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PubMed1996

[Top-Forum: an interactive multimedia knowledge database to improve quality of care in pediatric oncology].

The treatment of pediatric cancer patients is characterised by complex and aggressive chemotherapy, difficult decision making, the numerous protocols available and the necessity of highly skilled caregivers. Quality of care is a major issue in all pediatric oncology units. We created an interactive multi-media database available to each caregiver to permit him/her to have easy access to information and thus increase his/her knowledge and participate in increasing their group's know-how. The computer database is available to all on a free-access basis in each ward. This is a novel approach to quality care, as it accords great importance to personal formation, allowing each caregiver to broaden his/her knowledge via easily obtained data which he/she can help enrich by permanent feedback. This database may become the backbone of department know-how.

Adolescent↗
PubMed2000

CardioOp: an integrated approach to teleteaching in cardiac surgery.

INTRODUCTION/PURPOSE: The complexity of cardiac surgery requires continuous training, education and information addressing different individuals: physicians (cardiac surgeons, residents, anaesthesiologists, cardiologists), medical students, perfusionists and patients. Efficacy and efficiency of education and training will likely be improved by the use of multimedia information systems. Nevertheless, computer-based education is facing some serious disadvantages: 1) multimedia productions require tremendous financial and time resources; 2) the obtained multimedia data are only usable for one specific target user group in one specific instructional context; 3) computer based learning programs often show deficiencies in the support of individual learning styles and in providing individual information adjusted to the learner's individual needs. In this paper we describe a computer-system, providing multiple re-use of multimedia-data in different instructional sceneries and providing flexible composition of content to different target user groups. TOOLS AND METHODS: The ZYX document model has been developed, allowing the modelling and flexible on-the-fly composition of multimedia fragments. It has been implemented as a DataBlade module into the object-relational database system Informix Dynamic Server and allows for presentation-neutral storage of multimedia content from the application domain, delivery and presentation of multimedia material, content based retrieval, re-use and composition of multimedia material for different instructional settings. Multimedia data stored in the repository, that can be processed and authored in terms of our identified needs is created by using a next generation authoring environment called CardioOP-Wizard. High-quality intra-operative video is recorded using a video-robot. Difficult surgical procedures are visualized with generic and CT-based 3D-animations. RESULTS: An on-line architecture for multiple re-use and flexible composition of media data has been established. The system contains the following instructional applications (prototypically implemented): a multimedia textbook on operative techniques, an interactive module for problem based-training, a module for creation and presentation of lectures and a module for patient information. Principles of cognitive psychology and knowledge management have been employed in the program. These instructional applications provide information ranging from basic knowledge at the beginner's level, procedural knowledge for the advanced level to implicit knowledge for the professional level. For media-annotation with meta-data a metainformation system, the CardioOP-Clas has been developed. The prototype focuses on aortocoronary bypass grafting and heart transplantation. CONCLUSION: The demonstrated system reflects an integrated approach in terms of information technology and teaching by means of multiple re-use and composition of stored media-items to the individual user and the chosen educational setting on different instructional levels.

Computer Simulation↗
PubMed1998

Preconsultation education promoting breast cancer screening: does the choice of media make a difference?

BACKGROUND: Multimedia technology can be a valuable resource for health promotion and patient education initiatives because it allows messages to be presented within an environment that is both sensory-rich and interactive (i.e., the user can explore the information according to his or her particular needs and interests). Using clinic waiting time as an opportunity for breast cancer education, this investigation examined whether an educational intervention promoting breast cancer screening would be more effective when using interactive multimedia than when using written materials. METHODS: Over a five-month period, 108 women (40-70 years of age) from two clinics (a family practice clinic and a free clinic for the poor) participated in the study. Participants initially completed measures assessing perceptions of the personal importance of breast cancer, knowledge, and anxiety about screening procedures. They then were randomly assigned to receive breast cancer education by using an interactive multimedia program or by reading a brochure. Following the intervention, the participants once again completed the perceived importance, knowledge, and anxiety measures, and evaluated the educational materials. RESULTS: These women perceived breast cancer to be a more personally important health issue, learned more, and reported less anxiety about cancer screening following the intervention regardless of method. Younger women learned more from the educational materials than did older women. Although the multimedia program received more favorable evaluations than the brochure, this effect was mediated by the message recipient's age, as younger women responded more favorably to the multimedia materials than did older women. CONCLUSION: Preconsultation education is a valuable but rarely used opportunity to promote breast cancer screening. If well constructed, educational materials using a variety of media can be effective. While preferences for media may in part depend on the audience's age, considerably more research is needed to better understand how the interplay of media, message, and audience characteristics can help accomplish health-promotion objectives.

Adult↗
PubMed2005

[Preoperative information].

