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[Tox-Didact:CD-ROM for toxicology education. Value in hospital toxicology].

New teaching techniques should allow students more independence in their training, particularly in learning from problems and using clinical reasoning. We designed Tox-Didact, a modular multimedia educational software program, which is suitable for both students and professionals, regardless of their orientation (pharmacy or medicine) or level. Each module concerns four domains: diagnosis, biological monitoring, curative treatment and prevention. Tox-Didact is multidisciplinary, interactive, simple to use and reliable. Nineteen modules are now being prepared. In final form, Tox-Didact will cover all the acute and chronic pathologies of toxicology.

CD-ROM↗

SeCD electronic folder: CADMIO's application for the medical folder of a service for the care of drug addicts.

In this paper we will describe the SeCD (Service for the Care of Drug addicts) electronic folder, a specific application of CADMIO [1] (Computer Aided Design for Medical Information Objects) system. CADMIO is a system for the definition, construction and management of multimedia clinical folders. The Ser.T. (Servizio per la Tossicodipendenza/Service for Drug Addicts) has earned a very special place within the Italian clinical structures as well as any service for drug addicts has done in the rest of the world. Such a structure has special needs and the characteristics of its medical folders are very different from any other folder. Actually, a Ser.T. has to keep updated the patient situation either from the clinical point of view as well as the psychiatric one. Moreover, it must keep track of the clinician subjective considerations about the patient psychic state and his situation in regard of the law. So, we had to redesign some of the features of the existing CADMIO application, to accommodate such highly not structured data into objects easily manipulated by an informative system. The objectives we hope to achieve were mainly two: To show that a well designed adaptive system can be easily exploited to support even very complex and poorly structured data types and actions To design data structures able to accommodate medical, psychiatric and administrative data in an homogeneous manner.

Computer Systems↗

Features for a B-ISDN telemedicine system and its application.

Telemedicine technology is emerging as a new way of medical practice. It will provide more cooperative activity between departments and more comfortable access for disabled patients home. We developed two types of telemedicine system: a telediagnosis system and a home care system. Our telemedicine application is aimed to be run on the broadband-integrated services digital network (B-ISDN). The legacy network is also considered. The user interface is designed to help doctors to communicate easily. The key elements of telemedicine systems are user friendly interface, medical multimedia database design highly refined display technique.

Computer Communication Networks↗

Design of a 3D workbench interface for training in dental implantology.

The recent technological advances in the area of image processing and interactive computer graphics have lead to many sophisticated systems which support clinical experts in diagnosis and treatment planning tasks. In dentistry, the treatment with implants becomes more and more important. Although in the near future there will be increased demand for dentists who are trained in dental implantology, little effort has been made to introduce technologically new teaching methods into the curriculum of dentists. This paper describes the design of a virtual implant treatment planning system which is based on the concept of a three-dimensional horizontal display. The system is utilizing different VR and multimedia techniques to achieve a highly interactive virtual workbench environment which is suited for class-room experimental education in dental implantology.

Computer-Assisted Instruction↗

Experience journals: using computers to share personal stories about illness and medical intervention.

Medical advances make it increasingly possible for children with previously fatal illness to live and thrive. However, a significant number still experience repeated operations, hospitalization, and invasive procedures, or need special care at home. Many do so with little or no intervention to help them and their families cope with the emotional stresses involved. One significant source of emotional and cognitive support is the community of patients and families who have experienced similar medical procedures. However, in spite of a general willingness to share experiences, communication among patients and families is usually limited. To facilitate this process, we are investigating the use of computer technology to record, organize, and display stories about the experiences of families with children who have been treated for cardiac and neurological illness at Children's Hospital, Boston. We are asking children and their families to record text and multimedia vignettes describing some aspect of their illness, coping strategies, or care that might be useful to others. These contributions will be available for browsing at a secure World-Wide-Web site. However, economic realities preclude reliance on a professional site administrator to organize and monitor what we hope to be a rapidly growing Web site with a large, distributed authorship. The need to make the Web site fully accessible to users who have varying familiarity with computers and Web browsing imposes further constraints. We are therefore developing software to automate the process of managing and organizing an easily accessed Web site that contains an "Experience Journal." We describe this software, the rationale for its development, and our plans for its use in the coming year.

Adolescent↗

Developing an interactive intravenous education and training program.

