Research, the Internet, and the way things are.
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Adolescent↗
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What predicts patients' interest in the Internet as a health resource in primary care in England?
OBJECTIVES: To identify what factors predict patients' interest in using Internet health information in the light of poor uptake of a free, guided Internet service in one inner-city general practice. METHODS: Questionnaires were administered over a five-day period to consecutive adult patients attending two Manchester general practices: an inner-city practice serving a relatively deprived patient population where the free Internet service had previously been available, and a suburban practice serving a relatively affluent population. Data were analysed using multiple regression to identify predictors of self-reported interest in using the Internet for health information. RESULTS: A total of 753 (74%) patients completed the questionnaire although analyses were restricted to 660 (65%) cases. Independent predictors of patient-reported interest in getting health information from the Internet were (in order of relative 'importance'): positive outcome expectancy (i.e. the patient's strength of belief that it would enable them to deal better with their health); previous use of health websites; positive 'self-efficacy' (i.e. patients' confidence in their ability to use the technology); higher education; a positive attitude to getting health information from alternative sources; social deprivation; and having school-age children living at home. Level of Internet access was an important determinant of self-efficacy, but home access was the key predictor of outcome expectancy and past use of 'e-health'. CONCLUSIONS: Access, demographics and, particularly, motivational factors all influence patients' interest in the Internet as a health resource. Proposals to encourage more widespread use of digital health information need to take account of this complexity and not deal with access issues alone.
Adult↗
A randomized trial comparing digital and live lecture formats [ISRCTN40455708.
BACKGROUND: Medical education is increasingly being conducted in community-based teaching sites at diverse locations, making it difficult to provide a consistent curriculum. We conducted a randomized trial to assess whether students who viewed digital lectures would perform as well on a measure of cognitive knowledge as students who viewed live lectures. Students' perceptions of the digital lecture format and their opinion as whether a digital lecture format could serve as an adequate replacement for live lectures was also assessed. METHODS: Students were randomized to either attend a lecture series at our main campus or view digital versions of the same lectures at community-based teaching sites. Both groups completed the same examination based on the lectures, and the group viewing the digital lectures completed a feedback form on the digital format. RESULTS: There were no differences in performance as measured by means or average rank. Despite technical problems, the students who viewed the digital lectures overwhelmingly felt the digital lectures could replace live lectures. CONCLUSIONS: This study provides preliminary evidence digital lectures can be a viable alternative to live lectures as a means of delivering didactic presentations in a community-based setting.
Adult↗
Personality preference influences medical student use of specific computer-aided instruction (CAI).
BACKGROUND: The objective of this study was to test the hypothesis that personality preference, which can be related to learning style, influences individual utilization of CAI applications developed specifically for the undergraduate medical curriculum. METHODS: Personality preferences of students were obtained using the Myers-Briggs Type Indicator (MBTI) test. CAI utilization for individual students was collected from entry logs for two different web-based applications (a discussion forum and a tutorial) used in the basic science course on human anatomy. Individual login data were sorted by personality preference and the data statistically analyzed by 2-way mixed ANOVA and correlation. RESULTS: There was a wide discrepancy in the level and pattern of student use of both CAI. Although individual use of both CAI was positively correlated irrespective of MBTI preference, students with a "Sensing" preference tended to use both CAI applications more than the "iNtuitives". Differences in the level of use of these CAI applications (i.e., higher use of discussion forum vs. a tutorial) were also found for the "Perceiving/Judging" dimension. CONCLUSION: We conclude that personality/learning preferences of individual students influence their use of CAI in the medical curriculum.
Adult↗
Effectiveness of skills-based training using the Drink-less package to increase family practitioner confidence in intervening for alcohol use disorders.
