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Interactive computer-assisted instruction vs. lecture format in dental education.

PURPOSE: The purpose of this study was to compare computer-assisted instruction (CAI) with lecture format using recent hardware and software advances. A pre- and post-test was used to determine student performance and instructional preference. In addition, a post-instruction survey was used to determine student learning preferences. METHODS: Seventy-five first-year University of North Carolina (UNC) dental students who were registered for the introductory radiology course were asked to participate. All agreed and were randomly placed in one of three groups: interactive CD only, interactive CD and lecture, and lecture only. The content of the multimedia instruction focused on intraoral radiography. A pre- and post-test was administered to determine if there was a significant difference between interactive CD and lecture formats, and an evaluation instrument was used to determine if there was a student learning preference between CAI and lecture format. Analysis of covariance and the sign test were used to determine significance (p<.05). RESULTS: There was no significant difference between pre- and post-test outcomes, indicating that similar learning took place using the interactive CD and/or lecture format. However, students preferred CAI to lecture format.

Analysis of Variance↗

Online medical journals: need of the hours.

Online publication of the medical journals over the Internet saves time, cost and resources. This allows rapid incorporation of major advances in medical practice. Unlike conventional print media, e-journals permit multimedia enhancement of medical journal articles. It also makes it feasible, publication of negative studies that will enable more accurate appraisals of new studies.

Humans↗

[Human parasitology teaching in the 21st century].

Multimedia techniques were applied in parasitological teaching and experimental practices. In order to strengthen the practical ability of the undergraduate students, reform was conducted including a prioritization of the teaching content, use of series micro-slides and video show, etc.

Animals↗

[Electronic medical handbooks--are they suitable for implementation of guidelines in health care?].

BACKGROUND: The Directorate for Health and Social Affairs commissioned a project to evaluate the distribution and use of a Norwegian electronic medical handbook (NEL). MATERIAL AND METHODS: NEL uses multimedia techniques and is distributed on a CD twice a year. A questionnaire about the use of NEL was given to 91 medical students. Health professionals at two hospitals and 12 health centres were interviewed. RESULTS: The use of the electronic handbook differed more within than between groups of professionals. NEL is applied for three main purposes: decision support, quality assurance and as a source for information pamphlets designed for patients. The professionals believed that NEL has contributed to patients' receiving more information and more uniform treatment. Criticism was made about the price and for the lack of integration with the electronic patient record. INTERPRETATION: The study has revealed some barriers to implementation and use of electronic information sources. Under certain circumstances an electronic handbook might be suitable way for authorities and others to distribute professional guidelines.

CD-ROM↗

A comprehensive strategy for designing a Web-based medical curriculum.

In preparing for a full featured online curriculum, it is necessary to develop scaleable strategies for software design that will support the pedagogical goals of the curriculum and which will address the issues of acquisition and updating of materials, of robust content-based linking, and of integration of the online materials into other methods of learning. A complete online curriculum, as distinct from an individual computerized module, must provide dynamic updating of both content and structure and an easy pathway from the professor's notes to the finished online product. At the College of Physicians and Surgeons, we are developing such strategies including a scripted text conversion process that uses the Hypertext Markup Language (HTML) as structural markup rather than as display markup, automated linking by the use of relational databases and the Unified Medical Language System (UMLS), integration of text, images, and multimedia along with interface designs which promote multiple contexts and collaborative study.

Computer Communication Networks↗

A Web-based architecture for the intelligent management of chronic patients.

We describe a distributed architecture for medical informatics applications, based on the World-Wide Web (WWW) environment. After discussing previous experiences in the application of the WWW for medical purposes, we outline the features of a Common Lisp HTTP server designed to provide access to medical informatics applications using a standard Web browser. As an example of application, we describe a system for therapy planning and revision in the field of insulin-dependent diabetes. The system performs automatic data analysis and interpretation and provides advice on possible adjustments to the therapeutic protocol that the patients are following, taking advantage of the network and multimedia capabilities offered by the WWW for user interaction.

Chronic Disease↗

[Test of a teleradiology network based on ATM (asynchronous transfer mode)].

The retain project (Radiological Examination Transfer on ATM Integrated Network) consisted in teleradiology trials focused on pediatric imaging between two university hospitals. Rennes (France) and Barcelona (Spain) using an integrated broadband communication network based on ATM (asynchronous transfer mode), as part of a European research program. The network used was a full 10 Mbits/s ATM network directly connected to local PACSs (medical imaging hospital networks). One important reason to explicitly consider ATM for medical imaging is that multimedia applications on such networks allow integration of digital data and person-to-person communication. The utility of broadband communication for teleradiology has been confirmed. High quality video and sound are important for both human communication and medical video transfer. The project led to guidelines regarding technical options still open to improvement.

Computer Communication Networks↗

The importance of Java and CORBA in medicine.

One of the most powerful tools available for telemedicine is a multimedia medical record accessible over a wide area and simultaneously editable by multiple physicians. The ability to do this through an intuitive interface linking multiple distributed data repositories while maintaining full data integrity is a fundamental enabling technology in healthcare. We discuss the role of distributed object technology using Java and CORBA in providing this capability including an example of such a system (TeleMed) which can be accessed through the World Wide Web. Issues of security, scalability, data integrity, and usability are emphasized.