Intravenous therapy knowledge, skills, and attitudes of nurses within a healthcare organization vary greatly. Primary nursing education programs, responsibility for i.v. therapy in previous jobs, patient populations, types of therapies provided, and clinical setting are just a few of the factors contributing to these variations. However, administrators usually expect all nurses to function in all areas of clinical practice. The gap between actual and expected knowledge and skills can be extremely wide, especially in i.v. therapy. Interactive multimedia i.v. education products provide a way to narrow that gap in a quick and cost-effective manner when appropriate planning processes are used to incorporate them into an educational program.

Computer-Assisted Instruction↗

Student bodies: psycho-education communities on the web.

We have developed a Web-delivered, multimedia health educational program, Student Bodies, designed to improve body satisfaction, a probable risk factor for the development of eating disorders in young women. The program includes psycho-educational content and a newsgroup for communication, and is delivered in a structured framework of weekly readings, assignments and postings to the newsgroup. Intervention group participants improved their body image, and reduced other attitudes that predispose to eating disorders.

Body Image↗

Using multi media to enhance a flexible learning program: lessons learned.

Central Queensland University is a well-established distance education provider with an internationally recognized reputation in flexible learning. It has a well-developed infrastructure for the preparation of quality print and multimedia learning materials. A symposium and working conference linking twelve sites, including Auckland NZ via video conferencing, and supported by print based materials and web based conferencing was held during November 1998 with the assistance of Telstra's Conferlink. This paper provides the background, organisation, and evaluation results. Our conclusions are that appropriate use of a combination of print based materials, videoconferencing and a web based classroom works well for the provision of continuing education to health professionals. In addition this symposium was able to reach clinicians and demonstrate the value of informatics to support evidence based practice.

Attitude of Health Personnel↗

Restricted natural language processing for case simulation tools.

For Interactive Patient II, a multimedia case simulation designed to improve history-taking skills, we created a new natural language interface called GRASP (General Recognition and Analysis of Sentences and Phrases) that allows students to interact with the program at a higher level of realism. Requirements included the ability to handle ambiguous word senses and to match user questions/queries to unique Canonical Phrases, which are used to identify case findings in our knowledge database. In a simulation of fifty user queries, some of which contained ambiguous words, this tool was 96% accurate in identifying concepts.

Computer Simulation↗

A comparison of a computer and pencil and paper assignment.

Colleges are challenged to provide students with diverse teaching-learning experiences. Educators who introduce new teaching-learning experiences must evaluate the outcomes of these experiences. Three faculty members instituted a new multimedia computer-based assignment for undergraduate nursing students enrolled in a pediatric clinical course and then evaluated their knowledge and satisfaction. Students were asked to design a computer program about peripherally inserted central catheters, and to complete tests and summaries. During two semesters, 45 students participated in the assignment. As compared to another group of students who were asked to participate in a pencil and paper independent study assignment, these students were more satisfied with their computer assignment. Students in both groups, however, produced thought-provoking work and improved their knowledge base about central catheters. In many ways, the results support the use of a computer assignment.

Adult↗

Post-Doc: satisfying the information needs of general practitioners in continuing medical education and daily practice.

The learning needs of General Practitioners (GPs) are not optimally covered by traditional ways of Continuing Medical Education (CME). The European-funded Post-Doc project sets up a model for a European internet-based infra-structure and learning environment to support GPs' individual CME activities, focusing on problems of daily work. It integrates education, information and communication for both daily work and learning at home. Based upon a user requirements analysis, the service includes multimedia training applications, selections of relevant information sources, a calendar of events, and communication facilities. The service is intended to fit in existing health care structures and accreditation systems. Because of different languages and user requirements in Post-Doc's regions each region builds an own website. The regional prototypes are built and evaluated in cooperation with small core user groups. This regional approach proved feasible and also influenced the network structure with regional demonstrator websites and one master website including central functionality.

Computer-Assisted Instruction↗

Neural network in communication with medical computer system.

The paper presents a concept of an experimental module designed to recognise spoken utterances that cover a limited range of words indispensable in dialogues with computer medical systems. Research into the recognition of spoken words by a module based on artificial neural network is described. Usefulness of the obtained results for surgery-assisting multimedia systems and for a patient simulator supporting medical education of students in case history-taking and diagnosing is also discussed.

Artificial Intelligence↗

Awareness of the earth and possibilities for new science education in the Internet age.

