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Trends, current developments, and concepts in distance learning and E-learning.

A glance at the history of distance learning shows that there is a long tradition of using contemporary technical resources for learning and teaching purposes. For some, the holy grail of distance learning is the concept of the industrialization (mass production) of teaching and learning. Although reality has time and again caught up with technological promise, the scope for using new information and communication technologies in teaching has frequently been disregarded. In the future, learning will entail handling organized knowledge resources in demand-specific, organized communities formed for finding solutions to distinct problems and generating new knowledge about learning processes within the problem solving process. The development of the potential of "e-learning" (and actually, it bears contemplating whether this term puts too much emphasis on conventional learning organized in temporally-limited courses or similar, to the detriment of intelligent management of knowledge in its own working context) will depend upon the extent to which organizations succeed in promoting the development of a learning and working culture, for example, by incentive systems, team promotion, and free access to knowledge resources. The Masters degree in Organization Studies is presented against this background as an example of teaching using a combination of resources, leading to undreamed of learning success.

Computer-Assisted Instruction↗

Advances in biomedical informatics for the management of cancer.

Increased access to health care, and advances in education and technology have resulted in a larger proportion of the population having longer life expectancy. The strong correlation between age and cancer has resulted in a major healthcare problem for this century, and until recently cancer has defied any long-lasting cure. However, progress, especially in the field of biomedical informatics, promises a successful prediction and possibly a permanent cure for cancer within the next two decades. Biomedical informatics-with its roots in computer science, biomedical engineering, biostatistics, and mathematics-helps to bring the patient closer to the physician, facilitates access to specialist information and knowledge bases across the world, and makes it possible to identify genetic expression profiles for malignant or cancerous cells. This paper reviews the new research findings in biomedical informatics, working toward the ultimate goal of successfully predicting cancer, solving complex problems in prevention and treatment of cancer, and perhaps completely curing the scourge of cancer.

Biometry↗

Virtual reality simulator for vitreoretinal surgery.

AIM: To develop computer simulation of steps in vitreoretinal surgery using virtual reality technology. MATERIAL AND METHODS: A workstation with three-dimensional position tracking stylus was attached to a Pentium II desktop PC with a graphic accelerator. Computer algorithms were developed using Open GL and Microsoft Visual C++ languages to control the interaction and update the visual feedback tracking the instruments. Soft tissue computer modelling was carried out to mimic the removal of a vitreous opacity. Lens touch with the instruments was also detected. Mathematical modelling to allow for lens distortion was taken into account. RESULTS: A virtual reality computer model has been developed that can simulate initial steps of vitreoretinal surgery. Soft tissue modelling of the vitreous opacity and its removal by the vitrector was successfully simulated. The movements of the active and passive instruments in the dummy eye corresponded to the movements on the computer screen. On evaluation of the system, there was a minimal but discernable time lag between the stylus movement and the visual feedback. There was no tactile feedback when the lens touch was simulated. No further complex vitreoretinal surgery simulation was possible at this stage.

Algorithms↗

Checking an integrated model of web accessibility and usability evaluation for disabled people.

A combined objective-oriented and subjective-oriented method for evaluating accessibility and usability of web pages for students with disability was tested. The objective-oriented approach is devoted to verifying the conformity of interfaces to standard rules stated by national and international organizations responsible for web technology standardization, such as W3C. Conversely, the subjective-oriented approach allows assessing how the final users interact with the artificial system, accessing levels of user satisfaction based on personal factors and environmental barriers. Five kinds of measurements were applied as objective-oriented and subjective-oriented tests. Objective-oriented evaluations were performed on the Help Desk web page for students with disability, included in the website of a large Italian state university. Subjective-oriented tests were administered to 19 students labeled as disabled on the basis of their own declaration at the University enrolment: 13 students were tested by means of the SUMI test and six students by means of the 'Cooperative evaluation'. Objective-oriented and subjective-oriented methods highlighted different and sometimes conflicting results. Both methods have pointed out much more consistency regarding levels of accessibility than of usability. Since usability is largely affected by individual differences in user's own (dis)abilities, subjective-oriented measures underscored the fact that blind students encountered much more web surfing difficulties.

