Making multimedia training aids accessible to users. A new United Kingdom initiative.
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Biotechnology↗
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Developing a medical informatics education program to support a statewide health information network.
The Florida Health Information Network (FHIN) was established in October 1989 to provide biomedical information services to the University of Florida Health Science Center (HSC) and to health professionals throughout the state--especially the northern thirty-nine counties of the state. FHIN services are available to all affiliates of the HSC and by annual subscription to nonaffiliates. At present, FHIN services include database access, circulation services, document delivery, and information services. Training network users has been an objective since the inception. Training has targeted both the HSC Library staff and HSC users and now is expanding to include remote users. Because many users have had insufficient experience with computers, the library has to teach the mechanics of access and network use and to instruct users regarding applications and database searching. This paper describes the development and implementation of the medical informatics education program. Topics include library staff training; educational offerings for HSC faculty, staff, and students; development and implementation of the remote training program; and organizational and budgetary implications for the construction of such a program.
Computer Communication Networks↗
An adaptive window width/center adjustment system with online training capabilities for MR images.
OBJECTIVE: Adaptive and automatic adjustment of the display window parameters for magnetic resonance images under different viewing conditions is a challenging problem in medical image perception. An adaptive hierarchical neural network-based system with online adaptation capabilities is presented to achieve this goal in this paper. METHODOLOGY: The online adaptation capabilities are primarily attributed to the use of the hierarchical neural networks and the development of a new width/center mapping algorithm. The large training image set is hierarchically organized for efficient user interaction and effective re-mapping of the width/center settings. The width/center mapping functions are estimated from the new user-adjusted width/center values of some representative images by using a global spline function for the entire training images as well as a first-order polynomial function for each selected image sequence. The hierarchical neural networks are then re-trained for the new training data set after this mapping process. RESULTS: The proposed automatic display window parameter adjustment system is implemented as a program on a personal computer for testing its adaptation performance. Experimental results show that the proposed system can successfully adapt its parameter adjustment on a variety of MR images after user re-adjustment and re-training of neural networks. CONCLUSION: This demonstrates the effective adaptation capabilities of the proposed system based on the framework of training data mapping and neural network re-training.
Algorithms↗
Attitudes of Australian nurses toward the implementation of a clinical information system.
A computerized clinical information system (CIS) used for the majority of patient charting and medical records was installed in six of 15 beds in the intensive care unit (ICU) of a large Australian hospital in November 1993. Staff acceptance was identified as integral to the success of the system. A survey was issued to all nursing staff of the ICU to identify factors that affected attitude toward computers in the critical care environment. Factors resulting in negative attitudes then could be targeted through training and support for users. The factors considered that potentially could influence attitudes were age, nursing experience, intensive care nursing experience, and education. The study showed that nursing experience had a statistically significant effect on motivation to use computers. A strong relation was evident between the concepts of beliefs, attitudes, and motivation. A less apparent association was present between knowledge and the other concepts. Orientation and in-service education programs should provide appropriate and applied information to optimize the motivation, beliefs, and computer literacy of nurses using CIS frameworks.
Adult↗
BioVision: an application for the automated image analysis of histological sections.
We describe a computer application, "BioVision", that can be trained to quickly and effectively classify and quantify user definable histological objects (e.g., senile plaques, neurofibrillary tangles) within single or double-labeled immunocytochemically stained sections. For a given image population, BioVision is interactively trained (in Independent User Mode) by an investigator to perform the desired classifications. This training yields a statistical model of the different types of objects occurring in the target image population. The resulting model can then be used (in Automated User Mode) to classify all objects in any image or images from the target population. BioVision simplifies the quantification of complex visual objects and improves inter-rater reliability. The program accomplishes classification in two major stages: pixel classification and blob classification. In pixel classification, each pixel is assigned to one of some number of substance classes, based on its chromatic properties and local context, reflecting basic histological distinctions of interest. In the blob classification phase, the image's pixels are first partitioned into "blobs": maximal connected sets of pixels assigned to the same substance class. Then, based on its size, shape, textural and contextual properties, each blob is assigned to a histological object class. A Bayesian classifier is used in each of the pixel and blob classification stages. We report several tests of BioVision. First, we applied BioVision to classify senile plaques and neurofibrillary tangles in several test cases of Alzheimer's brain immunostained for beta-amyloid and PHF-tau and compared the results to those produced by experienced investigators. BioVision was trained to classify Plaque-type blobs as either plaques or plaque-type nonentities, and tangle-type blobs as either tangles or tangle-type nonentities. BioVision classified the objects with an accuracy comparable to the trained investigator. Next, we applied BioVision to the task of counting all the tangles in hippocampal images from 22 Alzheimer's disease (AD) cases selected to span a broad range of dementia levels from the tissue repository of UC Irvine's Center for the study of Brain Aging and Dementia. The tangle counts produced by BioVision proved to be significantly better predictors of the cases' adjusted MMSE scores than any of tangle load, age at death, post mortem interval or the interval between the last MMSE score and death.
