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PubMed1995

Internet for teaching and learning introductory health informatics.

Internet resources seem attractive for teaching and learning. But are they usable and useful in their present form? We explored Internet, in particular its World Wide Web (WWW) resources, in a course on "Medical Methodology" (HINF270) for students of health information science. This course offers a systematic overview of the methodological principles of clinical care. Its broad scope and low depth makes this course a reasonable model to explore the limits of WWW resources. During the course, students wrote summaries of individual lectures. After critiquing and appropriate corrections, the texts were edited with Hypertext Mark-up Language (HTML) and augmented with links to WWW resources. Grading based on the papers, on their improvements through HTML and WWW, and on the provision of information on the search experience were incentives to use WWW. A formal questionnaire, administered on-line on a voluntary basis, concluded the investigation. Results show: 1) Even under considerable pressure to use WWW, libraries remain the reference source of choice for research; 2) Internet provides entertainment appeal even though practical utility is currently limited; 3) Technological proficiency with HTML and search engines is perceived as an asset; 4) Varying availability of Internet resources, uncertain and varying quality of sources, and limited specificity of research results are the major disadvantages of WWW. The teaching implications of these findings are discussed.

British Columbia↗
PubMed1995

Teaching literature searching in the context of the World Wide Web.

As part of the required curriculum for medical students, we devised a literature-searching practicum that has been used for two years. In both years, we stressed going beyond the skills needed for using a particular searching program, towards a more conceptual approach to information searching. In the first year, the practicum was taught in a traditional lecture/hands-on format. In the second year, the lecture was replaced by a World Wide Web-based tutorial (http:@www.welch.jhu.edu/Education/tutorials/pra cticum.html). To our knowledge, this is the first Web-based resource intended to teach students about appropriate use of search technology. Comparison of student evaluations showed no difference in attitude toward the two versions of the practicum, and observation of student performance suggested similar levels of proficiency. We conclude that placing these educational materials on the Web (1) makes us practice what we preach; (2) is as effective as traditional teaching methods; and (3) gives students a resource for reinforcement learning.

Computer Communication Networks↗
PubMed1995

[Virtual reality in medicine].

The methods of virtual reality (VR) will come to play a routine part in the work of hospitals. It is difficult to understand and explain what VR means in medicine and its scope in medicine. This paper distinguishes the four functional categories of Immersive VR, Desktop VR, Pseudo VR and Inverse VR. Immersive VR uses a head-mounted display and data gloves as input devices, while Desktop VR uses VR shutter glasses and a 3D input device such as the 3D mouse. Pseudo VR comprises interactive controllable animation. Inverse VR uses, for example, biosignals as an input device in order to support the computer user in the real world. This paper discusses the potential applications of the four categories of VR in medicine with reference to topical projects.

Computer Graphics↗
PubMed1995

Integrating medical informatics into an undergraduate medical curriculum.

his paper outlines a rationale for medical schools to integrate medical informatics into their curricula. The approach used in the problem-based undergraduate curriculum at Dalhousie University School of Medicine is presented in three areas: organizational structure, implementation, and curriculum development. Seven goal areas defined to guide the curriculum development process are described.

Computer Literacy↗
PubMed1995

Computing education of medical students through a study of hospital and clinical activities: seven years' experience.

With the widespread use of information technology (IT) in health care, the need to teach computing to doctors and medical students has become increasingly apparent. This paper describes a course for medical students immediately before their clinical training; it lasts one semester and was first introduced in 1987 at St. George's Hospital Medical School, London. It is generally accepted that the present curriculum leaves little opportunity for the introduction of new subjects. This paper therefore describes the content of an elective in computing and the reactions of medical students to it. It is intended that this paper will help other educationalists who may obtain insights and consequently be able to negotiate medical informatics changes into their medical school environments.

Computer Literacy↗
PubMed1995

Medical informatics and problem-based learning in conjunction.

At Dalhousie, we integrated medical informatics as a horizontal theme in the problem-based learning undergraduate medical education curriculum. The rationales for these initiatives can be addressed along the following dimensions: political, philosophical, psychological, educational, and professional practice. Student attitudes towards computers are changing, and incoming students are increasingly computer-literate. Of those Med I students surveyed at the end of the 1993-94 academic year, 94% felt that computers were moderately important or essential to medical education; 86% of Med II students surveyed were of the same opinion. The education of future physicians can be enhanced when medical informatics is introduced into a curriculum in conjunction with the problem-based learning approach.

Attitude to Computers↗
PubMed1995

Implementation and evaluation of computerized patient management problems.

We developed and implemented computerized patient management problems (CPMP) for medical school education as a simulation of case management and evaluated its efficacy in the School of Medicine at Chiba University. PMP was first developed in the USA; it was used for examinations by the board of American College of Physicians and then introduced to Japan for examination purposes. This test is a practical clinical test for decision making in various medical situations. PMP is, however, a kind of case simulation from a doctor's point of view; it is also a sophisticated tool in training medical students. PMP had many disadvantages in the past, but by computerizing PMP, we solved many problems. We developed the CPMP system for bedside teaching and evaluated its efficiency in terms of education by giving the same test twice and analyzing a survey.