Computer Communication Networks↗

Telemedicine for AIDS patients accommodations.

People suffering from AIDS are subject to frequent hospitalisations. In some cases, they cannot go back home after hospitalisations, due to severe illness, family or sociologic problems. This is the reason why some therapeutic flats are at their disposal to make easier their medical follow-up after the hospital's discharge. In these Therapy Accommodation, they are treated by trained GP who often suffer from lack of information and lack of expertise in difficult cases. For this purpose we included these flats in the regional Telemedicine AIDS network to give these physicians free access to the computerised multimedia medical record of their patients and to provide them with synchronous co-operation facilities.

Acquired Immunodeficiency Syndrome↗

Managing medical research data with a Web-Interfacing Repository Manager.

This paper describes the Web-Interfacing Repository Manager (WIRM), a perl toolkit for managing and deploying multimedia data, which is built entirely from free, platform-independent components. The WIRM consists of an object-relational API layered over a relational database, with built-in support for file management and CGI programming. The basic underlying data structure for all WIRM data is the repository object, a perl associative array whose values are bound to a row of a table in the relational database. Based on our experience implementing a target application (the Brain Mapper Console), we describe five stages through which a system passes as it evolves from a primitive file hierarchy to a full-fledged repository console.

Brain Mapping↗

On lifting the fog of war in the battle on heart disease: Star Wars technology in pursuit of a seamless integration strategy.

In our efforts to reduce cardiac morbidity and mortality we often use terms such as the "battle" or "war" on heart disease. If we believe efforts to reduce cardiac disease are the moral equivalent of war, then perhaps we should explore ways that military strategic and tactical metaphors can be applied through technology to the cardiac battle. In this article we explore three major areas for technological advancement: adaptation of the strategies of outcomes management and evidence-based medicine, computer simulation and animation efforts to create horizontal and vertical integration of strategic efforts, and use of interactive multimedia in "recruiting an army" through community empowerment. The overall goal is to find ways to lift "the fog of war" in the battle on heart disease, in order to further the integration of our various efforts.

Cardiovascular Diseases↗

Hypertext markup language as an authoring tool for CD-ROM production.

The Hypertext Markup Language (HTML) used to create Web pages is an attractive alternative to the proprietary authoring software that is now widely used to produce multimedia content for CD-ROMs. This paper describes the advantages and limitations of HTML as a non-proprietary and cross-platform CD-ROM authoring system, and the more general advantages of HTML as data standard for biocommunications content.

Authorship↗

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↗

[Tools of the Internet in maxillofacial surgery and oral medicine. Practical applications].

Internet has a wide range of functions applicable in the medical domain. Its use has had a clear impact on routine medical practice. The user can consult colleagues, send and receive multimedia files, order books from the library, access specialized reviews or worldwide scientific data on-line as well as publish results, and participate in forums, telephone or organize teleconferences in real time. Faced with the abundance of the available information flow and the methodological difficulty in extracting precisely useful data, the ordinary user can wander a long time in cyber-space before learning the skills required for efficient navigation. We recall here the fundamental principles of the Internet and describe the types of information the maxillofacial surgeon can use in his everyday practice. Certain unanswered questions are debated as well as certain difficulties related to the use of the Internet in its present state of development.

Computer Communication Networks↗

The evolution of an integrated timeline for oncology patient healthcare.

The introduction of computers in the medical environment has contributed to the proliferation of medical data, often making it difficult to consolidate information on a single patient. In patients with complex medical problems, such as oncology patients, the lack of data integration can negatively impact on patient care. This paper presents an infrastructure for the creation of an integrated multimedia timeline that automatically combines patient information from distributed hospital information sources, and creates a visual summary of pertinent events in a patient's medical history. In this prototype, we focus on oncology patients under treatment for advanced cancers.

Database Management Systems↗

Information needs research in the era of the digital medical library.

The rapid adoption of Internet-accessible information resources by the clinical community, has resulted in an exponential growth in the variety and type of clinical information resources along with an increasing diversity of information technologies to deliver clinical information. To date, little formal work has been done to investigate the significance of new information technologies such as Internet-based digital libraries and multimedia record systems on clinical information need or information seeking behavior. In the work described in this paper, we highlight some results from our recent multimethod research design and investigation of the information-seeking behavior of Pittsburgh area medical oncologists to argue for the use of a multimethod research design as an essential component of any investigation of clinical information need and information-seeking behavior in the era of the digital medical library.

Computer Communication Networks↗

[Computer-based training exemplified by the carotid artery].

The purpose of computer-based training (CBT) is interactive use of multimedia components, such as text, graphics, animation, sound, digital slide shows, and videos. This CD-ROM illuminates different aspects of carotid surgery: cerebrovascular insufficiency, sonographic and neuroradiological diagnostics, indications and results of carotid surgery in the literature, perioperative complications and new developments such as interventional procedures. Digital imaging (60 minutes of video sequences and 250 graphics) especially focus on operative standard procedures (conventional and eversion technique) and alternative methods. CBT is an evolving supplement to improve education programs in vascular surgery.

CD-ROM↗