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PubMed1994

The multimedia textbook. A revolutionary tool for pediatric education.

Textbooks are now available via computers. These new electronic or multimedia textbooks appears similar to conventional books but differ in function. In addition to text and images, they contain video and audio clips and allow readers to interact with the content. Multimedia textbooks contain digital media, can be quickly and inexpensively updated and repurposed for lectures and handouts, and are available on-line via computer networks for distance learning. We present the concept of computer-generated multimedia text-books; describe their creation by an easy-to-use, sophisticated authoring system; and describe the underlying instructional design approach to guide future authors of multimedia textbooks.

Computer-Assisted Instruction↗

PubMed1989

A multimedia medical communication link between a radiology department and an emergency department.

The most critical aspect of a radiologist's work is communicating his findings to the attending physician responsible for the patient's care. This is also the part of the process that is least well organized and the most subject to failure. At the University of Ottawa Medical Communications Research Centre we are investigating technical means to improving communications between radiologists and attending physicians. We first introduce the radiology communication service problem and show why it is essentially a multimedia communication problem. We then briefly describe a multimedia communication system designed and implemented by our research team. The multimedia system consists of several work stations linked by the Hospital's local area network (LAN). Each physician work station comprises a Compaq 386/20-Mhz microcomputer with 16 Mbytes of RAM, a 500-Mbyte image disk, and an image memory that drives a 1,000-line monochrome monitor. The images are digitized using a Konica laser-based film digitizer (2430 by 2000 10-bit pixels for a standard chest radiograph). The multimedia file server manager station is built around a PC-AT compatible with a Northern Telecom Meridian SL-1ST digital PBX and a Meridian Mail digital voice messaging system. This last device is used to store voice data and is linked via the PBX to the workstations' digital telephones. A Sytek 6,000 LAN links all work stations to the file server. All data, image, and graphic information is transmitted via this network, while the twisted pair connections linking the digital PBX to the telephone sets are used for transmitting voice data.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗

PubMed1996

CD-ROM multimedia. The step before virtual reality.

Applications developed using key multimedia elements are finding their way into a number of training and information exchange environments including the laparoscopy training market. Emerging multimedia-based applications range from procedural information for patients to interactive CD-ROM-based applications used to train highly skilled surgeons. These products are designed with a high level of interactivity that allows the surgeon to plan a surgical procedure, review detailed patient information and then merge that information into the surgical planning process. Using this new technology, a surgeon now has the ability to review CD-ROM-based course materials and efficiently meet continuing education requirements. The factor found most limiting in the development of multimedia-based applications for laparoscopy training is generally not the technology, but the limits placed on the technology because of one's reluctance to think beyond what is accepted as the norm. Properly implemented, multimedia applications developed for laparoscopy training reduce the cost and time associated with learning new materials, assist a user in retaining more of the information reviewed, and in many cases make the learning experience much more enjoyable.

Audiovisual Aids↗

PubMed1995

Multimedia clinical examination: the time honoured art and science mirrored digitally.

In the recent years, multimedia has exhibited a tremendous presence in the personal computer market and it has exerted an influence in our homes and teaching institutions as well. To define it very simply, a multimedia PC is a personal computer capable of producing images and sound of reasonable quality by means of software toggles. This paper presents an Asymetrix Multimedia Toolbook application entitled Multimedia Clinical Examination (MCE) which harnesses the ability of affordable computers to create and display a variety of audiovisual media to supplement 'bed-side teaching' of elementary clinical methods which includes history taking and physical examination. MCE comprises a history taking module which helps in keeping track of the possible differential diagnoses and a physical examination module which shows digital videos of appropriate examination steps. The application runs on the Microsoft Windows platform.

Audiovisual Aids↗

PubMed1996

The use of multimedia computer-based patient records in ambulatory care.

The use of a multimedia computer-based patient record (CPR) within ambulatory care is a topic that has not achieved widespread understanding or acceptance. However, if the topic is divided into its parts, multimedia and computer-based patient record, it reflects both highly recognizable and desirable goals that most health care organizations are undertaking. Multimedia technology is quickly maturing. In addition, the goal of attaining a CPR is of primary interest to most health care organizations. It is inevitable that these two technologies will eventually become synergistic. This article presents the case for a multimedia ambulatory CPR and describes one example of this happy marriage.

Ambulatory Care Information Systems↗

PubMed2002

Intake fraction for multimedia pollutants: a tool for life cycle analysis and comparative risk assessment.