Alzheimer Disease↗
Utilization of medical information systems in American occupational medicine. A committee report.
In an attempt to define the nature of medical programs and the extent of utilization of information systems in occupational medicine, a questionnaire was directed to 230 corporate medical directors of the largest employers in the USA. Responses were received from 163 (nearly 70%) of those contacted. While industrial injury data and sickness absence statistics are the principal areas of present computer analysis, respondents indicated that future plans called for a shift in emphasis to the analysis and correlation of human medical data with work exposure data. Nearly three-quarters of the respondents are planning more extensive medical information systems. It is concluded that there is an apparent need for both trained personnel to develop appropriate systems and enhanced communication between the users and suppliers of the required computer technology.
Computers↗
Virtual reality for mine safety training.
Mining has long remained one of America's most hazardous occupations. Researchers believe that by developing realistic, affordable VR training software, miners will be able to receive accurate training in hazard recognition and avoidance. In addition, the VR software will allow miners to follow mine evacuation routes and safe procedures without exposing themselves to danger. This VR software may ultimately be tailored to provide training in other industries, such as the construction, agricultural, and petroleum industries.
Computer-Assisted Instruction↗
Information technology (IT) accessibility: implications for employment of people with disabilities.
Online technology has made significant inroads into human resource (HR) processes such as recruitment, benefits, and training, yet many web sites are inaccessible to people with disabilities. Cornell University surveyed 433 HR representatives regarding their organizations' use of information and Web technology in HR processes. Survey results report that nine of the ten organizations use Web processes for job postings, eight of ten for online benefits information dissemination, and about six out of ten for online benefits self service and online employee training. Employee use of computers was extensive, with the majority using computers more than half the workday. Knowledge of assistive technologies for computer users with disabilities and of Web accessibility considerations was low, but nearly half the respondents reported having made some type of adaptation to make a computer accessible to an employee with a disability. Very few organizations had trained any of their staff in Web accessibility topics or in making computers accessible, and the majority desired more information on those topics. These findings have implications not only for people with disabilities, but for the general workforce, which is aging.
Persons with Disabilities↗
Computer literacy in today's medical center environment.
The need for computer literacy is becoming increasingly important across the broad scope of the American work scene. At the Wilford Hall USAF Medical Center (WHMC) numerous computer systems have been introduced into the operational environment. Training for these systems has been restricted primarily to transaction processing and routine report generation for those actually involved as users of these systems. WHMC has developed and implemented a broad computer literacy program designed generally to raise the computer literacy of the overall staff, and specifically to inform executive and middle management of the general capabilities of the computer systems. The program consists of a brown-bag lunchtime videotape theater on a series of computer-related subjects as well as formal classes developed in a modular format. Each formal class is tailored to the specific needs of the target executive or middle-management group.
Administrative Personnel↗
User education: a basic program.
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Computers↗
Bringing the medical literature to physicians. Self-service computerized bibliographic retrieval.
Seven years ago physicians at the Beth Israel Hospital in Boston began doing their own searches of the medical literature. They used PaperChase, a computer program written especially for end users rather than for search librarians. The data base was initially limited to the journals shelved in the library of the Beth Israel Hospital, but it has since been expanded to include the entire MEDLINE collection of the National Library of Medicine-nearly 5 million references published in 3,400 biomedical journals dating back to 1966.PaperChase is now available throughout the United States and Canada to anyone who has a computer terminal or personal computer and a modem. No special training is needed for a successful search and there is no user's manual. Users can search by title word, "medical subject heading," author's name, journal title, year of publication, language of publication or any combination of the above. They can read abstracts on line, and they can request that a photocopy of the full text of any article be mailed to them.
Canada↗
Evaluation of a computer based interactive diabetes education program designed to train the estimation of the energy or carbohydrate contents of foods.
The objective of this study was to evaluate a computer based interactive diabetes education program designed to train patients with diabetes to correctly estimate the energy or carbohydrate contents of foods. The acceptance and the operator convenience of the program were evaluated with an integrated program and written questionnaires. The training success was calculated for each user from the data sets after multiple repetitions of the same exercise. Age, weight, type of diabetes, previous training and computer experience of 126 patients with type 1 or 2 diabetes from three different German diabetes centres were documented. The evaluation of the computer program indicated a good acceptance and operator convenience. Moreover, there was a significant training success in patients who have never used a structured diabetes education program before. Therefore, the potential impact of the program is to support but not to replace structured diabetes education programs and to further motivate and attract patients to diabetes education programs.
Computer-Assisted Instruction↗
Interactive atlas of joint anatomy on MR images.
