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W E Erkonen

Publications and source records attributed to W E Erkonen.

31 records · Page 2Linked to original sources

Evaluation of a computer-based program for teaching cardiac anatomy.

RATIONALE AND OBJECTIVES: The authors determined to what extent a computer-based program could enhance or substitute for cadaver dissection in teaching cardiac anatomy to first-year medical students. METHODS: First-year medical students (n = 175) were randomized into four groups. Group 1 (control) received no instruction, group 2 participated in cardiac dissection, group 3 viewed the computer application, and group 4 performed cardiac dissection and then viewed the computer application. Each group was tested with 10 ultrafast computed tomographic static images and 8 cardiac cadaver specimens. RESULTS: The computer program plus dissection was superior to either the computer program alone or dissection alone; however, the results varied according to the subtest used to assess the outcomes. CONCLUSIONS: Cardiac computer instruction after dissection resulted in dramatically improved image testing performance. However, computer instruction should not replace dissection for teaching cardiac anatomy.

Anatomy↗

Calculating the costs of undergraduate medical education in radiology.

RATIONALE AND OBJECTIVES: The current stringent financial constraints mandate that radiology departments carefully assess the costs involved in undergraduate medical education. We performed a cost-accounting analysis of the radiology department's participation in an introductory clinical medicine course, which could serve as a methodologic model for realistic cost assessment of any new or existing course. MATERIALS AND METHODS: Each day of the 5-week radiology portion of the second-year course consists of 1 hour of lecture and 5 hours of small-group discussions regarding chest, abdominal, and skeletal radiology; neuroradiology; and nuclear medicine. Marginal cost is defined as the additional real cost involved in creating or conducting a course. Opportunity costs represent alternative use of instructional resources. RESULTS: The marginal cost (additional real cost) of providing the course for the first time was $37,475. Subsequent offerings of the course will cost approximately $24,375. CONCLUSION: Resources expended for any instructional purpose must be weighed in terms of marginal and opportunity costs. It is mandatory that adequate cost analysis for undergraduate education in radiology be developed so that sound choices can be made regarding resource consumption.

Costs and Cost Analysis↗

The virtual hospital: a new paradigm for lifelong learning in radiology.

Medical training in radiology should be viewed as a continuum that begins in medical school and proceeds throughout the years in practice. Unfortunately, there are significant barriers to providing continuing medical education. One key barrier is the physical separation between the information source and the workplace. A multimedia medical library distributed via wide area networks has been developed that provides needed information at the point of use. The distribution software (Mosaic) that makes this project possible is found in the public domain.

Computer Communication Networks↗

The networked multimedia textbook: distributing radiology multimedia information across the Internet.

OBJECTIVE: The purpose of this project was to create an approach for global radiology multimedia publishing using the internet that would address the two largest problems facing radiology multimedia publishers today: the high percentage of radiologists who are computer novices and the variety of personal computers (Macintosh, Microsoft Windows/IBM-PC, X-Windows, Amiga) whose software is incompatible. MATERIALS AND METHODS: We developed a client/server approach to multimedia publishing, the networked multimedia textbook, that has a simple booklike user interface to facilitate use by computer novices. Once created, a networked multimedia textbook can be viewed on all current popular personal computers. The networked multimedia textbook is based on the internet, World-Wide Web, Mosaic, and Wide Area Information Servers software technologies, all of which are in the public domain. RESULTS: We created six radiology networked multimedia textbooks. CONCLUSION: This networked multimedia textbook approach for the global distribution of multimedia radiology information brings the benefits of multimedia publishing on the Internet to radiologists today.

Computer Communication Networks↗

The influence of clinical history on visual search with single and multiple abnormalities.

RATIONALE AND OBJECTIVES: Facilitation of detection by clinical history generally has been found with a single abnormality per image but not with multiple abnormalities. Multiple abnormalities per image can occasion a "satisfaction-of-search" effect in which detection of one lesion is reduced in the presence of other distant lesions. Our experiment studied the combined effect of multiple abnormalities and clinical history on accuracy. METHODS: Detection of native lesions was measured 1) with histories suggestive of the native abnormality; 2) with these histories and added simulated pulmonary nodules; and 3) with the same added nodules and histories suggestive of metastatic disease. These conditions also were compared with those of a previous experiment that were similar but included no history. RESULTS: Detection was substantially improved for appropriately prompted abnormalities even in the presence of a pulmonary nodule. In fact, satisfaction of search was not found in the presence of an appropriate history. Detection of unprompted abnormalities was unchanged when prompts indicated other abnormalities actually present. Prompted abnormalities were detected earlier in search. CONCLUSIONS: History appears to direct perceptual resources to the prompted abnormalities, thereby alleviating satisfaction of search. The presence of nodules yielded a small but consistent reduction in total search time for searches involving false responses, suggesting that satisfaction of search may depend more on reduction in search time than had been indicated by previous research.

Diagnostic Errors↗

The instructional effectiveness of a radiology multimedia textbook (HyperLung) versus a standard lecture.

RATIONALE AND OBJECTIVES: Information overload is a significant problem for the modern radiologist. This prospective study compares the instructional effectiveness of a multimedia textbook (HyperLung) with a lecture. HyperLung is a radiologic multimedia textbook about imaging diffuse lung disease created using a multimedia authoring tool, the Annotator (the University of Iowa Second Look Computing, Iowa City, IA), on the Apple Macintosh computer (Apple Computer, Cupertino, CA). METHODS: Forty-nine staff physicians and residents in the Department of Radiology were randomized to receive instruction either by HyperLung or by a lecture. The instructional content was the same in both groups, and both groups were tested before and after instruction. The actual time spent in each instructional situation was recorded. RESULTS: The instructional effectiveness of the multimedia textbook and lecture was equal. The instructional efficiency of HyperLung was only 60% of the lecture. Users of the multimedia textbook found it enjoyable and straightforward to use. CONCLUSIONS: Multimedia textbooks have a promising future in radiology education.

