The use of hypermedia for parent education in pediatric neurosurgery.
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This study explores the use of interactive graphics for patients about to undergo Ishiki Type I thyroplasty, a surgery for unilateral vocal cord palsy. Steps include exploration of previous studies, needs assessment, prototype creation, and formative evaluation. Research suggests that interactive graphics should include the opportunity for the patients to practice and engage in a relevant, realistic scenario. Needs assessment results suggest the need for further studies with interactive graphics using larger patient sample sizes.
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Early in the evolution of medical decision analysis, computers were employed to remove the tedium and insure the accuracy of repetitive calculations, a capacity they still serve today. However, user interfaces could be so complex as to be overwhelming, except for the capable few who designed them or used them often. HyperDecision is a hypercard-based decision analysis program with a simple user interface. A comprehensive tutorial and generic decision tree are integrated so that the fledgling user, whether medical student or seasoned clinician lacking evolved computer and/or decision analysis skills, can reap the benefits of computer support in their clinical practice. In the current political environment surrounding the practice of medicine, having easily accessible tools for both teaching and using medical decision analysis to evaluate and present the rational for medical decisions has taken on a new importance which the medical community must remain abreast of as we move toward the 21st century.
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The authors developed a multiple-choice medical testing system delivered using the World Wide Web. It evolved from an older, single-platform, locally-developed computer-based examination. The old system offered a number of advantages over traditional paper-based examinations, such as digital graphics and quicker, easier scoring. The new system builds on these advantages with its true cross-platform design and the addition of hypertext learning responses. The benefits of this system will increase as more medical educational resources migrate to the Web. Faculty and student feedback has been positive. The authors encourage other institutions to experiment with Web-based teaching materials, including examinations.
The practice of medicine is characterized by its great variability and by many rare diseases. When the medical students work in hospital units, they must learn the general medical practice in the care of the patient. The purpose of this work was to present a French multifunction decision aid system using artificial intelligence techniques and Hypercard tools for different modules. Through an ergonomic interface, the system assists the user in the construction of medical observations, suggests diagnostic hypothesis, provides documentation and helps the user perform retrieval tasks. The knowledge comes from senior experts and from the pre-existent and large knowledge database, ADM.
CBT (computer-based training) applications and hypermedia publications are two different approaches to the utilisation of computers in medical education. Medical CBT software continues to play a minor role in spite of the increasing availability, whereas hypermedia have become very popular through the World Wide Web (WWW). Based on the HTML format they can be designed by non-programmers using inexpensive tools while the production of CBT applications requires programming expertise. HTML documents can be easily developed to be distributed by a web-server or to run as local applications. In developed countries CBT and hypermedia have to compete with an abundance of printed or audio-visual media and a wealth of lectures, conferences, etc., whereas in developing countries these media are scarce and expensive. Here CBT programs, and hypermedia publications in particular, may be a cost-effective way to improve quality of education in the health sector.
The aim of this study was two-fold: to make available to the medical community a fast, efficient tool for troubleshooting PCR problems, and to demonstrate that hypermedia allow one to approach this kind of problem in a new, more useful way. The Web provides access to an enormous amount of information in the medical area, and in particular enables troubleshooting of new techniques in the medical laboratory. Currently it is possible to find textual information but it is not always easy to find hypermedia information. In many cases authors change only the means of dissemination of a book or paper to the Web, but do not adapt the information to the features of this new medium. The prototype of our hypermedia application was developed using Director and Flash programs (Macromedia), the application was developed from a decision tree built as a result of information compiled from expert PCR users and the existing literature. It was implemented on a website using Dreamweaver (Macromedia). The usefulness and possibilities of this application have been tested with physicians, medical laboratory technicians, and health science students, and have been proven to be more effective than traditional methods, both in education processes and in helping researchers and medical laboratory technicians in their daily work. The advance and popularization of the Internet in the medical profession requires information on the Web to adapt to the advantages offered by hypermedia. This new step must be taken, and the Web must offer medical users not only a different medium of information distribution but also a new way of handling and obtaining information.
Student use of pop-up text windows that support or extend information found in a high school social studies text provides a detailed look into the instructional effectiveness of a set of hypermedia study guides. Twenty-five students, 19 male and 6 female, with a mean age of 14.6 years participated in this study. Thirteen were students with learning disabilities and 12 were remedial students. Findings from the study indicate that hypertext (text-only) support provides adequate reinforcement to move remedial students and students with learning disabilities toward continued, unprompted use of a hypermedia study guide, and that short-term and long-term retention of information can be expected from text-only information support. Students who had access to the hypermedia study guides exhibited better information retention than students who did not use the hypermedia study guides.