BACKGROUND: Many empirical studies have identified the quality and communication of patient information as a major weak point in the treatment process. Patient information can be made considerably more effective by multimedia communication of contents tailored to the patient's needs. Computer-based training (CBT) takes the multimedia presentation one step further. METHODS: Using the Macromedia Director 8.5 authoring software, a multimedia system for pre-operative patient information was developed on CD-ROM for a limited area of oral and maxillofacial surgery. This information system was evaluated for quality assurance on the basis of a random sample of 85 patients in a test lasting about 20 min. Impressions were determined with regard to design features, motivation, understanding, the subjective communication of knowledge, the newly acquired competence and acceptance compared with other media (information leaflets, Internet, conventional information). RESULTS: The analysis of the program test revealed a hugely positive assessment of the interactive program in respect of layout, functionality and design as well as in respect of structuring and the subjective understanding of the underlying complaint, therapy and potential complications. In a comparison with other information media such as information leaflets and the Internet, the program was rated just as good or better by over 70% of the respondents. Only conventional consultation with a doctor came off better in a direct comparison. CONCLUSION: It was shown that the quality of preoperative patient information can be improved through multimedia presentation and that it would be sensible to make use of modern media for the purposes of giving patients graphic information.

Adolescent↗
PubMed1997

Demonstrating minimal invasive therapy over the Internet.

Use of the Internet for multimedia conferencing began in the early 1990s. Multimedia conferencing allows people at multiple, distributed locations to communicate using audio, video and shared workspace programs; the Multicast Backbone of the Internet (MBONE) provides the technical solution to make the most efficient use of the limited Internet bandwidth for such interactions. The scope for using this technology in medical applications was recognised by the MICE project which, in November 1994, used Sun SPARC workstations connected to the MBONE to send video and commentary of live operations from Sweden and San Francisco to a workshop held in London. These sessions were marred by severe congestion experienced on the networks on the day, but the consensus of those organising and attending the workshop was that the exercise was worthwhile. The main lessons learnt from this first transmission were the need to provide better quality links and to ensure confidentiality. In December 1995, the MERCI project, funded by the European Union under the TELEMATICS for Research programme, began work to refine and further propagate the use of the multimedia conferencing software. Part of this work is to provide these improved facilities to transmit operations to two more workshops scheduled for 1997. MERCI will offer confidentiality through encryption facilities built into the conferencing programs, improved programs which cope better with adverse network conditions, use of the new high-speed JAMES network and access to a multimedia server from which recordings of operations and medical instrumentation can be delivered to the workshop participants.

Computer Communication Networks↗
PubMed1995

[Surgical continuing education with multi-media techniques exemplified by endonasal micro-endoscopic pan-sinus operation].

The concept of multimedia involves the integration of various media into a single computer system which, properly configured, permits an interactive approach. Modern computer technology makes it possible to display of varied audio-visual documents on screen and allow the users to work independently and learn at their own pace. Our new teaching multimedia software (available in English or German) illustrates future possibilities for individualized interactive medical education. Required hardware consists of an IBM-compatible PC plus a CD-ROM drive, two speakers, and a special MPEG multimedia board. The program is supplied on a compact disc. The user begins at an introductory screen and works through the technique of endonasal sinus surgery individually and interactively. He can switch between the following chapters by clicking the mouse: an introduction to anatomy of this region, an atlas of computed tomography of the paranasal sinuses, and a chapter dealing with the danger areas. The main chapter contains a video about how to perform endonasal microendoscopic sinus surgery, which we have divided into thirteen sections. Each of these contains a section on dangers and complications with tips on to avoid and correct them (e.g. how to close a dura defect; what to do after damaging the anterior ethmoidal artery). In addition, CT scans of the relevant areas are shown. A special MPEG multimedia board permits full-screen video.

CD-ROM↗
PubMed2004

Computer aided learning versus standard lecture for undergraduate education in urology.

PURPOSE: The current model of undergraduate medical education is under debate since knowledge retention and student interest seem to be decreasing. To clarify this situation we developed and evaluated a computer aided learning program using a multimedia presentation about prostate cancer for undergraduate teaching in urology. MATERIALS AND METHODS: A total of 60 medical students from years 2 and 3 were divided into group 1-31 who used the multimedia program and group 2-29 who attended a standard lecture on the same subject. At the end the level of knowledge acquisition for the 2 groups was evaluated by a multiple choice test. Group 1 students also answered a questionnaire about subjective feelings on computer based teaching. RESULTS: Test performance in groups 1 and 2 was similar (60% vs 62% correct answers, p >0.05). On the other hand, 23 of 31 students using the multimedia program believed that it did not adequately replace the instructor and interaction with a mentor still seems to be relevant. CONCLUSIONS: According to this study computers and multimedia programs can be used for undergraduate education in urology, providing that direct contact with an instructor is concomitantly offered to students.

