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F Kallinowski

Publications and source records attributed to F Kallinowski.

At least 19 recordsLinked to original sources
PubMed2006

[Evaluation of traditional German undergraduate surgical training. An analysis at Heidelberg University].

BACKGROUND: The medical faculty of Heidelberg University implemented a new problem-based clinical curriculum (Heidelberg Curriculum Medicinale, or Heicumed) in 2001. The present study analyses the evaluation data of two student cohorts prior to the introduction of Heicumed. Its aim was to specify problems of the traditional training and to draw conclusions for implementation of a new curriculum. METHODS: The evaluation instrument was the Heidelberg Inventory for the Evaluation of Teaching (HILVE-I). The data were analysed calculating differences in the means between defined groups, with the 13 primary scales of the HILVE I-instrument as dependent variables. RESULTS: Teaching method and subject had no systematic influence on evaluation results. Thus, didactic lecture in orthopedic surgery achieved better results than small group tutorials, while the data on vascular and general surgery showed opposite results. Major factors for success were continuity and didactic training of lecturers and tutors. This is convincingly reflected by the results of the lecture course "Differential diagnosis in general surgery". The good evaluation data on small group tutorials resulted largely from the "participation" and "discussion" scales, which represent interactivity in learning. CONCLUSION: The results of the present study suggest the importance of two major pedagogic ideas: continuity and didactic training of lecturers and tutors. These principles were widely implemented in Heicumed and have contributed to the success of the new curriculum.

Attitude of Health Personnel↗
PubMed2002

["Multimedia symposium wares". An enrichment of medical and graduate education?].

The continual development of the internet has supported the spread of surgical knowledge by electronic means. High quality products have to be offered from a software as well as a contents point of view. The question as to whether these new media and their contents have a real value for efficient and motivating use in medical education needed to be answered by first assessing a quality profile for the development of surgical educational modules which were then evaluated on the basis of so-called "symposia ware". First, the reactions and opinions of physicians at 47 universities were assessed by a standardized questionnaire concerning their demands on multimedia teaching/learning modules. Several different aspects of technique, content, presentation, didactics and background knowledge were analyzed. In a second step, their opinions were evaluated concerning two applications (symposia implemented on CD-ROM as a slideshow with original slides and audio) with surgical and gastroenterological contents by standardized questionnaire. Questions concerning personal background such as educational status and experience with computers, e-mail and the internet on one hand and the CD-ROM itself concerning content, relevance for daily clinical work and continuing medical education as well as the quality of the application on the other hand, were evaluated using marks (1 = best, 6 = worst). A total of 320 physicians participated in the first part of the interview. Of these, 93% were equipped with computers in hospital as well as privately. The Internet was used by 90% of them. The majority declined a full text presentation as well as the application of scroll fields. The participants rather favored the integration of text, pictures, animations and videos. Furthermore, 95% demanded the provision on the internet. Thirty-seven colleagues in their 5th (1-11) year of training were interviewed, and of those, 27 were working in a surgical department and 10 in a medical department. Individual computer knowledge was rated with a median of 3. This revealed that 60% were equipped with computers in hospital as well as at home, the remaining 40% had computers either in hospital or at home. All participants used the internet. In total, 57% had experience with "Symposia ware". The rating of the "Symposia ware" itself was positive. Relevance and applicability of a slideshow for imparting knowledge were rated with a median of 2. This showed that 81% would buy the CD-ROM in principle, and 89% would spent up to 50 EUR. Quality, language, content and user-friendliness were all rated 2. Physicians frequently use computers and the internet. All this indicates a high degree of acceptance of electronic teaching/learning modules in medical education. A uniform structure of contents as well as a platform-independent, web-based presentation is appreciated. To enhance illustration, a picture and video-oriented visualization should be chosen. Overall, "symposia ware" is rated positively. It should cost no more than 50 EUR and it represents a valuable source of information for physicians.

CD-ROM↗
PubMed2000

A new way for surgical education--development and evaluation of a computer-based training module.

Computer-based training (CBT) programs teach the material of a specific field and at the same time offer various ways of objectively assessing the knowledge gained. The interactive use of multi-media components such as text, graphics, animation, sound, digital slide shows, and videos as well as quizzes can theoretically facilitate the learning process. The aim of this study was the development and evaluation of a CBT-program by surgeons for student training. Using SuperCard, a teaching module for Distal Radius Fracture (DRF) was developed, which contains detailed clinical information. Video clips and vivid animations combine theoretical knowledge with practical experience. Fourth-year medical students (n = 103) were tested after using the module for 90 min. Other students (n = 47) served as the control group. In a 90 min lecture, DRF was discussed. CBT gained in all evaluated criteria (distinctiveness, detailed description, presentation of materials, structure, motivation for learning, time saved learning and memory retention) 15-20% better scores than the lecture. Although 82% of the students stated that their experience with computers was limited or insufficient, 100% found the use of CBT systems useful in student teaching. Most of them suggested the use of such programs as a method of exam preparation/self study (90%) or as a supplement to a lecture (40%). Based on these evaluations, CBT modules are an appropriate future teaching and learning system that is well accepted. In conclusion, the results of this study show that CBT-programs could be a valuable supplement to medical education. In addition, further development of CBT-programs and their use as information systems for surgical residency programs at universities can be suggested.

