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Multimedia E-mail systems for computer-assisted radiological communication.

In the film-based organization of communicating radiological results to the referring physician, the different media (text, images, graphics, voice) are separated. When using computer technology, multimedia reports containing links between these different media can be used. This changes the way radiological reports are generated, accessed, and possibly discussed. We performed experiments in a clinical setting using two different metaphors for communicating multimedia information. In the 'paper metaphor', labels in the report text are linked to annotations in selected images. In the 'slide presentation metaphor', annotated images are presented synchronously to a spoken report. With both systems additional interaction between radiologist and referring physician is supported using multimedia 'electronic mail'. The experiments indicate that multimedia does not only significantly increase the efficiency of information transfer, but also has the potential to make reporting itself more efficient. Given that the amount of image-related information keeps growing, multimedia links are a promising method to give efficient access to the most relevant information.

Computer Graphics↗

Interactive multimedia dental education: the next five years and beyond.

This presentation is intended to provide "Ten Good Reasons" why interactive multimedia should play a major role in both undergraduate curriculum and graduate level continuing education in the next five years. Multimedia is currently best presented on CD-ROM disks, but virtual reality, interactive television, video-desktop conferencing, and Internet applications will become available before the end of the century. Many dental schools, associations and private companies have already entered the development and production of dental multimedia titles, and it is anticipated that schools and dentists will soon be constrained to purchase multimedia capable systems to take advantage of the "Ten Good Reasons." Guidelines are given to those who desire to publish material in interactive multimedia format. A vision of the future is presented.

CD-ROM↗

Comparative evaluation of multimedia driven, interactive, and case-based teaching in heart surgery.

BACKGROUND: Multimedia-augmented instruction with various approaches is used in heart surgery. There is little evidence which instructional techniques and media are of advantage to impart knowledge more effectively and lead to better application of knowledge in the operation room. METHODS: Sixty-nine students learned with an interactive, case-based teaching (ICBT) course about aortic valve replacement. They were compared with historic controls exposed to identical information provided by a multimedia module presenting content systematically (SMM; n = 69) and a print medium (PM; n = 57). Motivation, computer knowledge, and didactic quality were evaluated with psychometric tests. All groups performed multiple choice pretests and posttests and participated in live surgery during which their performance was assessed. RESULTS: All groups had equal computer knowledge, but the ICBT group felt significantly less-motivated and more challenged. Multiple choice posttest results were comparable (ICBT 80.2% +/- 10.9%, SMM 76.7% +/- 13.3%, PM 76.9% +/- 11.1). During surgery, the ICBT (79.2% +/- 16%) and SMM groups (82.9% +/- 10%) performed significantly better than the PM group (64.7% +/- 12%; both p < 0.0001). Overall didactic assessment was significantly worse in the ICBT group when compared with the SMM and PM groups. CONCLUSIONS: For novices in heart surgery, ICBT was less motivating than traditionally structured content (SMM and PM). The ICBT did not improve performance in the operation room. However, both multimedia groups could better apply their knowledge during live surgery. The PM is as effective as multimedia when factual knowledge has to be retained.

Aortic Valve↗

Development and validation of an evaluation tool for multimedia resources in health education.

The last decade saw a rapid increase in the use of multimedia in health education. Easy availability, accessibility, low cost of technological resources and the expanding body of research on the role of multimedia in student learning, among others, have all contributed to this increase in usage. Since one of the roles of educators is to assess and select learning resources based on curriculum goals and student needs, the development of standardized methods for multimedia evaluation becomes vital. To the learner, it is important for reviews of the quality of the resource to be readily available. An evaluation too was developed based on the recognition of this need. The validity of the tool was tested using experts in technology and education. Reliability was determined using faculty and students who reviewed the same software, using the tool. In addition, graduate students reviewed two versions of a nursing program, of varying quality. The results indicate that the tool is reliable and valid. It is envisaged that this tool can be utilized by health educators for evaluating multimedia resources and setting up a much needed clearinghouse for health education resources.

CD-ROM↗

Evaluating the effectiveness of a multimedia program on home safety.

PURPOSE: This study was designed to test the effectiveness and acceptance of multimedia home safety programming by community-dwelling seniors. DESIGN AND METHODS: A prototype CD-ROM was produced that required no reading or computer skills because the program included an audio narration of content and directions for operating the program on a touchscreen computer monitor. Volunteers (N = 126) from a senior center aged 55 and older were randomly assigned to (1) a multimedia group that used the interactive program to learn about home safety, (2) a traditional learning group that read well-established booklets on home safety, and (3) a control group that received no instruction on safety between the pre- and posttests. RESULTS: Repeated-measures multivariate analysis of variance showed that the multimedia group was the only group to improve in knowledge. The group was also very satisfied with the approach. IMPLICATIONS: Multimedia formats can effectively and economically provide information to older clients.