Computer User Training↗

Information superhighway or information traffic jam for healthcare consumers?

The phenomenal development and growth of the information superhighway over the past few years has brought with an ever-increasing number of sites associated with health care. At the same time, community access to the Internet and multimedia technology has allowed greater access to healthcare sites by consumers wishing to find healthcare information relevant to their needs. The Internet has greater potential for improving the healthcare knowledge of the community, especially in remote areas or in parts of the community that have limited access to community health infrastructure. However, most of the current development of healthcare sites has focused on the needs of healthcare professionals rather than consumers. Indeed, with the volume of information available over the Internet, it is easy to spend hours browsing through a maze of sites with information that often is fragmented, incomplete, or only accessible with a password. Once a relevant site is located, the information often is presented as vast amounts of text with possibly some graphics. It appears little consideration is given during the development of web sites to the actual presentation of the information. For the full potential of the information superhighway to be realized in relation to health care, more consideration should be given during the development stages of web sites to how the information is presented and how to make access more streamlined.

Australia↗

The use of instructional technology in poultry science curricula in the United States and Canada: 2. Factors contributing to the use of instructional technology.

This paper describes a study conducted in recognition of the increasingly widespread use of computers and the importance of exposure to instructional technology (IT) in all aspects of the poultry science curriculum. The study consisted of the distribution and analysis of two cross-sectional surveys. One survey was sent to departments to obtain profiles of poultry science degree programs and the availability of IT and general support for its use. The second survey was sent to faculty to obtain individual profiles of IT use and of factors which may influence IT use. Herein are reported the results and analysis of those factors that are thought to contribute to or limit the diffusion of these media among poultry science faculty. Analysis consisted of descriptive statistics and contingency table comparisons using Likelihood Ratio chi-square. Factors that appear to be most important to faculty use of IT are availability of desired IT equipment, access to adequate expert assistance, availability of knowledgeable peers willing to share their experience and expertise, and exposure to concrete examples and ideas of how to use IT. All of these factors contribute to another important factor in participation and adoption: making it as easy as possible for faculty to learn and to use advanced IT methods.

Agriculture↗

The virtual anatomy practical: a stereoscopic 3D interactive multimedia computer examination program.

Continuing advances in computer visualization and interface technologies have enabled development of "virtual reality" programs that allow users to perceive and to interact with objects in artificial three-dimensional environments. Such technologies were used to create an image database and program for administering a practical examination in human gross anatomy. Stereoscopic image pairs of prepared laboratory dissections were digitized from multiple views of the thorax, abdomen, pelvic region, and upper and lower extremities. For each view, the stereo pairs were interlaced into a single, field-sequential stereoscopic picture using an image processing program. The resulting color-corrected, interlaced image files were organized in a database stored on a large-capacity hard disk. Selected views were provided with structural identification pointers and letters (A and B). For each view, appropriate two-part examination questions were spoken by a human narrator, digitally recorded, and saved as universal audio format files on the archival hard disk. Images and digital narration were organized in an interactive multimedia program created with a high-level multimedia authoring system. At run-time, 24-bit color 3D images were displayed on a large-screen computer monitor and observed through liquid crystal shutter goggles. A 90-second interval timer and tone were provided to give student users a time limit for each question comparable to that of a conventional practical examination. Users could control the program and select regional "subexams" using a mouse and cursor to point-and-click on screen-level control words ("buttons").

Anatomy, Regional↗

Self-directed work teams: application to a drug information center.