We employ the intake fraction (iF) as an effective tool for expressing the source-to-intake relationship for pollutant emissions in life cycle analysis (LCA) or comparative risk assessment. Intake fraction is the fraction of chemical mass emitted into the environment that eventually passes into a member of the population through inhalation, ingestion, or dermal exposure. To date, this concept has been primarily applied to pollutants whose primary route of exposure is inhalation. Here we extend the use of iF to multimedia pollutants with multiple exposure pathways. We use a level III multimedia model to calculate iF for TCDD and compare the result to one calculated from measured levels of dioxin toxic equivalents in the environment. We calculate iF for emissions to air and surface water for 308 chemicals. We correlate the primary exposure route with the magnitudes of the octanol-water partition coefficient, Kow, and of the air-water partitioning coefficient (dimensionless Henry constant), Kaw. This results in value ranges of Kow and Kaw where the chemical exposure route can be classified with limited input data requirements as primarily inhalation, primarily ingestion, or multipathway. For the inhalation and ingestion dominant pollutants, we also define empirical relationships based on chemical properties for quantifying the intake fraction. The empirical relationships facilitate rapid evaluation of many chemicals in terms of the intake. By defining a theoretical upper limit for iF in a multimedia environment we find that iF calculations provide insight into the multimedia model algorithms and help identify unusual patterns of exposure and questionable exposure model results.

Algorithms↗

PubMed2003

Content-based searching of multimedia databases by use of approximate digital signatures.

We propose the use of approximate digital signatures of selected multimedia feature vectors for fast content-based retrieval in large multimedia databases. We adapt and extend the approximate message authentication code (AMAC), introduced by some of the authors recently in the area of message authentication, to the multimedia searching problem. An AMAC is a binary signature with the ability to reflect changes in the message it represents. The Hamming distance between two AMACs is used to measure the degree of the similarity between multimedia objects. We develop a method to compress AMAC signatures to create a direct look-up table that allows for fast searching of a database. The color histogram is used as the example feature space to show how the signature is applied. Experimental results show that the performance of the proposed method is comparable with existing methods based on other popular metrics, but it significantly decreases search time.

Journal Article↗

PubMed1999

Teaching medical students cancer risk reduction nutrition counseling using a multimedia program.

BACKGROUND AND OBJECTIVES: There are many barriers to medical students receiving education about the linkage between nutrition and cancer, including the lack of role models and teachers and insufficient curricular time. We tested the use of a multimedia program as a possible solution to teaching diet-risk assessment and counseling skills. METHODS: Images of Cancer Prevention, The Nutrition Link is a CD-ROM multimedia program that was developed and evaluated by 147 medical students. Pre-use and post-use surveys, computer log files, and recorded response sessions were used to determine the learner's 1) ease in using the program, 2) attitudes about the treatment of the content, 3) knowledge gain, and 4) attitudes about the role of physicians in nutrition assessment and counseling for cancer risk reduction. RESULTS: Students improved their knowledge of dietary guidelines for cancer risk reduction and made positive changes in their attitudes toward the role of physicians in dietary counseling. However, most students reported that they would not use the program unless it was required that they do so. CONCLUSIONS: The multimedia program was successful; it affected students' knowledge and attitudes concerning nutrition as a modifiable risk factor for some cancers. In addition, the design and delivery of the multimedia product was positively reviewed by the students for ease of access, message design, individualized instruction, and flexibility. Despite these favorable ratings, it was not clear that students would use the program unless required to do so.

Health Knowledge, Attitudes, Practice↗

PubMed2000

[Multimedia (visual collaboration) brings true nature of human life].