Accidental Falls↗

An overview of a multimedia benchmarking analysis for three risk assessment models: RESRAD, MMSOILS, and MEPAS.

Multimedia modelers from the United States Environmental Protection Agency (EPA) and the United States Department of Energy (DOE) collaborated to conduct a detailed and quantitative benchmarking analysis of three multimedia models. The three models--RESRAD (DOE), MMSOILS (EPA), and MEPAS (DOE)--represent analytically-based tools that are used by the respective agencies for performing human exposure and health risk assessments. The study is performed by individuals who participate directly in the ongoing design, development, and application of the models. Model form and function are compared by applying the models to a series of hypothetical problems, first isolating individual modules (e.g., atmospheric, surface water, groundwater) and then simulating multimedia-based risk resulting from contaminant release from a single source to multiple environmental media. Study results show that the models differ with respect to environmental processes included (i.e., model features) and the mathematical formulation and assumptions related to the implementation of solutions. Depending on the application, numerical estimates resulting from the models may vary over several orders-of-magnitude. On the other hand, two or more differences may offset each other such that model predictions are virtually equal. The conclusion from these results is that multimedia models are complex due to the integration of the many components of a risk assessment and this complexity must be fully appreciated during each step of the modeling process (i.e., model selection, problem conceptualization, model application, and interpretation of results).

Air Pollutants↗

Instructional multimedia program versus standard lecture: a comparison of two methods for teaching the undergraduate orthodontic curriculum.

AIM: To compare the effectiveness of an interactive multimedia courseware package versus standard lectures regarding knowledge, understanding, and transfer of content, as well as problem-solving skills in orthodontics. METHODS: Pre- and post-test assessments of final-year dental students (n = 26), who either used an interactive multimedia courseware package (n = 15) or attended standard lectures (n = 11) on equivalent material of the undergraduate orthodontic curriculum were carried out. Both groups were tested by written and multiple-choice questions covering knowledge, understanding, and application areas in the curriculum. A one-way anova was carried out in order to check statistical difference between the two groups. The P-value was set at 0.05. RESULTS: There was no difference in prior knowledge between the groups at baseline. Generally, no significant difference was seen between the two groups in relation to answers to questions about knowledge, understanding, and application in the orthodontic curriculum. However, both groups improved their scores after the course. In one question investigating the extent of understanding the instructional content of the multidisciplinary orthodontic treatment, the multimedia courseware package group scored significantly better. CONCLUSION: In this study, the instructional interactive multimedia program was found to be at least as effective as the standard lecture of the orthodontic curriculum for undergraduate training in orthodontics.

Analysis of Variance↗

The use of multimedia in the informed consent process.

OBJECTIVE: The goal of the project was to create recommendations and design specifications for a multimedia tool to enhance the informed consent process for clinical trials. The authors focused on the needs of patients with potential cognitive impairment. DESIGN: The authors first performed a needs assessment using focus groups and interviews with health care researchers, institutional review board members, and three groups of patients (who had depression, breast cancer, or schizophrenia). Their feedback was incorporated into the design of a prototype multimedia tool. The design included general modules with information about clinical trials and informed consent as well as trial-specific modules. The authors then used the resulting prototype multimedia tool for informed consent in follow-up focus groups and interviews to obtain feedback on the feasibility and potential effectiveness of using such a tool routinely for clinical trials. RESULTS: The authors showed that it was feasible to adapt a structured multimedia informed consent system to a specific clinical trial and to incorporate techniques to improve the understandability of informed consent content. Patients generally felt the prototype system was useful and could replace the paper document. They felt using the system would be less stressful, because they would have a greater sense of control and could proceed at their own pace. They liked the hierarchic and modular approach to providing information and felt that the use of video made information more understandable. Researchers and institutional review board members also found the system to be valuable in these ways but had concerns about how to review the system for potential biases in presentation and about the legal issues associated with replacing the paper document.

Adult↗

Cancer cell biology: a student-centered instructional module exploring the use of multimedia to enrich interactive, constructivist learning of science.

Multimedia has the potential of providing bioscience education novel learning environments and pedagogy applications to foster student interest, involve students in the research process, advance critical thinking/problem-solving skills, and develop conceptual understanding of biological topics. Cancer Cell Biology, an interactive, multimedia, problem-based module, focuses on how mutations in protooncogenes and tumor suppressor genes can lead to uncontrolled cell proliferation by engaging students as research scientists/physicians with the task of diagnosing the molecular basis of tumor growth for a group of patients. The process of constructing the module, which was guided by scientist and student feedback/responses, is described. The completed module and insights gained from its development are presented as a potential "multimedia pedagogy" for the development of other multimedia science learning environments.