Computer-Assisted Instruction↗
PubMed2003

Developing interactive course Web sites for distance education and characteristics of students enrolled in distance learning courses.

The ubiquity of the Internet has made disseminating information across geographical boundaries a relatively easy task. Apart from text-based materials, the Internet provides an easy means to transmit images, sound, video, and other multimedia content to a global audience, making it an ideal medium for establishing distance learning programs. Two Internet-based distance learning courses were developed to teach animal physiology to veterinary technicians in the School of Veterinary Medicine at Purdue University. These distance learning course sites are designed to take advantage of multimedia technology to enhance students' learning experiences. Multimedia has been used in education to make the learning process more engaging and interactive. The two course sites have a number of multimedia features that complement the textual subject matter. This article describes the features of the course Web sites and summarizes our experiences in designing and conducting Web-based physiology courses to distance learners. In addition, we describe the characteristics of our distance learning students.

Adolescent↗
PubMedDate not supplied

Touch-screen computerized education for patients with brain injuries.

The use of computer technology for patient education has increased in recent years. This article describes a study that measures the attitudes and perceptions of healthcare professionals and laypeople regarding the effectiveness of a multimedia computer, the Brain Injury Resource Center (BIRC), as an educational tool. The study focused on three major themes: (a) usefulness of the information presented, (b) effectiveness of the multimedia touch-screen computer methodology, and (c) the appropriate time for making this resource available. This prospective study, conducted in an acute care medical center, obtained healthcare professionals' evaluations using a written survey and responses from patients with brain injury and their families during interviews. The findings have yielded excellent ratings as to the ease of understanding and usefulness of the BIRC. By using sight, sound, and touch, such a multimedia learning center has the potential to simplify patient and family education.

Attitude of Health Personnel↗
PubMed2001

Optimisation and evaluation of an asynchronous transfer mode teleradiology co-operative system: the experience of the EMERALD and the BONAPARTE projects.

This paper describes the work carried out to optimise and evaluate in clinical routine a multimedia telemedicine application for co-operative imaging diagnosis. This research has been attained within the framework of two European research projects, namely the EMERALD [1] and the BONAPARTE [2]. A user-centred telemedicine application was developed on an existing advanced broadband multimedia teleradiology platform to exploit the possibilities offered by Asynchronous Transfer Mode (ATM) technology to support real-time teleconsultation services for medical imaging. The evaluation of this telemedicine system in both projects has been performed with the aim of (1) characterising and optimising the ATM teleradiology platform, minimising the bandwidth requirements without degrading the quality of service offered to users and (2) evaluating the telemedicine system usability to improve the fulfillment of user's needs. The assessment outcomes have provided insights into technical limitations of broadband multimedia technologies for an optimum usage of a teleradiology co-operative diagnosis systems and the organisational difficulties and limitations involved in setting-up these new advanced telemedicine services to achieve the expected clinical benefits.

Computer Graphics↗
PubMed2000

Local CD-ROM in interaction with HTML documents over the Internet.

The internet and computer assisted learning have enhanced the possibilities of providing quality distance learning in dentistry. The use of multimedia material is an essential part of such distance learning courses. However the Internet technology available has limitations regarding transmission of large multimedia files. Therefore especially when addressing undergraduate students or geographically isolated professionals, large download times make distance learning unattractive. This problem was technically solved in a distance learning course for undergraduate students from all over Europe. The present communication describes a method to bypass the problem of transmitting large multimedia files by the use of a specially designed CD-ROM. This CD-ROM was run locally on the students' PC interacting with HTML documents sent over the Internet.

CD-ROM↗
PubMed2000

Examining the impact of administration medium on examine perceptions and attitudes.

The present study explored the impact of administration medium on examinees' affective reactions. The research compared managers' reactions with 3 versions of the Conflict Resolution Skills Assessment (J. B. Olson-Buchanan et al., 1998) that were identical in content but varied in terms of the level of technology used: a paper-and-pencil form, a written form administered by computer (i.e., a computerized page-turner), and a multimedia form administered by computer. Managers completing the multimedia assessment perceived the assessment as more face valid and had more positive attitudes, relative to managers who completed the other 2 assessments. Computerization, however, was not enough to make a difference; instead, it was the multimedia nature of the computer presentation that resulted in the most positive affective reactions. Study limitations and implications for research and practice are discussed.

Analysis of Variance↗
PubMed2003

Introducing HEAL: the Health Education Assets Library.

