Claiming the computer.
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Remote as it once seemed that dental surgeons would some day be interested in introducing computers in their daily practice, the degree of motivation now increasingly impulsing dentists to apply this technology in their offices is indeed amazing. The object of this article is to offer some helpful information to those who are contemplating or have recently adopted the computer in their dental practice.
In 1985 Harvard Medical School initiated an experimental curriculum that incorporated many of the recommendations of the report on the General Professional Education of the Physician (GPEP). Key features are problem-based small group tutorials that emphasize active learning, with increased independent study time and a decreased number of lectures. Tutors serve as guides to their students and are not necessarily experts in the discipline of the cases studied. Learning skills are taught, including information acquisition and criticism and computer literacy. Knowledge is integrated from the beginning by interdisciplinary basic science courses, by earlier introduction of the clinical sciences, and by juxtaposition of the scientific and humanistic aspects of medicine. Preventive medicine, health maintenance, and ambulatory care are given more attention. The students are organized into societies that provide vertical integration and promote cooperation among students and closer contact with faculty. Pathology has proved to be a popular and key bridge in the new curriculum. The success of the early efforts at Harvard and several pioneering medical schools should encourage others to move toward more problem-solving, student-centered, integrative medical education.
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In 1984 the Western Consortium for the Health Professions, Inc., under contract to the United Nations Fund for Population Activities (UNFPA), began a project to assist Bangladesh's National Institute for Preventive and Social Medicine (NIPSOM) in establishing a microcomputing capability. The project's goal was to enable NIPSOM to become self-sufficient in the analysis by microcomputer of health, population, and family planning data; program evaluation; and policy activities. Lack of a local microcomputer infrastructure demanded that a local team of experts be developed to run the system described in a previous report. Five NIPSOM faculty members--three of whom had taken the workshop held when the system was first installed--were assigned to a computer committee, which was responsible for the computer's well-being. Six months after the microcomputer system was installed, a second 2-week workshop was given. The consortium's consultant facilitated the development of a basic microcomputer course, which was taught by four members of the computer committee to an additional eight NIPSOM faculty members. Emphasis was placed on developing local self-reliance and the need to overcome obstacles imposed by the lack of local hardware and software support systems. A strategy is proposed for the successful introduction of microcomputers in developing countries.
Writing courseware with the aid of an authoring system is a bold step that can bring together the health education content expert and the power of the microcomputer. The microcomputer can be programmed to present essential knowledge to students in a low pressure setting, specifically geared to their levels of comprehension and rates of progression. Microcomputer-based simulations and patient management problems seem suited to the task helping students develop adequate problem-solving skills in health education (Lewis, 1983; Peterson, 1984). Furthermore, many lecture hours can be replaced by an infinitely patient tutor with which students can interact at their convenience. Creating self-study materials delivered via microcomputer is also a step toward providing the most effective type of learning experiences for individual students. Despite the fact that putting authoring systems in the hands of well-informed content specialists may meet a number of pressing needs in health education, there is one drawback. Authoring systems have a built-in pedagogical structure that, to some extent, dictates the design of the lesson. However, spending time in the evaluation process prior to purchase will enable educators to identify a system that can be used to develop courseware that very closely matches the desires of the author. Integrating microcomputer courseware into health education courses is certainly an attractive solution to some of the educational problems faced in health education today. An authoring system can be used to develop courseware that can substituted for lectures on basic concepts. In addition, students will have more opportunities to develop the ability to apply, in problem-solving situations, the factual knowledge they are learning before they are responsible for making judgments in real-life situations. The time is ripe, then, for health educators to investigate how authoring systems can help them utilize the technology of the microcomputer to improve health education.
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A computer is nothing more than an organized bureaucratic structure that allows one to perform a large number of very simple acts by the issuance of a few simple commands. It has the disadvantage of being a machine and, at the present time, being incapable of interpretive behavior. Such machines can only follow orders blindly. On the other hand, the computer is capable of performing simple tasks at lightning speed. Learning how to take advantage of this ability is no more difficult than learning to reduce a Colle's fracture. Buy a book, obtain some "clinical material" (a computer), and start experimenting. Learn from your mistakes; it only takes time and interest--not genius.
The organization of data and the services available from a computerized data base management system are discussed in this article. A primitive medical office management system is built to illustrate how one such system (dBASE III) could be used. The case study shows not only the immediate applications, but also how the system allows new features and functions to be added.
On a regular basis we are upgrading and modifying our software package to meet our ever-changing needs. The day of the user-friendly computer is upon us. We have found the computer to be an ever-important extension of our own minds, truly our own electronic servant. It has relieved us of the mental tedium that in the past has eaten up so much of our time, leaving us free to accomplish the tasks that our electronic servant could never accomplish, including the creation of new ideas and the appreciation and nurturing of old ones.