clinical case in which life and death decisions are made. Learners can explore various perspectives and treatment options within the framework of the dramatic case presentation without the usual time constraints or worries about causing harm to patients. The program involves learners in a variety of ethical and legal dilemmas that centers around a patient, her family, and a variety of health care professionals. Dramatic advances in the development of life-sustaining medical technologies have given hope to many people whose conditions would have meant certain death only a few years ago. As access to the technologies has expanded, concern for their appropriate utilization has become an issue worthy of increasing attention. Questions about the benefits of life-sustaining treatments are being raised in many quarters, particularly when the technology is viewed as a modern means of postponing death and prolonging suffering. Tough Choices brings to life the story of Irene Sullivan, an elderly widow who has an unexpected heart attack. Suddenly, her very existence depends on the life-support provided by mechanical ventilation and cardiopulmonary resuscitation (CPR). This is a growing area of concern since more than half of the patients who receive CPR and tube feedings and one third of the people receiving mechanical ventilation are 65 or over. Mrs. Sullivan's health care team is forced to deal with the opposing viewpoints of several close family members regarding the utilization of advanced medical technology. The interactive program invites viewers to explore the complex ethical and legal dilemmas involved in making life-and-death decisions about her care. It also permits immediate access to supportive resources in three areas: the clinical chart, abstracts of relevant research studies on life-sustaining technologies, and information from the professional literature on advance directives. The program incorporates practical steps involved in implementing the Patient Self-Determination Act as it follows the patient from the time of hospitalization through a series of life-threatening crises. Two very different aspects of the role of the health care professionals were explored: a crisis mode which covers the steps in managing a full-blown crisis situation, and a prevention mode which analyzes steps that could have been followed to keep an ethical crisis from occurring. The strong role models for practice display many of the characteristics that the helping professions need to foster in an atmosphere of healthcare reform.
Microcomputers have now become a working tool of the biologist. This article explores some of the consequences of this revolution both in terms of the skills and working habits needed and of the range of uses which have been found. The primary consequence is that biologists must learn how to become computer managers. This does not mean learning BASIC and computer architecture, though this will usually prove valuable, but that we must be able to grasp from the flood of sales literature and computer specialists what tasks can or should be undertaken with the aid of microcomputers. Secondly it means being able to choose and maintain the right machinery for the tasks needed. An overview of applications shows four main areas of use. 1) The standard packages where one can expect the computer manufacturer to provide a complete working system. These are word-processing, database reference systems, spreadsheet calculations, graphics production and communications. 2) Specialist scientific programs such as statistics, data processing and model making. 3) The use of the microcomputer as a laboratory instrument for control or measurement. 4) Educational applications. Each of these areas has separate, often conflicting, requirements which can only be balanced by the user.
Sexual risk assessment is a vital component of early detection of HIV infection and other sexually transmitted diseases (STDs). We developed the Interactive Multimedia Sexual Risk Assessment, which uses a "video doctor" to question patients about risk-associated sexual behavior, and administered it to a convenience sample of 393 people. Their acceptance of the technology was evaluated, and their risk of contracting an STD was identified according to both liberal and conservative criteria. Most respondents (99%) reported that they had answered the questions truthfully, 74% reported that they had felt comfortable answering the questions, and 79% stated that they would return to the physician portrayed in the video. Fifty-nine percent were at risk for an STD according to the liberal definition, compared with 8% according to the conservative definition.
A computer-assisted interactive videodisc instructional program, HP-RHEUM was designed to teach clinical findings in arthritis to occupational and physical therapy students. Using the Rheumatology Image Library videodisc produced by the National Library of Medicine, HP-RHEUM consists of instructional modules which employ advance organizers, examples/nonexamples, summaries, and immediate feedback. To see if HP-RHEUM would be as effective as traditional classroom instruction, control data were collected in 1991 from 52 OT and PT students. Treatment data were collected from 61 students in 1992 when HP-RHEUM entirely replaced lectures. Identical pre- and post-tests consisted of 70 multiple choice questions, with 24 matched to slides. On the slide questions the HP-RHEUM group had significantly higher scores. Otherwise, there was no significant difference in performance between groups. HP-RHEUM provided an independent learning method and enhanced visual comprehension of rheumatologic disease concepts.
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A study was conducted to compare the effectiveness of interactive videodisc instruction (IVDI) with the traditional lecture/demonstration as an alternative method for learning and performing a critical nursing skill. Students were assigned randomly to a treatment group that worked in small groups to complete the IVDI on intravenous therapy skills and a control group receiving the same content in a classroom lecture/demonstration format. After the instruction, each subject performed a re-demonstration of the learned skills using specific guidelines. Results revealed that although the IVDI group scored higher on the overall re-demonstration, there was no significant difference in the ability of the two groups to effectively perform this critical nursing skill. These findings support the use of IVDI as an alternative self-paced, independent study method for learning psychomotor skills and are consistent with previous studies, which indicate that working in small groups on the computer has a positive effect on self-efficacy and achievement.
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A randomised-controlled trial compared outcomes for women recently diagnosed with breast cancer who either received support and information from a multidisciplinary team or used a shared decision-making programme on an interactive video disk (IVD) system. Using the IVD did not have a significant effect on the decisions women made about treatment, yet it was evaluated positively by those who used it. The results suggest that the role of clinical staff is more significant than the form of information provided. Potential benefits for the IVD were apparent such as standardising the information received by patients, promoting evidence-based practice and providing a measure for quality assurance.
Our group is creating a database of x-, y-, z- coordinates of central nervous system structures from serial cross-sections. We produce 3D computer images of the brain and its components and record them on videodisc. Useful animations include combining objects from different databases to correct anatomical scale, rendering a surface translucent to reveal underlying components, slicing and paging brain slabs with and without protruding individual objects, and dissecting functional pathways. We are beginning to use videodisc animations of the nervous system in computer-based interactive tutorials.