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Biomedical subjects

Norman B Berman

Publications and source records attributed to Norman B Berman.

4 recordsLinked to original sources

Computer-assisted instruction in clinical education: a roadmap to increasing CAI implementation.

This reflection is based on the premise that clinical education can be improved by more widespread use of computer-assisted instruction (CAI) and that a roadmap will enable more medical educators to begin using CAI. The rationale for CAI use includes many of its inherent features such as incorporation of multimedia and interactivity yet the use of CAI remains limited, apparently because educators are not convinced about the role for CAI. Barriers to CAI use are discussed including misinterpretation of the literature for CAI effectiveness; a disconnect between CAI developers and the educators who make decisions about CAI use; and the paucity of knowledge regarding how to integrate CAI effectively into clinical education. Specific roles for CAI in undergraduate and graduate medical education can include improving uniformity of instruction, providing documentation of exposure or competence, improving the learners' educational experience or outcomes, and assessment that is matched to learning. Funding for CAI remains an important barrier but the authors believe that this will be overcome when use of CAI becomes more widespread.

Computer-Assisted Instruction↗

Clerkship enhancement of interpersonal skills.

BACKGROUND: The purpose of this research was to determine if students improve interpersonal skills as the third year progresses despite the lack of any specific curriculum or teaching methods. METHODS: Third-year students completed 1 of 3 16-week sequential clerkship blocks. Each student completed a clinical performance examination before and after clerkship consisting of a videotaped standardized patient interview and physical examination. Videotapes were randomly assigned to communication faculty for evaluation. RESULTS: Although the majority (73%) of students improved during their block, 17% showed no improvement, and 12% had deficient interpersonal skills after their clerkship. CONCLUSIONS: Despite the lack of skill-directed curriculum, most medical students showed improved interpersonal skill performance after a 16-week clerkship. Developing an interpersonal curriculum for all third-year students may not be necessary. Because faculty are being asked to do more with less, we believe efforts focused on individual students during the third year will be more productive.

Clinical Clerkship↗

Multi-institutional development and utilization of a computer-assisted learning program for the pediatrics clerkship: the CLIPP Project.

Computer-assisted instruction (CAI) holds significant promise for meeting the current challenges of medical education by providing consistent and quality teaching materials regardless of training site. The Computer-assisted Learning in Pediatrics Project (CLIPP) was created over three years (2000-2003) to meet this potential through multi-institutional development of interactive Internet-based patient simulations that comprehensively teach the North American core pediatrics clerkship curriculum. Project development adhered to four objectives: (1) comprehensive coverage of the core curriculum; (2) uniform approach to CAI pedagogy; (3) multi-institutional development by educators; and (4) extensive evaluation by users. Pediatrics clerkship directors from 30 institutions worked in teams to develop a series of 31 patient case simulations. An iterative process of case content and pedagogy development, case authoring, peer review, and pilot-testing ensured that the needs of clerkship directors and medical students were met. Fifty medical schools in the United States and Canada are presently using CLIPP. More than 8,000 students have completed over 98,000 case sessions, with an average of 2,000 case sessions completed per week at this time. Each CLIPP case has been completed by more than 3,000 students. The current cost of CLIPP development is approximately $70 per student user, or $6 per case session. The project's success demonstrates that multi-institutional development and implementation of a peer-reviewed comprehensive CAI learning program by medical educators is feasible and provides a useful model for other organizations to develop similar programs. Although CAI development is both time-consuming and costly, the initial investment decreases significantly with broad use over time.

Adult↗

Apical ventricular septal defects: follow-up concerning anatomic and surgical considerations.

BACKGROUND: Apical ventricular septal defects (VSDs) are difficult to visualize and close transatrially. We described their distinctive anatomic features, which have seldom been documented angiocardiographically and pathologically, in order to develop an effective approach for their surgical management. METHODS: Fourteen postmortem cases, two explanted hearts, 9 successfully operated patients, and 1 unoperated living patient were included in this report. Angiocardiographic documentation of the apical VSD was available in 14 of 16 (87.5%) of the postmortem and transplanted cases, and in 6 of 10 (60%) of the living patients. Echocardiograms were available in 23 of all 26 cases (88%). RESULTS: Severe associated malformations were present in 14 of 16 (87%) of the pathologically documented cases. Large VSDs allowed extensive communication between the left ventricular and the right ventricular sinuses in 4 patients. In 12 of the pathologically documented cases and in the 10 living patients, the left ventricular apex communicated with the right ventricular apical infundibular recess. CONCLUSIONS: Extremely large apical VSDs with severe biventricular dysplasia and dysfunction may require cardiac transplantation. Large apical VSDs can be successfully closed through a small apical infundibulotomy. This approach, applicable even in small infants, can avoid pulmonary artery banding or left ventriculotomy.

Angiocardiography↗