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At least 19 recordsLinked to original sources

Electronic imaging in endoscopy.

Endoscopy evolved from a hollow tube view of visually restricted areas into an expansive, distal representation of the anatomy. Rod lens telescopes, improved coherent imaging bundles, superior light sources, and other optical advances enhanced endoscopic observations. Yet complicated endoscopic procedures remained visible to the endoscopist alone, relegating assistance and consultation to verbal description of sophisticated visual observation. Instrumentational advances alone did not promote three crucial elements: participation, cooperation and documentation. The importance of these elements has increased with the need for coordinated assistance in complex operative endoscopic manipulations, as well as in a visual record for improved documentation and consultation. New imaging technologies are supplanting the unwieldy, often daunting equipment once required for photodocumentation. The charged couple device (CCD) 2/3 and 1/2 in. "chip" video camera miniaturization provides nearly weightless TV coobservation. Distal chip placement has created the "video endoscope". Combined with the 8 mm tape format, the chip has created a lightweight, single unit camera, monitor, and recorder. A recent advantage, magnetic disc recording, permits still video storage of up to 25 images. An electronic printer produces a hard color copy (4 x 5), which is inserted in the chart before the patient leaves the endoscopy room. The cost of the equipment can be shared in multidisciplinary institutions.

Costs and Cost Analysis

AI/LEARN: an interactive videodisk system for teaching medical concepts and reasoning.

This paper describes AI/LEARN, an educational videodisk system designed to teach clinical observational skills and reasoning in medicine. The AI/LEARN system uses a learning conditions approach to teaching. To teach visual concepts, we use the principle of exemplar/nonexemplar pairs and immediate feedback. To teach If-Then problem solving we use the format of minicases with delayed feedback. The software to operate the system has been custom developed and is domain independent. The result is a prototype of a new authoring package for videodisk teaching which operates on IBM compatible microcomputers. The medical domain selected for this prototype system was rheumatic diseases; the knowledge used to teach reasoning skills is derived from the knowledge base of an expert system: AI/RHEUM.

Computer Systems

Sources of variability in speechreading sentences: a generalizability analysis.

Generalizability theory (Cronbach, Gleser, Nanda, & Rajaratnam, 1972) was used to estimate the percentage of variance explained by three sources of variability in speechreading sentences: the subject, the talker, and the sentence materials. Videodisc recordings of the 100 CID Everyday Sentences (Davis & Silverman, 1970), spoken by a male and a female talker, were presented to 104 subjects with normal hearing. For performance on individual sentences (total number of words correct), the most important systematic sources of variability were the sentence (26.3%), the speechreader (10.5%), the talker (4.9%), and the interaction of talker and sentence (5.1%). Residual error accounted for 51.2% of the variance. Generalizability functions are presented, as a function of test length, for five models of test administration and interpretation. For 10-, 50-, and 100-item lists, generalizability is predicted to be .70, .92, and .96, respectively, for a single talker. Psychometric characteristics of these recordings of the CID sentences are also presented.

Adolescent

Microcomputers, interactive videodisks, and psychodynamic simulations.

Recent endeavors have applied microcomputers and interactive laser/optical videodisks to create simulations of psychodynamic processes. This paper briefly describes the technical aspects of microcomputers and videodisks, explores attributes and drawbacks of these simulation systems, and outlines future directions toward the ideal psychodynamic simulation.

Computers

CD-ROM MEDLINE use and users: information transfer in the clinical setting.

Effective delivery of biomedical information to health professionals depends on the availability of systems that are compatible with the information-seeking patterns of health professionals. MEDLINE is a major source of biomedical information, but has been available primarily through libraries via telecommunications networks. The recent availability of MEDLINE on CD-ROM has made it possible to provide MEDLINE directly to clinicians without the associated problems of telecommunications and online use charges. The MEDLINE on CD-ROM Evaluation Forum sponsored by the National Library of Medicine reported on clinicians' use of CD-ROM MEDLINE at seven different clinical settings. This article summarizes the findings from these sites and places them in the context of current understanding of information-seeking behaviors of health professionals. Key issues in the design and development of information technologies in the clinical setting are also articulated.

Ambulatory Care Information Systems

Monitoring patron use of CD-ROM databases using SignIn-Stat.

SignIn-Stat, a PC-based, menu-driven program, collects information from users of the library's public access computer systems. It was used to collect patron use data for the library's four CD-ROM workstations for the period September 1987 to April 1988 and to survey users for the period December 1987 to March 1988. During the sample period, 5,909 CD-ROM uses were recorded. MEDLINE was the most heavily used database, followed by PsycLIT and Micromedex CCIS. Students accounted for 61% of the use, while faculty, residents, and staff were responsible for 31%. Graduate students had the highest rate of use per student. Nineteen percent of use was by patrons who had never used CD-ROMs before, while 37% was by patrons who had used CD-ROMs ten or more times. Residents were the least experienced user group, while graduate students and faculty were the most experienced.

Faculty

Factors influencing the development and use of interactive video in nursing education. A Delphi study.

The purpose of this study was to identify factors impeding development and use of interactive video (IAV) in nursing education in order to specify actions that would facilitate its development and use. Nurse educators with experience in development of IAV programs were defined as the experts, and a three-round Delphi study was conducted. Study findings revealed that participants were aware of obstacles to development and were able to suggest some ways to overcome them. Subjects clearly identified content they want in IAV programs, and were especially united on applications for simulations. They agreed on benefits of IAV for students, but were less certain about how it might affect faculty roles, and were undecided about measurable advantages of IAV. Conservative predictions were made about how evolving IAV technology might change the process of nurse education in the future. To promote IAV development and use the author recommends cooperative efforts between nurse educators and developers in the business sector and an educational thrust targeted for specific groups. Moving beyond existing nursing roles and institutional models, the author makes two major suggestions: establishment of a new nursing specialist, the nurse/instructional designer, and the creation of an information center staffed by these new specialists who will design and develop programs, provide education and consultation, maintain a clearinghouse for IAV programs, research, and technology, and take a leadership role in the integration of this powerful instructional delivery system into the entire health field.

Communication

[Video-endoscopy--a new step in diagnosis].

The first fiberoptic endoscope was introduced 30 years ago. It has since become an increasingly important diagnostic tool in the field of gastroenterology and pulmonary diseases. The advances in semiconductor technology have enabled the construction of video endoscopic systems. It is thereby possible to improve the optical performance and easily produce documents and hardcopies from graphic information. Computer aided endoscopy brings a new dimension of efficiency into clinical endoscopy routines and research.

Bronchoscopy