Videoconferencing system, high-quality visual collaboration, is bringing Multimedia into a society. Multimedia, high quality media such as TV broadcast, looks expensive because it requires broadband network with 100-200 Mpbs bandwidth or 3,700 analog telephone lines. However, thanks to the existing digital-line called N-ISDN (Narrow Integrated Service Digital Network) and PictureTel's audio/video compression technologies, it becomes far less expensive. N-ISDN provides 128 Kbps bandwidth, over twice wider than analog line. PictureTel's technology instantly compress audio/video signal into 1/1,000 in size. This means, with ISDN and PictureTel technology. Multimedia is materialized over even single ISDN line. This will allow doctor to remotely meet face-to-face with a medical specialist or patients to interview, conduct physical examinations, review records, and prescribe treatments. Bonding multiple ISDN lines will further improve video quality that enables remote surgery. Surgeon can perform an operation on internal organ by projecting motion video from Endoscope's CCD camera to large display monitor. Also, PictureTel provides advanced technologies of eliminating background noise generated by surgical knives or scalpels during surgery. This will allow sound of the breath or heartbeat be clearly transmitted to the remote site. Thus, Multimedia eliminates the barrier of distance, enabling people to be just at home, to be anywhere in the world, to undergo up-to-date medical treatment by expertise. This will reduce medical cost and allow people to live in the suburbs, in less pollution, closer to the nature. People will foster more open and collaborative environment by participating in local activities. Such community-oriented life-style will atone for mass consumption, materialistic economy in the past, then bring true happiness and welfare into our life after all.

Endoscopy↗

PubMed2003

Comparative assessment of two interfaces for delivering a multimedia medical course in the French-speaking Virtual Medical University (UMVF).

The UMVF aims at helping medical students during their normal curriculum via the facilities provided by Internet based techniques. This paper describes a comparative assessment of two interfaces delivering a multimedia course: a conventional web server (WS) and an integrated e-learning platform in the form of a Virtual Campus (VC). Eleven students were arbitrarily divided into two groups. We used a qualitative method for comparing their acceptance of the on line course provided by the two different interfaces. The two groups were globally satisfied. However, a decrease in satisfaction was noted at the end of the experimentation in the VC group. This may be explained by a more complex Graphical User Interface (GUI) of the VC and some constraints which do not exist with the WS. The current e-learning platforms are probably not optimised for working conditions where presential and virtual activities are mixed. We think that a new type of "light" platforms should be developed for these specific working conditions. Students of the two groups also had limitations about the multimedia environment. They may change their opinion if they get more accustomed with the multimedia environment and if their teachers make a more adequate use of the multimedia techniques.

Academic Medical Centers↗

PubMed1992

Multimedia for clinical education in myocardial perfusion imaging.

Interactive multimedia has many advantages as a presentation medium for diagnostic imaging case studies, particularly for teaching digital imaging techniques such as myocardial perfusion imaging. Multimedia documents may incorporate interactive audiovisual presentations, sophisticated diagnostic images, anatomical illustrations, and text in medical instructional materials. The article describes a multimedia teaching atlas of SPECT and planar myocardial perfusion imaging delivered on Apple Macintosh II microcomputers, and discusses some of the advantages of delivering medical educational materials with interactive multimedia techniques.

Computer-Assisted Instruction↗

PubMed1995

Multimedia cardiac catheterization record document system.

In this paper, we present the design and implementation of a multimedia cardiac catheterization record (CCR) system. A traditional CCR contains medical report, electrocardiograms, X-ray images, and possibly video sequences for angiograms. The physicians found it difficult to access and manage these multimedia information easily. Current advances in multimedia technology has made possible the authoring, storage and presentation of these medical information in a systematic and easily-accessible way. This paper discusses the background and rationale that led to the design and implementation of a cost-effective multimedia medical document system framework and prototype.

Cardiac Catheterization↗

PubMed1997

Filmless multimedia display following cardiac catheterization.

In traditional cardiac catheterization laboratories, anatomic images are acquired onto 35-mm cine film and presented in series with related information days, weeks, or months later to an audience of decision-makers. These data are projected onto a convenient light-colored wall or silver screen, while echocardiograms and electrophysiologic data are displayed using small single-user computer monitors. This presentation format is not ideal, because full audience participation is not fostered, image quality may be degraded, and small computer screens can be adequataly visualized only by those individuals immediately in front of them. Modern video multimedia systems now make an ideal data presentation format practical, in which all types of media including digitally acquired angiograms can be displayed in parallel with full annotation, using large diagonal multisync color monitors. This communication discusses how to design a multimedia conference center in which remotely acquired filmless digital images can be displayed and processed together with all other pertinent cardiac multimedia to a large audience.

Cardiac Catheterization↗

PubMed1999

The clinical display of radiologic information as an interactive multimedia report.