We designed and developed an atlas of joint anatomy based on MR images. Using a workstation that consisted of a computer and a videodisc player, each with its own monitor, the program presented complete sets of labeled MR images of the joints by using a variety of common pulse sequences in standard imaging planes. The images were stored on videodisc and were retrieved and displayed under the control of the computer program. The images could be viewed in a self-paced, structured sequence or in any arbitrary, self-directed way. Interactive features included a quiz mode that challenged the user to name the anatomic structures, one at a time. The atlas has been exhibited at national meetings and currently is used in our residency and fellowship training programs.
Computer-Assisted Instruction↗
[Emergency medicine online course--integrating into curriculum of computer-based training].
Emergency medicine is characterized by rapid decision making to help patients in life-threatening situations. Teaching these skills requires a high level of interaction between medical students and the lecturer. We designed, implemented, and evaluated a generic computer-based training (CBT) system to provide a more active way of learning emergency medicine. The content of the training program is adapted to the knowledge of third year medical students and is focused on basic skills and real-world problems. The teacher presents the case with authentic video sequences and slides. The cases are classified into four groups: heart (e.g., myocardial infarction), respiration (e.g., asthma bronchiale), trauma (e.g., car accident), and loss of consciousness (e.g., coma). Within a realistic time frame, the students have to answer free text and multiple choice questions on a work-station. All answers given by the students are processed anonymously by the CBT system via a central server and displayed on a large video screen, thus enabling a detailed discussion without intimidation of individual students. This interactive technique allows for immediate feedback from the lecturer based on the specific knowledge of his group and his own experience. The IT concept, which is scalable to many subjects, is based on state of the art internet technology and therefore suitable for teleteaching. A major design objective for the program was a self-explaining and robust user interface. The system has been in routine use since 1998. We designed an evaluation form consisting of 21 items focused on subjective rating of learning success, acceptance of CBT, and technical feasibility. We analyzed forms from 138 students and found high scores for acceptance and learning success (median 5 on a 6-point scale). user problems with the program were denied (median 1 on a 6-point scale). Computer-based training with Internet technology can provide a successful method for interactive teaching of emergency medicine and is well accepted by students.
Computer Graphics↗
Human responses to augmented virtual scaffolding models.
This study investigated the effect of adding real planks, in virtual scaffolding models of elevation, on human performance in a surround-screen virtual reality (SSVR) system. Twenty-four construction workers and 24 inexperienced controls performed walking tasks on real and virtual planks at three virtual heights (0, 6 m, 12 m) and two scaffolding-platform-width conditions (30, 60 cm). Gait patterns, walking instability measurements and cardiovascular reactivity were assessed. The results showed differences in human responses to real vs. virtual planks in walking patterns, instability score and heart-rate inter-beat intervals; it appeared that adding real planks in the SSVR virtual scaffolding model enhanced the quality of SSVR as a human - environment interface research tool. In addition, there were significant differences in performance between construction workers and the control group. The inexperienced participants were more unstable as compared to construction workers. Both groups increased their stride length with repetitions of the task, indicating a possibly confidence- or habit-related learning effect. The practical implications of this study are in the adoption of augmented virtual models of elevated construction environments for injury prevention research, and the development of programme for balance-control training to reduce the risk of falls at elevation before workers enter a construction job.
Adult↗
Structured computer-based training in the interpretation of neuroradiological images.
Computer-based systems may be able to address a recognised need throughout the medical profession for a more structured approach to training. We describe a combined training system for neuroradiology, the MR Tutor that differs from previous approaches to computer-assisted training in radiology in that it provides case-based tuition whereby the system and user communicate in terms of a well-founded Image Description Language. The system implements a novel method of visualisation and interaction with a library of fully described cases utilising statistical models of similarity, typicality and disease categorisation of cases. We describe the rationale, knowledge representation and design of the system, and provide a formative evaluation of its usability and effectiveness.
Artificial Intelligence↗
Computer user groups: a shared rural hospital experience.
For the small or rural hospital with a stand-alone system, a user group can be a way to obtain programming, education and training, assistance from the manufacturer, and greater influence in the marketplace--abilities which many larger hospitals have. Moreover, the use of such a group is a way for individual hospitals to maximize the use of and make computer operators more comfortable with their systems. The UB-82 programming project is an illustration of how a group of hospitals with limited resources can work together to achieve a common goal.
Colorado↗
[A new method for accommodation training].
A new method for accommodation training making use of a computer is proposed. A specially generated dynamic grid of concentric rings serves the stimulus. Changes of the accommodation parameters (the nearest and farthest points of clear vision) were examined in 11 display users aged 30 to 50 during a training session and in the course of 15 sessions. The training improved the accommodation volume by an average of 0.9 diopters at the expense of approximating the nearest and withdrawing the farthest clear vision points. In 4 subjects anisoaccommodation disappeared almost completely. The proposed method may be used to normalize the accommodation of display users.
Accommodation, Ocular↗