OBJECTIVE: To describe the transition of a drug information center from a traditionally managed center to a self-directed work team responsible for service, education, research, and drug use policy development. SUMMARY: To adapt to economic, educational, and technologic changes, traditional management structures in healthcare organizations are being reassessed. In some instances, a team approach (using self-directed work teams [SDWTs]) is being implemented. SDWTs have the potential to provide a number of benefits to an organization, including reduced costs and greater employee motivation. The University of Illinois at Chicago Drug Information Center had functioned under a traditional management structure. For economic and professional reasons, the management structure of the center was changed to an SDWT, prompting a reevaluation of the mission and activities of the center. DISCUSSION: Although still in transition, the center's change to a team structure has proven to be positive. The nature of the SDWT requires greater involvement by team members in all aspects of the center's operation, adding to the experience of team members. The team structure also allows for greater freedom to pursue projects of personal interest to individual team members. A number of issues still need to be resolved, such as performance-based compensation and peer- and self-evaluations. CONCLUSIONS: SDWTs can provide many benefits. The successful implementation of an SDWT, however, has a number of requirements, the most important of which are a commitment from management and effective communication among team members and with management.

Drug Information Services↗

ATLes: the strategic application of Web-based technology to address learning objectives and enhance classroom discussion in a veterinary pathology course.

A case-based program called ATLes (Adaptive Teaching and Learning Environments) was designed for use in a systemic pathology course and implemented over a four-year period. Second-year veterinary students working in small collaborative learning groups used the program prior to their weekly pathology laboratory. The goals of ATLes were to better address specific learning objectives in the course (notably the appreciation of pathophysiology), to solve previously identified problems associated with information overload and information sorting that commonly occur as part of discovery-based processes, and to enhance classroom discussion. The program was also designed to model and allow students to practice the problem-oriented approach to clinical cases, thereby enabling them to study pathology in a relevant clinical context. Features included opportunities for students to obtain additional information on the case by requesting specific laboratory tests and/or diagnostic procedures. However, students were also required to justify their diagnostic plans and to provide mechanistic analyses. The use of ATLes met most of these objectives. Student acceptance was high, and students favorably reviewed the online ''Content Links'' that made useful information more readily accessible and level appropriate. Students came to the lab better prepared to engage in an in-depth and high-quality discussion and were better able to connect clinical problems to underlying changes in tissue (lesions). However, many students indicated that the required time on task prior to lab might have been excessive relative to what they thought they learned. The classroom discussion, although improved, was not elevated to the expected level-most likely reflecting other missing elements of the learning environment, including the existing student culture and the students' current discussion skills. This article briefly discusses the lessons learned from ATLes and how similar case-based exercises might be combined with other approaches to enhance and enliven classroom discussions in the veterinary curriculum.

Computer-Assisted Instruction↗

Clinical laboratory technician to clinical laboratory scientist articulation and distance learning.

Laboratory workers and educators alike are challenged to support access to education that is current and provides opportunities for career advancement in the work place. The clinical laboratory science (CLS) program at the Medical College of Georgia in Augusta developed a clinical laboratory technician (CLT) to CLS articulation option, expanded it through distance learning, and integrated computer based learning technology into the educational process over a four year period to address technician needs for access to education. Both positive and negative outcomes were realized through these efforts. Twenty-seven students entered the pilot articulation program, graduated, and took a CLS certification examination. Measured in terms of CLS certification, promotions, pay raises, and career advancement, the program described was a success. However, major problems were encountered related to the use of unfamiliar communication technology; administration of the program at distance sites; communication between educational institutions, students, and employers; and competition with CLT programs for internship sites. These problems must be addressed in future efforts to provide a successful distance learning program. Effective methods for meeting educational needs and career ladder expectations of CLTs and their employers are important to the overall quality and appeal of the profession. Educational technology that includes computer-aided instruction, multimedia, and telecommunications can provide powerful tools for education in general and CLT articulation in particular. Careful preparation and vigilant attention to reliable delivery methods as well as students' progress and outcomes is critical for an efficient, economically feasible, and educationally sound program.

Computer-Assisted Instruction↗

A survey of information technology management at U.S. dental schools.