BACKGROUND: Misuse of alcohol is second only to tobacco as a leading cause of preventable death in Australia. There is an opportunity in family practice to detect problems and intervene with people at risk of alcohol-related harm before complications occur. However, family practitioners (FPs) report low levels of confidence in managing patients with drinking problems. The aim of this study was to determine whether the interactive training session using the 'Drink-less' package led to improvement in FPs' self-reported level of confidence in detecting and providing interventions for risky alcohol consumption. METHOD: FPs in urban and rural New South Wales were invited to training sessions in their local area. An introductory overview preceded a practical skills- based session, using the Drink-less package. Participants completed before and after evaluation forms. RESULTS: While 49% (CI 43-55) of the attending FPs indicated at baseline that they felt confident in identifying at-risk drinkers, this proportion rose to 90% (95% CI: 87-93) post-session, and they also reported increases in confidence from 36% (95% CI: 31-41) to 90% in their ability to advise patients. Urban FPs reported lower levels of confidence than rural FPs, both pre- and post-session. CONCLUSION: Training sessions in the Drink-less intervention resulted in increased self-reported confidence in detection and brief intervention for alcohol problems. Further research is needed to determine the duration of this effect and its influence on practice behaviour.
Accidents, Traffic↗
Scientific issues related to the cytology proficiency testing regulations.
The member organizations of the Cytology Education and Technology Consortium believe there are significant flaws in current cytology proficiency testing regulations. The most immediate needed modifications include lengthening the required testing interval, utilizing stringently validated and continuously monitored slides, changing the grading scheme, and changing the focus of the test from the individual to laboratory level testing. Integration of new computer-assisted and located-guided screening technologies into the testing protocols is necessary for the testing protocol to be compliant with the law.
Journal Article↗
Critical care procedure logging using handheld computers.
INTRODUCTION: We conducted this study to evaluate the feasibility of implementing an internet-linked handheld computer procedure logging system in a critical care training program. METHODS: Subspecialty trainees in the Interdepartmental Division of Critical Care at the University of Toronto received and were trained in the use of Palm handheld computers loaded with a customized program for logging critical care procedures. The procedures were entered into the handheld device using checkboxes and drop-down lists, and data were uploaded to a central database via the internet. To evaluate the feasibility of this system, we tracked the utilization of this data collection system. Benefits and disadvantages were assessed through surveys. RESULTS: All 11 trainees successfully uploaded data to the central database, but only six (55%) continued to upload data on a regular basis. The most common reason cited for not using the system pertained to initial technical problems with data uploading. From 1 July 2002 to 30 June 2003, a total of 914 procedures were logged. Significant variability was noted in the number of procedures logged by individual trainees (range 13-242). The database generated by regular users provided potentially useful information to the training program director regarding the scope and location of procedural training among the different rotations and hospitals. CONCLUSION: A handheld computer procedure logging system can be effectively used in a critical care training program. However, user acceptance was not uniform, and continued training and support are required to increase user acceptance. Such a procedure database may provide valuable information that may be used to optimize trainees' educational experience and to document clinical training experience for licensing and accreditation.
Adult↗
Cancer cell biology: a student-centered instructional module exploring the use of multimedia to enrich interactive, constructivist learning of science.
Multimedia has the potential of providing bioscience education novel learning environments and pedagogy applications to foster student interest, involve students in the research process, advance critical thinking/problem-solving skills, and develop conceptual understanding of biological topics. Cancer Cell Biology, an interactive, multimedia, problem-based module, focuses on how mutations in protooncogenes and tumor suppressor genes can lead to uncontrolled cell proliferation by engaging students as research scientists/physicians with the task of diagnosing the molecular basis of tumor growth for a group of patients. The process of constructing the module, which was guided by scientist and student feedback/responses, is described. The completed module and insights gained from its development are presented as a potential "multimedia pedagogy" for the development of other multimedia science learning environments.
Biology↗
An inquiry into protein structure and genetic disease: introducing undergraduates to bioinformatics in a large introductory course.