Audiovisual Aids↗
PubMed1996

Clinician information activities in diverse ambulatory care practices.

Ambulatory care is assuming an increasing role in health-care delivery. Yet, most health-care information systems were developed for the acute-care setting. To address the needs of ambulatory care, developers need a comprehensive understanding of the information-related activities of clinicians in heterogeneous outpatient practices. We studied the information activities of clinicians in seven diverse (primary-care, specialty-care, faculty, and independent private practices) ambulatory care sites. The results of our study allow us to characterize clinicians' information-related activities, their perceived information needs, and their satisfaction with computer resources. Developers of health-care information systems can use the results to design applications for clinicians in ambulatory care.

Ambulatory Care↗
PubMed2005

Implementation and evaluation of a low-literacy diabetes education computer multimedia application.

OBJECTIVE: To evaluate a clinic-based multimedia intervention for diabetes education targeting individuals with low health literacy levels in a diverse population. RESEARCH DESIGN AND METHODS: Five public clinics in Chicago, Illinois, participated in the study with computer kiosks installed in waiting room areas. Two hundred forty-four subjects with diabetes were randomized to receive either supplemental computer multimedia use (intervention) or standard of care only (control). The intervention includes audio/video sequences to communicate information, provide psychological support, and promote diabetes self-management skills without extensive text or complex navigation. HbA(1c) (A1C), BMI, blood pressure, diabetes knowledge, self-efficacy, self-reported medical care, and perceived susceptibility of complications were evaluated at baseline and 1 year. Computer usage patterns and implementation barriers were also examined. RESULTS: Complete 1-year data were available for 183 subjects (75%). Overall, there were no significant differences in change in A1C, weight, blood pressure, knowledge, self-efficacy, or self-reported medical care between intervention and control groups. However, there was an increase in perceived susceptibility to diabetes complications in the intervention group. This effect was greatest among subjects with lower health literacy. Within the intervention group, time spent on the computer was greater for subjects with higher health literacy. CONCLUSIONS: Access to multimedia lessons resulted in an increase in perceived susceptibility to diabetes complications, particularly in subjects with lower health literacy. Despite measures to improve informational access for individuals with lower health literacy, there was relatively less use of the computer among these participants.

Blood Pressure↗
PubMed2001

The multimedia computer for low-literacy patient education: a pilot project of cancer risk perceptions.

OBJECTIVE: Inadequate reading literacy is a major barrier to better educating patients. Despite its high prevalence, practical solutions for detecting and overcoming low literacy in a busy clinical setting remain elusive. In exploring the potential role for the multimedia computer in improving office-based patient education, we compared the accuracy of information captured from audio-computer interviewing of patients with that obtained from subsequent verbal questioning. SETTING: Adult medicine clinic, urban community health center PATIENTS: Convenience sample of patients awaiting clinic appointments (n = 59). Exclusion criteria included obvious psychoneurologic impairment or primary language other than English. INTERVENTION: A multimedia computer presentation that used audio-computer interviewing with localized imagery and voices to elicit responses to 4 questions on prior computer use and cancer risk perceptions. MEASUREMENTS AND MAIN RESULTS: Three patients refused or were unable to interact with the computer at all, and 3 patients required restarting the presentation from the beginning but ultimately completed the computerized survey. Of the 51 evaluable patients (72.5% African-American, 66.7% female, mean age 47.5 [+/- 18.1]), the mean time in the computer presentation was significantly longer with older age and with no prior computer use but did not differ by gender or race. Despite a high proportion of no prior computer use (60.8%), there was a high rate of agreement (88.7% overall) between audio-computer interviewing and subsequent verbal questioning. CONCLUSIONS: Audio-computer interviewing is feasible in this urban community health center. The computer offers a partial solution for overcoming literacy barriers inherent in written patient education materials and provides an efficient means of data collection that can be used to better target patients' educational needs.

Adult↗
PubMed2006

Online learning: the potential for occupational therapy education.

Online learning continues to have a significant impact on higher education. Increasingly students seek a combination of online learning and face-to-face instruction at undergraduate and graduate levels and occupational therapists ask for online continuing professional development opportunities. However, occupational therapy educators have been slow to adopt web-based instructional technology. This paper presents background information on the use of web-based learning in the general sphere of higher education and outlines the current range of usage in occupational therapy education. Research findings are presented to stimulate discussion regarding online learning and occupational therapy professional socialisation, student satisfaction and outcomes. There is a fine line between full and partial online course delivery, so research on technology-enhanced campus-based delivery is also included in the review. Evidence suggests that blending combinations of technologies with computer mediated learning enhances interaction and could address the higher order learning needs of professional programmes such as occupational therapy.

Computer Literacy↗
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↗
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↗