Electrical activity of an isolated frog muscle spindle was investigated in hypertonic solutions obtained by adding 400 mM of sucrose, glucose or glycerine to the Ringer solution. In sucrose and glucose hypermedia the frequency of background impulse activity first increased and then decreased up to zero; receptor potentials and evoked impulse activity simultaneously decreased and disappeared. In the glycerine hypermedia impulse activity after some increase returned to normal and then a second rise of frequency to a constant supernormal level was observed. After returning to the Ringer solution from sucrose or glucose the background and evoked impulse activity progressively returned to normal. But after glycerine hypermedia a significant growth in the background impulse activity and a small change in frequency of evoked impulse activity were observed. The observed changes of electrical activity of the muscle spindle in hypermedia are discussed in terms of deformation of sensory endings and intrafusal muscles fibres leading to depolarization of the receptor membrane.
Hypermedia data browsing is a mean for improving information access. However, the overload and the heterogeneity of medical information, as well as the multitude of possible navigational paths, turn the consultation of data into a difficult task. We present in this paper a solution for the development of adaptive user interfaces in a hypermedia data browsing environment. It is based on the capitalization of the users knowledge in the decision-making process, expressed in terms of navigational paths and of data presentation modes that are customized to the user's preferences and practice. This capitalization offers the user a way to automatically store and reuse the experience accumulated in browsing through patient records. We illustrate our approach with the implementation of HEMA, a clinical workstation prototype that we have specialized for the cardiology domain.
Hypermedia data browsing is a mean for improving information access. However, the overload and the heterogeneity of medical information, as well as the multitude of possible navigational paths, turn the consultation of data into a difficult task. We present in this paper a solution for the development of adaptive user interfaces in a hypermedia data browsing environment. It is based on the capitalization of the users knowledge in the decision-making process, expressed in terms of navigational paths and of data presentation modes that are customized to the user's preferences. This capitalization offers the user a way to reuse the cumulative experiences in browsing through patient records. We illustrate our approach with the implementation of HEMA, a clinical workstation prototype.
RATIONALE AND OBJECTIVES: Although computer-aided detection (CAD) improves the diagnosis rate of early breast cancer, it has not been well integrated into radiology residency and technician training program. Moreover, CAD performance studies ignore the reader's training and experience with CAD. The purpose of this study was to investigate whether CAD training via a cognitive-perceptual based hypermedia program has effects on the performance studies of mammogram reading. MATERIALS AND METHODS: Three observers read a pretest set of 80 breast cancer cases (43 negative, 23 benign, and 14 malignant cancer cases). During 4 weeks' training, the observers used a hypermedia instructional program in CAD-aided mammography interpretation. The program includes modules of CAD attention-focusing schemes, CAD procedural knowledge, and case-based simulations in mammography interpretation in consensus with CAD. By the end of the fourth week of the training, they reviewed a posttest set of cases. Data were analyzed with multireader, multicase receiver operating characteristic methods. RESULTS: Three readers performed better in mammogram reading after training in CAD knowledge than they did before CAD training. CAD training and experience improved the performance of CAD-aided mammography interpretation. CONCLUSION: A statistically significant difference was found in each observer's performance in CAD-aided mammogram reading before and after the training. CAD training will influence the perception, recognition, and interpretation of early breast cancer and CAD performance studies. Furthermore, the young generation of radiologic professionals can have more training in various attention-focusing features, declarative knowledge, procedural knowledge, and conditional knowledge of CAD and incorporate them into their knowledge base and strategic processing for the purpose of improving the accuracy of mammography interpretation performance.
The computer-based textbook is a new educational tool that promises to play a prominent role in the coming years. Classical instructional technologies, such as video, stills, audio files and computer programs with a textbook orientation, have been merged into one multimedia computer system and have created additional opportunities for learning in medical, dental and nursing education. The authors developed a hypermedia textbook of â San-Yin-Jiao pressure for reducing the labor pain and shortening the labor time' using a personal computer with hypermedia software that contains texts, images, videos, audios and literature citations. The target population of this educational CD-ROM would be nurse-midwives, clinical nurses working for the obstetric units, and faculty members who teach the Maternity and Women's Health Nursing. Valuable and practical experiences were obtained and shared.
DentLE, the Dental Learning Environment is a hypermedia software system being prototyped as part of a research and development project at the State University of New York at Buffalo School of Dental Medicine. The design seeks to reach beyond single discipline software or cases, and integrate a range of patient problems within a comprehensive dental knowledge base. The approach is to use computer and hypermedia technology to weave together the disciplines of dentistry so that learning occurs in relation to patients, as they appear in the real world. The DentLE system prototype allows the learner to explore information in all the disciplines related to patient problems, as well as other information including "blind alleys" and results of curiosity.