Education, Medical, Continuing↗

An approach to the creation of multimedia textbooks for radiology instruction.

We developed a standardized approach for creating computerized multimedia textbooks based on four principles: (1) multimedia textbooks should resemble printed books, (2) the creation of multimedia textbooks should be relatively inexpensive, (3) multimedia textbooks should be completely digital, and (4) the construction of multimedia textbooks should be simple. To facilitate this approach, an inexpensive, user-friendly multimedia authoring tool called The Annotator was used. The Annotator, a Hypercard-based program that runs on any Macintosh computer, helps authors rapidly create sophisticated radiologic multimedia textbooks. This program provides a textbooklike shell that can be filled with digitized media (video clips, audio clips, images, and text). This approach, which is applicable to any multimedia hardware platform, allows the authorship of multimedia textbooks that can be easily transported to any future multimedia platform.

Computer Graphics↗

Effectiveness of teaching radiologic image interpretation in gross anatomy. A long-term follow-up.

This prospective study was designed to gauge the effectiveness of teaching radiologic interpretation during a gross anatomy course for first-year medical students by measuring short- and long-term ability to identify normal anatomic structures on radiologic diagnostic images. The evaluation required students to identify normal anatomic structures on radiographs, computed tomographs, ultrasonograms, and magnetic resonance images (MRIs). The assessments were made before (pre-test) and during (post-test) the experimental radiology portion of the gross anatomy course. The students were then retested 14 to 17 months later (long term). The pre-test correct response rate of 17% improved to 88% on the post-tests. After 14 to 17 months, the students had a 74% correct response rate on the same images and anatomic structures. This high level of long-term retention documents the effectiveness of integrating diagnostic radiologic imaging into normal gross anatomy instruction.

Anatomy↗

Diagnostic image use by nonradiologist lecturers in an introductory clinical medicine course.

RATIONALE AND OBJECTIVES: A curriculum-tracking study was designed to determine the type and amount of diagnostic imaging used by nonradiologists teaching an Introduction to Clinical Medicine (ICM) course to second-year medical students. METHODS: Two second-year medical students independently recorded the type and number of images shown, the length of the lecture, the departmental affiliation of the lecturer, and the amount of time devoted to either didactic radiology or radiologic images during each of 288 lectures in the 1990 ICM course. RESULTS: A total of 35.2% of the lectures presented some type of diagnostic image, and 7.0% of all lecture time was devoted to radiology. No mammography or diagnostic nonangiographic interventional images were shown. CONCLUSIONS: The results suggest that a more consistent and uniform presentation of diagnostic images across disciplines is required, emphasizing the need for more coordination of radiology instruction through consultation with the Department of Radiology.

Clinical Medicine↗

Cardiac anatomy instruction by ultrafast computed tomography versus cadaver dissection.

RATIONALE AND OBJECTIVES: This prospective study was designed to determine to what extent an ultrafast computed tomography (UFCT) videotape of the heart could enhance or substitute for cadaver dissection in teaching anatomy to first-year medical students. METHODS: A student population (n = 180) was randomized into four groups. Group 1 (control) received no instruction, group 2 viewed the videotape, group 3 participated in cardiac dissection, and group 4 performed cardiac dissection and viewed the videotape. After randomized instruction, each group was tested with 10 UFCT static cardiac images and 8 cardiac cadaver specimens. A different population consisting of nonrandomized fourth-year medical students also was tested. RESULTS: The results point to an interaction between instruction and the manner in which it was assessed. There was more carryover from the videotape-acquired knowledge to specimens than from dissection-acquired knowledge to UFCT images. CONCLUSIONS: Cardiac UFCT instruction resulted in dramatically improved image testing performance. This image-acquired knowledge was not sufficiently transferred to cardiac specimen identification; thus, videotape instruction should not replace dissection for teaching cardiac anatomy. Video provided instruction benefits beyond that gained through general clinical experience.

Audiovisual Aids↗

Gross anatomy instruction with diagnostic images.

A new module of instruction for diagnostic imaging with emphasis on cross-sectional anatomy was developed within the existing course of gross anatomy for freshmen medical students. Two lectures introduced radiation protection, radiology history, and the basic principles of computed tomography, magnetic resonance imaging, ultrasound, and radiograph image production. Six radiographic anatomy correlation sessions allowed student-teacher interaction while studying viewbox images in a "hands on" fashion. Relevant exhibits complemented cadaver dissection. Testing established that significant improvement occurred in the students' ability to identify anatomic structures on diagnostic images.

Anatomy↗

The Virtual Hospital: an IAIMS integrating continuing education into the work flow.

Researchers at the University of Iowa are developing an integrated academic information management system (IAIMS) for use on the World Wide Web. The focus is on integrating continuing medical education (CME) into the clinicians' daily work and incorporating consumer health information into patients' life styles. Phase I of the project consists of loosely integrating patients' data, printed library information, and digital library information. Phase II consists of more tightly integrating the three types of information, and Phase III consists of awarding CME credits for reviewing educational, material at the point of patient care, when it has the most potential for improving outcomes. This IAIMS serves a statewide population. Its design and evolution have been heavily influenced by user-centered evaluation.

Attitude to Computers↗