Biology↗

Internet-enabled interactive multimedia asthma education program: a randomized trial.

OBJECTIVE: To determine whether health outcomes of children who have asthma can be improved through the use of an Internet-enabled interactive multimedia asthma education program. METHODS: Two hundred twenty-eight children with asthma visiting a pediatric pulmonary clinic were randomly assigned to control and intervention groups. Children and caregivers in both groups received traditional patient education based on the National Asthma Education and Prevention Program. Intervention group participants received additional self-management education through the Interactive Multimedia Program for Asthma Control and Tracking. Pediatric Asthma Care Knowledge Survey, Pediatric Asthma Caregiver's Quality of Life Questionnaire, asthma symptom history, spirometry, and health services utilization data were collected at the initial visit and at 3 and 12 months. RESULTS: Interactive Multimedia Program for Asthma Control and Tracking significantly increased asthma knowledge of children and caregivers, decreased asthma symptom days (81 vs 51 per year), and decreased number of emergency department visits (1.93 vs 0.62 per year) among the intervention group participants. The intervention group children were also using a significantly lower average daily dose of inhaled corticosteroids (434 vs 754 micro g [beclomethasone equivalents]) at visit 3. Asthma knowledge of all 7- to 17-year-old children correlated with fewer urgent physician visits (r = 0.37) and less frequent use of quick-relief medicines (r = 0.30). CONCLUSIONS: Supplementing conventional asthma care with interactive multimedia education can significantly improve asthma knowledge and reduce the burden of childhood asthma.

Adolescent↗

Multimedia persistence as an indicator of potential for population-level intake of environmental contaminants.

Although intuitively it is apparent that population-level exposure to contaminants dispersed in the environment must be related to the persistence of the contaminant, there has been little effort to quantify this link formally. In this paper we investigate the relationship between overall persistence and/or overall residence time in a multimedia exposure environment and the population-level intake of contaminants as expressed by intake fraction (iF), the cumulative fraction of chemical emitted to the environment that is taken up by members of the population. We demonstrate that for any given contaminant and emission scenario the definition of iF implies that it is directly proportional to the overall multimedia persistence (Pov), or the overall multimedia residence time (Tov). The proportionality constant has dimensions of time and represents the characteristic time for population intake (CTI) of the chemical from the environment. We then apply the CalTOX fate and exposure model to explore how Tov and CTI combine to determine the magnitude of iF We find that CTI has a narrow range of possible values relative to Tov across multiple chemicals and emissions scenarios. We use data from the Canadian Environmental Protection Act Priority Substance List (PSL1) Assessments and multimedia Pov to show that exposure assessments based on empirical observation are consistent with interpretations from the model. Results indicate that Pov derived from screening-level assessments of persistence, bioaccumulation potential, and toxicity (PBT) is a useful indicator of the potential for population-level exposure.

Environmental Exposure↗

Telepathology applications of the Internet multimedia electronic mail.

Telepathology is based on the sharing of medical images coming from the microscope, and comprises different applications: intra-operative telediagnosis, second opinion teleconsultation, reference case archives, remote data and image processing, quality assessment. Since the Internet is available worldwide, it can be of interest to define which of these tasks can be performed by means of some telepathology method based on it. This paper focuses particularly on the use of Internet multimedia electronic mail for exchanging multimedia cases. To test the validity of the proposed approach for transmission of multimedia cases, the first step is to evaluate its diagnostic accuracy. Trials involving the transmission of 299 cases have been carried out between two departments of Pathology in Italy (at the University of Udine and at the City Hospital of Trento, respectively) in order to evaluate the diagnostic accuracy as well as the time needed for acquisition and transmission. First results show that good diagnostic agreement can be reached, but the time needed for transmission, generally low, is not sufficiently affordable to be adopted in those cases where time is important. In particular, telepathology through multimedia e-mail can be adopted for second opinion consultation, remote image processing, quality assessment and continuing education possibly by means of software that integrates acquisition and delivery of cases with HIS functionalities.

Evaluation Studies as Topic↗

[The effect of web-based multimedia contents for a course of physical examination and health assessment].

PURPOSE: This study was to test the effectiveness of Web-based multimedia contents for Physical Examination and Health Assessment on learning achievement. METHOD: Multimedia contents based on Jung's teaching and learning structure model were used to enhance learning achievement. Learning achievement was measured by the knowledge of Physical Examination and Health Assessment. The participants of this study were students in a BSN and RN-BSN program in a university located in Seoul. 59 students in the experimental group received lectures using web-based multimedia contents and 75 students in the control group received regular lectures. RESULTS: The mean score of the degree of educational achievement in the experimental group(mean=31.09) was significantly higher than in the control group(mean=25.55)(t=-3.883, p=.000). CONCLUSION: These web-based multimedia contents were found to maximizethe effectiveness of the teaching process when used as a teaching aid, and yet kept the strength of a face to face teaching learning method. This program is recommended as part of a main text, vital teaching aid or cyber lecture materials in nursing schools and in health care educational institutions.