This inquiry-based lab is designed around genetic diseases with a focus on protein structure and function. To allow students to work on their own investigatory projects, 10 projects on 10 different proteins were developed. Students are grouped in sections of 20 and work in pairs on each of the projects. To begin their investigation, students are given a cDNA sequence that translates into a human protein with a single mutation. Each case results in a genetic disease that has been studied and recorded in the Online Mendelian Inheritance in Man (OMIM) database. Students use bioinformatics tools to investigate their proteins and form a hypothesis for the effect of the mutation on protein function. They are also asked to predict the impact of the mutation on human physiology and present their findings in the form of an oral report. Over five laboratory sessions, students use tools on the National Center for Biotechnology Information (NCBI) Web site (BLAST, LocusLink, OMIM, GenBank, and PubMed) as well as ExPasy, Protein Data Bank, ClustalW, the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, and the structure-viewing program DeepView. Assessment results showed that students gained an understanding of the Web-based databases and tools and enjoyed the investigatory nature of the lab.
Algorithms↗
Perfusion safety: defining the problem.
Perfusion safety is not an isolated component of cardiac surgery, but encompasses many facets, including equipment, safety devices, conduct of perfusion, surgical technique, vigilance, and communication within the operating room. Over the last 25 years, several surveys have provided an estimation of the occurrence of perfusion-related incidents and documented the frequency with which they affected patient morbidity and mortality. As the focus of attention turned to correcting these problem areas, each subsequent survey demonstrated changes, but also pointed out new areas needing improvement. As technology and education improved, so did results. With refinements in perfusion equipment and techniques, and increasing use of computer assistance and automation, cardiopulmonary bypass should become even safer. The key ingredient, though, will remain the knowledge and expertise of the perfusionist.
Cardiopulmonary Bypass↗
Cyberspace violence against girls and adolescent females.
Children and adolescents today are the first generation raised in a society in which technological literacy is essential for effective citizenship in the 21st century. With many more youth using digital technologies for educational and recreational purposes, there has been an increase in social problems in cyberspace, exposing them to different forms of cyberviolence. This article gives an overview of the developments in cyberspace, describes different types of cyberviolence, and focuses on cyberbullying among girls and adolescent females as both victims and perpetrators of cyberbullying. At-risk online activities among girls and adolescent females as well as strategies to promote cybersafety are presented. Current research and future directions for research are reviewed.
Adolescent↗
It is not how much you have but how you use it: toward a rational use of simulation to support aviation training.
One of the most remarkable changes in aviation training over the past few decades is the use of simulation. The capabilities now offered by simulation have created unlimited opportunities for aviation training. In fact, aviation training is now more realistic, safe, cost-effective, and flexible than ever before. However, we believe that a number of misconceptions--or invalid assumptions--exist in the simulation community that prevent us from fully exploiting and utilizing recent scientific advances in a number of related fields in order to further enhance aviation training. These assumptions relate to the overreliance on high-fidelity simulation and to the misuse of simulation to enhance learning of complex skills. The purpose of this article is to discuss these assumptions in the hope of initiating a dialogue between behavioral scientists and engineers.
Aviation↗
A three-dimensional interactive virtual dissection model to simulate transpetrous surgical avenues.
OBJECTIVE: This project involves the development of a three-dimensional surgical simulator called interactive virtual dissection, which is designed to teach surgeons the visuospatial skills required to navigate through a transpetrosal approach. METHODS: A robotically controlled microscope is used for surgical planning and data collection. The spatial anatomic data are recorded from sequentially deeper cadaveric head dissections as a series of superimposed anatomic pictures in stereoscopic digital format. The sequential series of images are then merged to form the final virtual representation. RESULTS: The current three-dimensional virtual reality simulator allows the user to drill the petrous bone progressively deeper and to identify crucial structures much like an experienced surgeon drilling the petrous bone. The program allows surgeons and trainees to manipulate the virtual "surgical field" by interacting with the surgical anatomy. The interactive system functions on a desktop computer. CONCLUSION: The ability to visualize and understand anatomic spatial relationships is crucial in surgical planning, as is a surgeon's confidence in performing the surgery. The virtual reality simulator does not replace the need for practicing surgery on cadavers. However, it is designed to facilitate, via stereoscopic projection, learning how to manipulate a drill in complicated or unfamiliar surgical approaches (e.g., a transpetrosal approach).
