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Computer-assisted instruction for medicine and nursing: sources and programs.

A list of computer-assisted instruction (CAI) vendors and programs was compiled as a resource for medical librarians who are building a nonprint collection. It includes only computer-assisted instruction for clinical education in medicine and nursing. The very brief description of each program is followed by price, audience, and hardware requirements.

Computer-Assisted Instruction↗

Enhancement of achievement and attitudes through individualized learning-style presentations of two allied health courses.

This investigation analyzed the effects of the instructional resource Programmed Learning Sequence (PLS) on the achievement and attitudes of college students and correlated the findings with the individuals' learning styles. The subjects were enrolled in Sonography I and Cross-Sectional Anatomy in a college of health-related professions. Both classes were administered the Productivity Environmental Preference Survey to identify learning-style strengths, and alternately presented with lessons using a PLS in a book format and traditional lectures. The sonography class also was exposed to a PLS in multimedia computer format. The Semantic Differential Scale measured the students' attitudes comparing the instructional methods experienced, and class examinations measured content mastery. In both classes, examination scores were significantly higher (effect size for the sonography class was 1.42; for the anatomy class, 0.63) and students' attitude scores were significantly higher when PLS rather than the traditional method was used. In the sonography class, achievement was significantly higher with the book PLS than with the computer PLS (effect size, 1.11). Significant correlations emerged between learning-style elements and achievement: students who preferred learning with the book PLS required more quiet in the environment than did those who preferred the computer PLS; students who preferred learning traditionally and with the computer PLS required more light than those preferring the book PLS; and students who preferred learning with an authority figure favored the traditional method. Examination of the data for other correlations between learning-style preferences and attitudes using the book PLS also revealed many other significant findings, demonstrating its ability to accommodate diverse styles.

Adolescent↗

An electronic instructor for gross anatomy dissection.

Gross anatomy is time consuming to teach and to learn. Because the process of dissection takes up so much student time, assistance in the form of an in-lab instructional DVD program might improve student performance. The DVD could be viewed with a portable device by individual dissection groups at their tables. Groups could dissect at their own pace, with access to step-by-step demonstrations and answers to frequently asked anatomical questions. We created an instructional DVD program demonstrating dissection of the canine ventral neck and thoracic limb. The effect on student exam scores of using the DVD versus not using it was measured in a controlled, two-sample study using incoming first-year veterinary students as volunteers. Volunteers were told the study was of two different dissection methods; the DVD was not specifically mentioned until after the students were separated into two groups (Blue/DVD group and Orange/No DVD group), and then only to volunteers in the Blue group. Except for the DVD, the two groups had the same resources. The difference in scores on an exam given after a single dissection period did not differ sufficiently to conclude that DVD use raised the mean score; however, 73% of the DVD group scored 60% or higher, while only 38% of the No DVD group scored 60% or higher. The difference in mean scores overall was 2.3 points out of a possible 49, suggesting that the DVD helped students, especially those with lower scores, to earn two to three more points than they would have otherwise.

Adult↗

Education of the patient with cardiac disease in the twenty-first century: an overview.

The current status of education, behavioral change, and use of technology identifies a need for professionals who can develop interactive educational programs and apply existing techniques in a cost-effective manner. The general public, including patients with cardiac disease, are sophisticated consumers of information technology and demand quality production. The challenge is to train specialists to produce educational programs, to instruct health professionals in use of these programs, to deliver appropriate messages, to teach needed skills to patients with cardiac disease, and to evaluate the outcomes. Unless incentives to restore cardiac patients to an optimal functional status with few recurrences and complications are as tangible as are incentives for treating acute cardiac illnesses, the appropriate use of technology to educate patients with heart disease is unlikely to develop. However, the trend to increased ambulatory care under prospective payment systems makes it likely that technology will be applied to improve the efficiency in maintaining health and preventing acute illness. The potential benefits to the nation are substantial.

Attitude to Health↗

FMTUTOR: a computer-aided instructional system for teaching fetal monitor interpretation.

FMTUTOR is a computer program for instruction in the interpretation of fetal monitor recordings. The system runs on IBM-PC-compatible microcomputers and uses text and computer graphics to illustrate and reinforce important concepts. By means of a 2-hour introductory tutorial session and generation and guided interpretation of an unlimited variety of tracings, it simulates one-on-one instructor-student interactions and allows rapid accumulation of a store of information and experience in monitor tracing interpretation. FMTUTOR is currently used to teach third- and fourth-year medical students at the University of New Mexico. Acceptance has been enthusiastic, and development of more advanced instructional systems targeting nurses, residents, and obstetricians is underway.

Computer-Assisted Instruction↗

High-fidelity simulation-based training in neonatal nursing.

Simulation-based training is a novel approach that facilitates the use of higher order thinking skills. Simulation-based training challenges medical professionals to develop cognitive, technical, and behavioral skills through the use of mannequins, working medical equipment, and human colleagues. During scenarios, trainees must make use of their knowledge base, analyze and synthesize factors contributing to the crises, and evaluate the effects of their actions. Feedback indicates that simulation-based training programs are more pertinent to and better accepted by adult learners than traditional programs. The instructional methodologies used in simulation-based training programs are more in line with the tenets of adult learning.

Education, Nursing, Graduate↗

Vision information center: a user-oriented data base.

In response to the information needs of scientists and physicians who work in the field of vision, we have developed a direct-access, on-line specialized information retrieval system which combines computer-assisted instruction and bibliographic retrieval. An essential feature of the system is its accessibility via remote computer terminal. The key to the data base is a thesaurus which contains specific terminology arranged in a hierarchical structure. The thesaurus is used both for indexing the literature and for retrieving the information stored in the computer. Courses of instruction on selected subjects in ophthalmology have been programmed and form part of the data base. A search of the literature retrieval system by single subject, or by a combination of several subjects chosen from the thesaurus, retrieves the appropriate bibliographic citations. The response to the service offered by the Vision Information Center indicates that the center should expand its facilities to satisfy the needs of its clients.

Boston↗

An asthma self-management program for children, including instruction in peak flow monitoring by school nurses.

A randomized trial of an instructional method was conducted in which school nurses taught children asthma self-management principles and skills, including peak flow monitoring, in 20-min, individual sessions over an 8-week period. Thirty-six children participated. An intervention group of 18 children received the teaching sessions. A control group of 18 children received regular care by the nurses, but no teaching sessions. The sample included 64% boys, 69% African-Americans, and 69% Medicaid recipients. The average age of subjects was 10.2 years. The two groups were demographically similar, but despite random assignment, the control group had a significantly earlier age of onset of asthma and tended to have had more asthma attacks in the preceding year. These factors were statistically controlled in outcome analyses. Results of group comparisons showed no significant differences in the number of postintervention emergency room visits and days absent from school. However, nurses reported that children who practiced breathing exercises had less anxiety during exacerbations, and the nurses' knowledge of the children's baseline peak expiratory flow rates facilitated care of the children. Nurses expressed the opinion that the individual sessions with students might be useful in motivating them to participate effectively in later group sessions. The intervention was well accepted by students, parents, and nurses. We believe that this intervention is promising as a practical, low-cost approach to enhancing children's asthma self-management skills and warrants further testing in a larger sample, with the intervention conducted over a longer period.

Absenteeism↗