The purpose of this project is to assess how information technology (IT) is being implemented and managed in U.S. dental schools. Recent advances in IT have restructured many of the administrative, curricular, and clinical functions in dental schools. Purchasing hardware and software and hiring personnel to maintain IT present significant financial and administrative commitments for these schools. A nine-question survey was sent to all U.S. dental schools via email with a follow-up postal mailing. Forty-six surveys were returned (83.6 percent response rate). The analysis indicates that dental schools are managing IT in vastly different ways. For example, 71 percent of the schools report a centralized structure, and 61 percent have a line item in the budget to manage IT. On average there are 4.4 full-time equivalents hired to manage IT, with the majority of these people being trained in IT (eight schools reported dually trained IT/dental personnel). The majority of schools report using software to manage their admissions process (70 percent), curriculum analysis (72 percent), and delivery of curriculum content (72 percent), as well as to manage their student clinics (91 percent, business aspect; 87 percent, patients; 65 percent, grading on clinic floor; 76 percent, managing clinical evaluations) and faculty practices (85 percent, business aspect; 65 percent, patients). The use of multimedia (50 percent) and simulation (52 percent) in the preclinical area is mixed. The purchase of laptops (24 percent) and PCs (11 percent) is required in almost a third of all schools participating in this survey. Dental schools in the United States are managing IT in a variety of different ways, using various internally and commercially available tools. The cost to institutions can be large and is usually handled in centralized structures in the school with fixed budgets. The results of this survey can be used to assist schools in the planning and implementation of IT at their institutions.

Curriculum↗

Assessment of construct validity of the endoscopic sinus surgery simulator.

OBJECTIVE: To study the relationship between performance on an endoscopic sinus surgery simulator (ES3) and fundamental perceptual, visuospatial, and psychomotor abilities. DESIGN: Validation study. SETTING: Tertiary care medical center. PARTICIPANTS: Thirty-four medical students and 4 otolaryngology residents voluntarily enrolled. INTERVENTIONS: Subjects performed tasks on the ES3, minimally invasive surgical trainer virtual reality (MIST-VR), pictorial surface orientation (PicSOr), and 3 visuospatial tests (cube comparison, card rotation, and map planning). MAIN OUTCOME MEASURES: The MIST-VR was scored for time, task error, economy of hand movement, economy of diathermy, and total score. Scores were generated for the PicSOr task and visuospatial tests. Scores were correlated with time, accuracy, and total subscore on navigation, injection, and dissection tasks, as well as hazard score and total trial score on the ES3. RESULTS: The PicSOr score was statistically significantly correlated with the hazard score on the ES3 (r = 0.50, P < .001). Cube comparison (r = 0.43, P < .01) and card rotation (r = 0.45, P < .01) scores correlated significantly with the ES3 trial score, as did the MIST-VR total score and the ES3 trial score (r = 0.57, P < .001). In a multiple regression model, the PicSOr, cube comparison, and MIST-VR total scores were statistically significant predictors of ES3 performance (r = 0.63, P < .01). CONCLUSIONS: Scores on the ES3 correlate strongly with scores on previously validated measures of perceptual, visuospatial, and psychomotor performance. The ES3 provides a reliable assessment of factors that are important to the acquisition of minimally invasive surgical skills, demonstrating construct validity.

Computer Simulation↗

Educational programs in US medical schools, 2000-2001.

We used data from the 2000-2001 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, and other sources to describe the status of medical education programs in the United States. In 2000-2001, the number of full-time medical school faculty members was 103, 553, a 1.1% increase from 1999-2000. The 37, 092 applicants for the class entering in 2000 represented a 3.7% decrease from the number of applicants in 1999. The majority of medical schools (58%) were in the process of major curriculum review and change during 2000-2001. In 72 schools (58%), students were required to pass both Steps 1 and 2 of the United States Medical Licensing Examinations to advance or graduate. The availability of patients to participate in clinical teaching during 2000-2001 decreased in almost half of schools compared with 1999-2000. Many schools reported difficulty in recruiting or retaining volunteer faculty members to provide clinical education in the community. Forty medical schools provided monetary payment to some or all community volunteer faculty members.

Curriculum↗