Brain↗
Virtual reality surgery:neurosurgery and the contemporary landscape a three-dimensional interactive virtual dissection model to simulate transpetrous surgical avenues.
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Brain↗
A comparison between three electronic media and in-person learning for continuing education in physical rehabilitation.
We produced continuing education material in physical rehabilitation using a variety of electronic media. We compared four methods of delivering the learning modules: in person with a computer projector, desktop videoconferencing, Web pages and CD-ROM. Health-care workers at eight community hospitals and two nursing homes were asked to participate in the project. A total of 394 questionnaires were received for all modalities: 73 for in-person sessions, 50 for desktop conferencing, 227 for Web pages and 44 for CD-ROM. This represents a 100% response rate from the in-person, desktop conferencing and CD-ROM groups; the response rate for the Web group is unknown, since the questionnaires were completed online. Almost all participants found the modules to be helpful in their work. The CD-ROM group gave significantly higher ratings than the Web page group, although all four learning modalities received high ratings. A combination of all four modalities would be required to provide the best possible learning opportunity.
Education, Distance↗
The Pentalfa project. 1: the development of distance continuing medical education via videoconferencing in the Dutch-speaking region of Belgium.
A distance continuing medical education programme was established at the Katholieke Universiteit Leuven in Belgium using multipoint videoconferencing via ISDN lines at 384 kbit/s. The sessions, held in the evening, comprised oral presentations followed by interactive questions and answers, and concluded with a multi-site panel discussion. At all sites the session could be followed on two screens. The speaker/moderator or a questioner at a peripheral site, for example, was shown on the first screen and digital images were projected on the second screen. A multi-site voting system was provided. In weekly sessions between five rotating sites, a multipoint videoconference dealing with a different medical topic was presented and treated in a multidisciplinary way. During the three years of the project, 20 different peripheral sites were visited or revisited. On a five-point scale (with higher scores representing more positive evaluations), the average score for the quality of the image was 3.72 (SEM 0.01) and for sound 3.87 (SEM 0.01) (n = 3743). The mean rating of the voting system was 3.76 (SEM 0.02) (n = 3119). For sound, image quality and the voting system, respectively, 73%, 65% and 70% of all participants gave ratings of 'very good' or 'good'. The older participants gave slightly more positive ratings than the younger ones. Videoconferencing appears to be a suitable alternative to face-to-face seminars.
Attitude of Health Personnel↗
The Pentalfa project. 3: participant evaluations of the interactivity of the educational videoconferences and the effectiveness of project promotion.
A distance continuing medical education programme was established at the Katholieke Universiteit Leuven using multipoint videoconferencing via ISDN lines at 384 kbit/s. During each academic year, 24-26 sessions were organized. The interactivity afforded by the videoconferencing was investigated during the first three years of the project. More than 60% of the participants rated the interactivity as good or very good. No differences were found between the sites or over the three years of the project, but female participants were more positive (66% making ratings of good or very good) in this regard than male participants (57%). Also, the effectiveness of the various types of publicity used to promote the programme was analysed. A brochure was the main source of information (62% of participants heard of the programme by this means), followed by direct mailings (27%), posters (15%), personal contact (14%) and the programme's Website (1%). The proportions of participants who heard of the programme through these different means varied with age and gender.
Adult↗
The Pentalfa project. 4: educational aspects.
A distance continuing medical education programme was established at the Katholieke Universiteit Leuven using multipoint videoconferencing via ISDN lines at 384 kbit/s. During each academic year, 24-26 sessions were organized. During the first three years, a questionnaire was completed by 29% of the 13,489 participants. The effects of the videoconferencing on the information content and the educational effectiveness of seminars was analysed. Overall, participants were satisfied with the educational approach. Fifty-six per cent of the participants found the Pentalfa session easier to follow than conventional seminars. Participants at the peripheral sites and older participants gave higher ratings of the information content and educational effectiveness of the programme than other participants. The training of speakers and moderators was seen as useful, but most speakers could adapt themselves quite easily to the new medium.
Adult↗