Digital multimedia, such as images and videos, are playing an increasingly important role in health sciences education. Educators, however, often do not have the time or resources to create high-quality materials. The authors describe the development of a new Health Education Assets Library (HEAL), a freely accessible, national library of high-quality digital multimedia to support all levels of health sciences education. HEAL's primary mission is to provide educators with high-quality and free multimedia materials (such as images and videos) to augment health science education. In addition, HEAL is working with other organizations to establish a network of distributed databases of high-quality teaching resources. By using state-of-the-art Internet technologies HEAL enables educators across the country to efficiently search and retrieve teaching materials from a variety of sources.

Education, Medical↗
PubMed2003

Sharing digital teaching resources: breaking down barriers by addressing the concerns of faculty members.

PURPOSE: Regional and institutional databases have been created to improve access to educational resources and to avert unnecessary duplication. The growth and success of these databases depend upon the willingness of faculty members to contribute their materials. This qualitative study seeks to identify the barriers that block the free exchange of educational multimedia and the incentives that could be created to overcome educators' concerns. METHOD: In 2001, 34 faculty members from 13 U.S. medical schools each participated in one of five focus groups. They responded to three hypothetical scenarios depicting opportunities for sharing educational resources. Participants' responses were categorized hierarchically and sent back to them for feedback. RESULTS: Participants strongly supported multimedia databases, particularly those that serve a national audience. Obstacles for contributing materials included the lack of institutional recognition for educational innovation, confusing intellectual property policies, the hassle involved in sharing materials, and the perceived commercial potential of the materials. Peer review of educational materials was seen as an important incentive. CONCLUSIONS: Medical schools could benefit from the free exchange of high-quality educational multimedia but need to address the concerns of faculty by clarifying institutional copyright rules, streamlining the donation process, and providing assistance with cataloging assets. Removing departmental pressures to commercialize materials and recognizing peer-reviewed donations as academic achievement could foster a culture of sharing.

Attitude of Health Personnel↗
PubMed2005

Using a computer to teach patients about fecal occult blood screening. A randomized trial.

OBJECTIVE: To determine whether a multimedia computer program could effectively teach patients about fecal occult blood testing (FOBT) and increase screening rates. DESIGN: Randomized trial. SETTING: University-affiliated, community-based Internal Medicine outpatient practice. PARTICIPANTS: All English-speaking patients aged 50 years and older who were offered FOBT screening by their providers were invited to participate. Two hundred and four patients enrolled in the study. Ten patients were later determined to be ineligible. INTERVENTIONS: Patients were randomized to either the educational multimedia computer program or usual nurse counseling about FOBT screening. Screening instructions were based on the material pre-printed on each test kit. Educational sessions were held in a private setting immediately after each patient's office visit. MEASUREMENTS AND MAIN RESULTS: A knowledge-assessment questionnaire was administered in a blinded fashion by telephone the following day. Successful screening was defined as return of the test kits within 30 d. Completion of the FOBT kits was similar in both groups: 62% (58/93) in the computer group and 63% (64/101) in the nurse group (P=.89). Mean knowledge scores were also similar, but there was a trend toward increased knowledge mastery in the computer group (56% vs 41%, P=.09). CONCLUSIONS: A multimedia educational computer program was as effective as usual nurse counseling in educating patients and achieving adherence to FOBT screening. Future studies are needed to determine whether computer-assisted instruction can improve health outcomes.

Aged↗
PubMed2005

Advantage of three dimensional animated teaching over traditional surgical videos for teaching ophthalmic surgery: a randomised study.

BACKGROUND/AIM: Owing to the complex topographical aspects of ophthalmic surgery, teaching with conventional surgical videos has led to a poor understanding among medical students. A novel multimedia three dimensional (3D) computer animated program, called "Ophthalmic Operation Vienna" has been developed, where surgical videos are accompanied by 3D animated sequences of all surgical steps for five operations. The aim of the study was to assess the effect of 3D animations on the understanding of cataract and glaucoma surgery among medical students. METHOD: Set in the Medical University of Vienna, Department of Ophthalmology, 172 students were randomised into two groups: a 3D group (n=90), that saw the 3D animations and video sequences, and a control group (n=82), that saw only the surgical videos. The narrated text was identical for both groups. After the presentation, students were questioned and tested using multiple choice questions. RESULTS: Students in the 3D group found the interactive multimedia teaching methods to be a valuable supplement to the conventional surgical videos. The 3D group outperformed the control group not only in topographical understanding by 16% (p<0.0001), but also in theoretical understanding by 7% (p<0.003). Women in the 3D group gained most by 19% over the control group (p<0.0001). CONCLUSIONS: The use of 3D animations lead to a better understanding of difficult surgical topics among medical students, especially for female users. Gender related benefits of using multimedia should be further explored.

Cataract Extraction↗