Adult↗

Basic computing for dental practitioners: 6. Multimedia and communication.

This final article in the series on computing for dental practitioners examines multimedia and the Internet. Multimedia is one area where the greatest advances have been made in recent years; almost all PCs marketed today have multimedia capabilities and more and more software is being written with multimedia attributes.

Computer Graphics↗

Multimedia explorer: image database, image proxy-server and search-engine.

Multimedia plays a major role in medicine. Databases containing images, movies or other types of multimedia objects are increasing in number, especially on the WWW. However, no good retrieval mechanism or search engine currently exists to efficiently track down such multimedia sources in the vast of information provided by the WWW. Secondly, the tools for searching databases are usually not adapted to the properties of images. HTML pages do not allow complex searches. Therefore establishing a more comfortable retrieval involves the use of a higher programming level like JAVA. With this platform independent language it is possible to create extensions to commonly used web browsers. These applets offer a graphical user interface for high level navigation. We implemented a database using JAVA objects as the primary storage container which are then stored by a JAVA controlled ORACLE8 database. Navigation depends on a structured vocabulary enhanced by a semantic network. With this approach multimedia objects can be encapsulated within a logical module for quick data retrieval.

Computer Graphics↗

The interactive use of networking multimedia--innovative education resource for professionals and patients.

The combination of new and rapidly developing interactive multimedia computers and applications with electronic networks will require a restructuring of our traditional approach to strategic planning and organizational structure. Worldwide telecommunication networks (using satellites, cable) are now facilitating the global pooling of healthcare information and medical knowledge independent of location. The development of multimedia information and communication systems demands cooperative working teams of authors, who are able to master several areas of medical knowledge as well as the presentation of these in different multimedia forms. The assemblage of telematics and services offers a base for multimedia applications, for example teleteaching, telelearning, telepublishing, teleconsulting, teleconferencing, telemedicine etc. The expansion of the internet will also lead to the formation of interdisciplinary "Global Education Networks". The theory and practice of education are undergoing dramatic changes. Lifelong learning and adaptation of medical practice to new knowledge and new techniques will be even more important in the future.

Computer-Assisted Instruction↗

Multimedia-based courseware in the Virtual Learning Center at the Hannover Medical School.

The commercial use of the World Wide Web causes an extensive change in information technology. Web browser are becoming the universal front-end for all kinds of client-server applications. The possibilities of telematics offer a base for multimedia applications, for instance telelearning. Learning is not limited by geography and does not cause pressure of time by the user. The development of such multimedia information and communication systems demands cooperative working teams of authors, who are able to master several areas of medical knowledge as well as the presentation of these using different multimedia facilities. A very important part of graphic design in the context of multimedia applications is the creation and interactive use of images (still, moving). The growth and the complexity of medical knowledge as well as the need for continuous, fast, and economically feasible maintenance impose requirements on the media used for medical education and training. Web-based courseware in the Virtual Learning Center at the Hannover Medical School is an innovative education resource for medical students and professionals.

Computer-Assisted Instruction↗

Web-based multimedia courseware for emergency cardiac patient management simulations.

This is a multidisciplinary inter-departmental/faculty project between the departments of computer science, electronic, communications and electrical engineering and nursing and paramedic sciences. The objective is to develop a web based multimedia front end to existing simulations of cardiac emergency scenaria. It will be used firstly in the teaching of nurses. The University of Hertfordshire is the only University in Britain using simulations of cardiac emergency scenaria for nurse and paramedic science education and therefore this project will add the multimedia dimension in distributed courses over the web and will assess the improvement in the educational process. The use of network and multimedia technologies, provide interactive learning, immediate feedback to students' responses, individually tailored instructions, objective testing and entertaining delivery. The end product of this project will serve as interactive material to enhance experiential learning for nursing students using the simulations of cardiac emergency scenaria. The emergency treatment simulations have been developed using VisSim and may be compiled as C code. The objective of the project is to provide a web based user friendly multimedia interface in order to demonstrate the way in which patients may be managed in critical situations by applying advanced technological equipment and drug administration. Then the user will be able to better appreciate the concepts involved by running the VisSim simulations. The evaluation group for the proposed software will be the Department of Nursing and Paramedic Sciences About 200 nurses use simulations every year for training purposes as part of their course requirements.

Allied Health Personnel↗