We regard the delivery of radiological information as an interactive multimedia report. We use a multimedia report model based on Extensible Markup Language (XML), rather than a traditional workstation model. Others have suggested a similar document-based approach. This display presentation includes image-related and text-based information and may contain interactive components (e.g., window, level and zoom). Using XML as a foundation for this multimedia presentation, we achieve flexibility and platform independence at a lower cost. XML allows for the separation of content and form. Content information, defined as elements (e.g., images, radiologic reports, and demographic information), is treated as independent information objects. The behavior of the elements can be changed for different users and tasks. In addition, by separating format detail from content, the appearance of the elements within the report can be modified. XML does not replace existing standards (i.e., Digital Imaging and Communications in Medicine [DICOM], Transmission Control Protocol/Internet Protocol [TCP/IP]). Instead, it provides a powerful framework that is used in combination with existing standards to allow system designers to modify display characteristics based on user need. We describe our application of XML to the clinical display of radiologic information.

Computer Systems↗

PubMed2002

Formative evaluation of a multimedia program for patients about the side effects of cancer treatment.

Formative evaluation of multimedia programs can prevent costly and time-consuming revisions and result in more effective programs. Yet systematic formative evaluation is seldom conducted. This paper reviews the basic principles of formative evaluation and describes how we applied those principles to the formative evaluation of a multimedia program for patients about the side effects of cancer treatment. It discusses the challenges of developing multimedia programs for patients and provides guidance to other health professionals interested in developing programs on other topics.

Humans↗

PubMed1998

Multimedia system based on programmed instruction in medical genetics: construction and evaluation.

A multimedia system used as an auxiliary didactic tool for teaching medical genetics, HGEN, is based on non-linear programmed instruction and multimedia. HGEN was implemented in layers for PC compatible using MULTIMEDIA TOOLBOOK and DELPHI. It includes basic medical genetics concepts (inheritance patterns and cytogenetics) and it is based on multiple choice questions with images, diagrams and animations. The student-program interaction occurs by choosing an alternative in a question and receiving a specific answer as feedback and additional information. Links send the students to a glossary, to short descriptions of diseases used as examples, or to references for further studies. In order to evaluate the performance of the HGEN the authors used two questionnaires: (a) about the students' background in using computers; and (b) the system efficiency as a didactic tool, the software quality and user satisfaction. HGEN was used by 63 students from three medical schools and it was considered efficient as a learning tool (100%). Furthermore the implementation of a navigation map for frequencies analysis of followed path enable the study to detect structure and content inadequacies that could be correct for version 1.1 and proved to be an efficient tool to optimize a didactic software.

Computer-Assisted Instruction↗

PubMed2003

Chemical-specific representation of air--soil exchange and soil penetration in regional multimedia models.

In multimedia mass-balance models, the soil compartment is an important sink as well as a conduit for transfers to vegetation and shallow groundwater. Here a novel approach for constructing soil transport algorithms for multimedia fate models is developed and evaluated. The resulting algorithms account for diffusion in gas and liquid components; advection in gas, liquid, or solid phases; and multiple transformation processes. They also provide an explicit quantification of the characteristic soil penetration depth. We construct a compartment model using three and four soil layers to replicate with high reliability the flux and mass distribution obtained from the exact analytical solution describing the transient dispersion, advection, and transformation of chemicals in soil layers with different properties but a fixed boundary condition at the air-soil surface. The soil compartment algorithms can be dynamically linked to other compartments (air, vegetation, groundwater, surface water) in multimedia fate models. We demonstrate and evaluate the performance of the algorithms in a model with applications to benzene, benzo[a]pyrene, MTBE, TCDD, and tritium.

Air Pollutants↗

PubMed2002

Teaching paediatric dentistry by multimedia: a three-year report.

Clinical cases can now be simulated utilising multimedia and used to teach case management to dental students. The modules developed should provide intellectual stimulation, user-interaction and immediate feedback, in addition to being intuitively navigated and user-helpful. Five paediatric dental case modules (early childhood caries, anterior trauma, anterior coronal fragment, anterior crossbite and dentigerous cyst) were created, installed in a multimedia presentation tool, PathFinder (from Westmead Hospital Dental Clinical School, New South Wales, Australia), and used to teach three classes of fourth year dental students at The University of Melbourne. Questionnaires, focus groups and a review were conducted by an external educational expert. Students responded anonymously to general learning questions and case specific questions using a five-point Likert scale (strongly agree to strongly disagree). Student responses indicated they were very enthusiastic about learning via multimedia, although a few students disliked this educational approach. Focus groups and external review indicated that the modules were navigated readily and were suitably interactive.

Case Management↗