Biomedical subjects
E Cobbs
Publications and source records attributed to E Cobbs.
An interactive learning environment for health care professionals.
This article summarizes experiences to date with building and deploying a clinical simulator that medical students use as part of a 3rd year primary care rotation. The simulated microworld helps students and health care professionals gain experience with and learn meta-cognitive skills for the care of complex patient populations that require treatment in the biopsychosocial-value dimensions. We explain lessons learned and next steps resulting from use of the program by over 300 users to date.
PC CLIN-SIM: a toolbook based clinical simulation environment.
The Departments of Computer Medicine, Health Care Sciences, Medicine, and Electrical Engineering & Computer Science at the George Washington University have joined forces to create a clinical simulation program. The purpose of this program is to provide experience in the management of complex patient populations (eg geriatrics). A number of simulation programs are available commercially, however none provide adequate geriatric content, or were deemed to lack functionality important to the developers. The immediate goal of this effort was to create a computer-based, core curriculum in geriatric medicine for medical and allied health students. The curriculum includes case simulations linked to a comprehensive reference database. The development objectives were to create an intuitive, friendly, consistent user interface which could serve as a shell for additional content areas. In order to increase fidelity, free text entry and time simulation were included.
Plasma erythropoietin in polycythemia.
Erythropoietin titers of plasma cannot be used to differentiate polycythemia vera from secondary polycythemia since the limit of sensitivity of our current bioassay technics is 50 mU, considerably higher than levels found in normal subjects and in patients with polycythemia. However, erythropoietin is relatively heat stable, and since abundant plasma is available from therapeutic phlebotomies it is possible to prepare and assay highly concentrated, erythropoietin-containing extracts. In 35 normal subjects, erythropoietin levels ranged from less than 5 mU/ml (the limit of sensitivity) to 18 mU/ml with a mean of 7.8 mU/ml. In 21 patients with proved polycythemia vera, the levels were less than 5 mU/ml in all. In 41 patients with suspected secondary polycythemia or polycythemia of unknown origin, the levels ranged from less than 5 to 3,000 mU/ml. Three of the 11 patients with levels less than 5mU/ml were subsequently shown to have polycythemia vera. These results suggest that this refinement of the routine bioassay for erythropoietin may be of clinical importance in the differential diagnosis of polycythemia.