The internet as "the nervous system of global size" and multimedia technology have changed our global experience radically and suggests possibilities of entirely new approaches to the conventional education of sciences and the environment. They are not merely the changes where printed text books are converted into dynamic things with vivid appeal to our senses and information about the world's museums and art galleries, digitalized and shared by all. If the seismic activities occurring every day in various parts of the world can be seen in real form directly through the internet by all the people of the world, how will children's views of the earth change and how will their scientific understanding improved? If there was a system whereby one could monitor, in real time, how one member or others of the world net surf the global home pages, and if one could follow the "moving" process on the internet, children would certainly appreciate the presence of the internet as a global network of information. The web site "Sensorium" (http://www.sensorium.org) was created by us in an effort to put these live experiences of the internet into design. Sensorium is not a site merely to digitalize and list the existing knowledge and data. It is an experiment for the Digital Museum as a new "forum" where we may experience and share a moment. It is also an attempt to create tools for science and environment education which are only available on the network.

Child↗

[Telemedicine collaboration between the Rikshospitalet and the Ulleval hospital].

BACKGROUND: During the last two years the Intervention Centre at the Nation Hospital of Norway and Ullevål Hospital have pursued a research programme in telemedicine aimed at exploring the potential of inter-hospital collaboration. MATERIAL AND METHODS: Both hospitals established a communication network between operating rooms and lecture halls. Sound and video from minimally invasive surgical and radiology procedures were transmitted on a wide bandwidth ATM network (34 Mbits/s) to gain experience with the use of telemedicine for educational purposes and the treatment of patients. RESULTS: Evaluations of technical off-line and clinical line transmissions have given us helpful information about the potential of telemedicine and what it will take to utilise this potential. With the MPEG2 standard, a wide bandwidth network yields sufficient sound and image quality for educational and clinical collaboration. However, multimedia communication requires changes in the organisation to secure quality of service in relation to technical management and telemedical production. INTERPRETATION: Inter-hospital collaboration on telemedicine may be a resource in clinical practice, facilitating professional enhancements, particularly in surgery, radiology and internal medicine. Changes in the organisation are needed, but they are feasible.

Computer Communication Networks↗

LAHYSTOTRAIN intelligent training system for laparoscopy and hysteroscopy.

Rapid developments in the medical field, as an expanding knowledge base and emerging new technologies require continuing medical education to achieve life long learning and to keep the surgeons up to date. Consequently, specific training is necessary to guarantee qualification of the surgeons. The goal of LAHYSTOTRAIN is to overcome the current drawbacks of traditional training methods for laparoscopic/hysteroscopic procedures. A computer-assisted simulator for training and quality control in laparoscopy and hysteroscopy is developed using Virtual Reality (VR), Multimedia (MM) technology, and Intelligent Tutoring Systems (ITS).

Artificial Intelligence↗

[Computer-assisted instruction applied to preventive medicine in adolescents: bibliographic analysis and perspectives].

Computer-assisted instruction (CAI) for adolescent health promotion is still underused in France. We analysed the literature on existing systems in terms of current issues, techniques used, efficacy and difficulties experienced. All the authors noted that youth show a great interest in computer-assisted instruction and that they have made progress in their knowledge of health related risks. In some cases, an improvement in behaviours has been seen. CAI has many advantages due to the use of computers and in particular, the interactivity involved. Designers of CAI software for prevention issues must work as a team. Directed by a group of experts, the development of an interactive dialogue must involve youth input, take the adult point of view into consideration, and utilise the expertise of education and communication specialists. The use of computers and the Internet in schools provides great opportunities for developing multimedia health programmes.

Adolescent↗

The sleep tutorial.

A multimedia Sleep tutorial for General Practitioners was implemented from scratch. The implementation had into account the following features: 1) Specific needs of GPs evaluated in 3 different countries, related with Tutorial contents and technical features; 2) Multinational authorship from European experts; 3) Multilingual possibilities; 4) User friendliness and easy navigation. The tutorial was implemented and tested and its gama version is now available for commercialization.

Adolescent↗

Headache tutorial.

The headache multimedia educational tool for the general practitioners, consists of five different modules, i.e. classification, clinical data, headache tutorial, diagnostic headache diary and nomenclature. It is possible to move between the modules both vertically and horizontally. This paper concerns the headache tutorial. It consist of case records that the user can test his diagnostic abilities on. Each case record is subdivided into an interview by the physician, physical and neurological examination, laboratory test, sum of positive diagnostic elements, suggestions of diagnoses and management. A total of 12 case records are provided. The system will be available on a CD-ROM.

Adult↗