Adult↗
PubMed1999

[MRI of the kidneys. New diagnostic strategies].

AIM: New diagnostic strategies for evaluation of the kidney by fast MR imaging techniques. MATERIAL AND METHODS: A comprehensive morphologic and functional evaluation of the kidney is proposed using fast MR imaging of renal morphology, multiphase 3D gadolinium MR angiography, MR urography and MR flow measurements. A single MR examination is designed to grade renovascular disease and assess the hemodynamic and functional significance, detect and characterize renal lesions and evaluate the urinary tract. RESULTS: The combined analysis of morphologic and functional data allows reliable assessment of renal artery stenosis, benign and malignant renal masses and diseases of the renal collecting system and ureters, as well as congenital abnormalities in good agreement to the results of conventional imaging modalities. The improved tissue contrast and additional functional information compensates for the disadvantage of a lower spatial resolution. CONCLUSION: Combined morphologic and functional MR examination represents a reliable, non-invasive and cost-effective alternative imaging modality for comprehensive diagnostic evaluation of renal disease.

Acute Kidney Injury↗
PubMed1999

Development of a computer based training program for liver transplantation.

The existence and future of every scientific area is directly and indirectly dependent on advanced education in that area and the quality of the work performed. Our aim in developing this program was to improve advanced education in liver transplant surgery and to ensure the quality of the work performed by every surgeon operating in this field. We developed a module that contains extensive information on the pathogenesis, symptoms, diagnosis, X-rays and treatment plans as well as operation-videos and case studies on the most common aspects in liver transplantation. This "teachware" is now on CD-ROM and can be installed on every personal computer without special computer knowledge. The expansion and updating of the material is technically facilitated with the help of an authoring tool.

CD-ROM↗
PubMed1999

Renal arteries: optimization of three-dimensional gadolinium-enhanced MR angiography with bolus-timing-independent fast multiphase acquisition in a single breath hold.

PURPOSE: To compare two different three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiographic techniques. MATERIALS AND METHODS: In 26 patients suspected of having renal artery stenosis, results with fast multiphase 3D MR angiography were compared to those with standard 3D MR angiography in 37 patients. With both techniques, 31-second breath-hold acquisitions were performed. Multiphase angiography comprised five discrete 6.4-second acquisitions without bolus timing, and standard angiography comprised a single acquisition based on test-bolus timing. Two readers evaluated images obtained with both techniques in terms of image quality, artifacts, and vessel conspicuity. Accuracy of findings on the multiphase 3D MR angiograms for assessment of renal artery stenosis was determined by comparing them to digital subtraction angiograms and surgical findings. RESULTS: In the early arterial phase, multiphase 3D MR angiograms showed no image degradation by venous overlay, whereas standard 3D MR angiograms depicted at least minor overlay in 53 of 83 renal arteries (P < .001). Less parenchymal enhancement in the early arterial phase resulted in a higher vessel conspicuity for the divisions and segmental arteries (P < .001). Both readers detected and correctly graded 18 of 20 stenoses on the multiphase angiograms with almost perfect interobserver agreement (kappa > 0.89). CONCLUSION: Renal multiphase 3D MR angiography is an accurate technique requiring no bolus timing. The performance of early arterial phase imaging leads to improved depiction, particularly of the distal renovascular tree, compared to that with standard single-phase 3D MR angiography.

Adult↗
PubMed1998

The partial gluteus maximus musculocutaneous turnover flap. An alternative concept for simultaneous reconstruction of combined defects of the posterior perineum/sacrum and the posterior vaginal wall.

Three cases with posterior perineo-sacral defects are presented. One is a 57-year-old white female following amputation of her rectum for carcinoma, radiation and chemotherapy with a significant residual sacral/perineal defect and loss of the posterior vaginal wall. The two other patients had radical pelvic exenteration after recurrent rectum carcinoma. A new myocutaneous turnover flap as a modification of the conventional gluteus maximus flap was designed to solve the particular reconstructive problems. The flap is based on branches of the inferior gluteal artery. The posterior cutaneous femoral nerve and the motor branches of the inferior gluteal nerve not leading into the muscle portion of the flap are left intact. The skin island can be used for vaginal reconstruction or can be de-epithelialised to fill perineal cavities. This new flap eventually enabled the successful reconstruction of the posterior vaginal wall and appropriate sacral/perineal soft tissue coverage in the first case. In the other patients the flap was used to achieve closure of the deep through-and-through defect acutely in one case, and after a 3-week interval in the other.

Aged↗
PubMed1998

[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↗
PubMed1998

[Development of a computer-assisted learning program for liver transplantation].

The German Society for Surgery recently decided to rename the "video library" as a "multimedia library", which will include also interactive, nonlinear computerised teachware in surgery. We report on the complex interaction of authors, editor, and the computer-based training laboratory, and the pitfalls with respect to data collection, structure, implementation, and technical aspects of the CD-ROM liver transplantation.

Computer-Assisted Instruction↗
PubMed1998

[Development of a multimedia CD-ROM series for improving surgical education and continuing education].

In the past 4 years, the computer-based training laboratory of the Department of Surgery, University of Heidelberg, has developed a multimedia library, the med.LIVE-series. This CD-ROM series contains 5000 multimedia units with information of a uniform structure that comprises 26 CD-ROMs. These modules contribute significantly to the training and education of medical students and doctors. Furthermore, this multimedia library is intended to aid in the development of a database-supported online information system. Authors interested are encouraged to contribute to the series.

CD-ROM↗
PubMed1997

[Computer-based training--a new method in surgical education and continuing education].

Computer-based training (CBT) programs teach the material of a specific field and at the same time offer various ways of objectively checking the knowledge gained. The interactive use of multimedia components, such as text, graphics, animation, sound, digital slide shows, videos and quizzes, facilitates the learning process. The aim of this study was the development and evaluation of a CBT program for use by surgeons teaching students. Using SuperCard, a teaching module for distal radius fracture (DRF) was developed, containing detailed clinical information. Video clips and vivid animation combine theoretical knowledge with practical experience. Fourth-year medical students (n = 103) were tested after using the module for 90 min. Other students (n = 47) served as the control group. In a 90-min lecture, DRF was discussed. In all evaluated criteria (distinctness, detailed description, presentation of materials, structure, motivation to learn, time saved while learning and memory retention), CBT gained 15-20% better scores than the lecture. Although 87% of the students stated that their experience with computers was limited or insufficient, 100% found the use of CBT systems helpful in student teaching. Most of them suggested the use of such programs as a exam preparation/self study method (90%) or as a supplement to a lecture (40%). Based on these evaluations, it is clear that CBT modules are an appropriate future teaching and learning system that will be well accepted. In conclusion, CBT programs should be integrated into medical education as a valuable supplement. With this aim, CBT systems should be developed and used at universities as an information system for the surgical residency program.

Achievement↗
PubMed1997

[Classification of hemodynamic changes in renal artery stenosis using cine magnetic resonance phase contrast flow measurements].

PURPOSE: To evaluate the use of high-temporal resolution cine MR phase-contrast flow measurements for assessment of flow dynamics in renal artery stenosis (RAS). MATERIAL AND METHODS: In a dog model, cine MR flow measurements were validated by comparing the MR flow data to an invasive transit-time ultrasound reference technique for different degrees of RAS. Cardiac-gated MR flow curves were recorded in 56 renal arteries of 28 patients with a temporal resolution of at least 32 ms. In all cases RAS was confirmed by digital subtraction angiography (DSA). Abnormalities of flow dynamics were assessed in the calculated flow curves using the MR parameters mean flow, maximum velocity, and time to systolic maximum. RESULTS: By means of the MR blood flow parameters high-grade stenoses (> 50%, n = 23) were detected with sensitivity of 100% and specificity of 94% with reference to DSA. The overall differentiation between stenoses (n = 37) and non-stenosed vessels (n = 19) revealed a sensitivity of 87% and a specificity of 100%. CONCLUSION: Analysis of cardiac-gated MR flow curves provides a non-invasive method to assess the hemodynamic significance of RAS and thus allows a functional evaluation in relation to the morphologic characteristics of the stenosis.

Adolescent↗
PubMed1997

Renal artery stenosis: grading of hemodynamic changes with cine phase-contrast MR blood flow measurements.

PURPOSE: To analyze the blood flow dynamics in renal artery stenosis with high-temporal-resolution cine phase-contrast magnetic resonance (MR) flow measurements. MATERIALS AND METHODS: Cine phase-contrast MR flow measurements were invasively validated with real-time intraoperative transit-time ultrasound (US). In 23 patients, 48 renal artery stenoses were confirmed at digital subtraction angiography. Cardiac-gated cine phase-contrast MR flow measurements were obtained in 32-msec intervals, and flow curves were calculated for the whole cardiac cycle. Hemodynamic parameters evaluated included the decrease in mean flow and the delay and reduction in the systolic velocity maximum due to decrease in or absence of the early systolic peak. RESULTS: Overall differentiation between renal artery stenosis (n = 31) and nonstenosed vessels (n = 17) with cine phase-contrast MR revealed a sensitivity of 90% and specificity of 94% compared with findings at digital subtraction angiography. High-grade stenoses (>50%, n = 19) were detected with cine phase-contrast MR with sensitivity of 100% and specificity of 93%. CONCLUSION: Quantitative and qualitative analysis of cardiac-gated cine phase-contrast MR flow velocity curves provided a highly accurate method to detect hemodynamic abnormalities in patients with suspected renal artery stenosis.

Adolescent↗