Evaluation of an interactive case simulation system in dermatology and venereology for medical students

BACKGROUND: Most of the many computer resources used in clinical teaching of dermatology and venereology for medical undergraduates are information-oriented and focus mostly on finding a "correct" multiple-choice alternative or free-text answer. We wanted to create an interactive computer program, which facilitates not only factual recall but also clinical reasoning. METHODS: Through continuous interaction with students, a new computerised interactive case simulation system, NUDOV, was developed. It is based on authentic cases and contains images of real patients, actors and healthcare providers. The student selects a patient and proposes questions for medical history, examines the skin, and suggests investigations, diagnosis, differential diagnoses and further management. Feedback is given by comparing the user's own suggestions with those of a specialist. In addition, a log file of the student's actions is recorded. The program includes a large number of images, video clips and Internet links. It was evaluated with a student questionnaire and by randomising medical students to conventional teaching (n = 85) or conventional teaching plus NUDOV (n = 31) and comparing the results of the two groups in a final written examination. RESULTS: The questionnaire showed that 90% of the NUDOV students stated that the program facilitated their learning to a large/very large extent, and 71% reported that extensive working with authentic computerised cases made it easier to understand and learn about diseases and their management. The layout, user-friendliness and feedback concept were judged as good/very good by 87%, 97%, and 100%, respectively. Log files revealed that the students, in general, worked with each case for 60–90 min. However, the intervention group did not score significantly better than the control group in the written examination. CONCLUSION: We created a computerised case simulation program allowing students to manage patients in a non-linear format supporting the clinical reasoning process. The student gets feedback through comparison with a specialist, eliminating the need for external scoring or correction. The model also permits discussion of case processing, since all transactions are stored in a log file. The program was highly appreciated by the students, but did not significantly improve their performance in the written final examination

The role of multimedia in cognitive surgical skill acquisition in open and laparoscopic colorectal surgery

Introduction: Changing work patterns have led to reduction in training hours with potential to affect surgical skills training. Multimedia can be used to supplement cognitive surgical skills training outside the operating room. A systematic review of 21 studies on the role of multimedia in surgical training and assessment demonstrated that multimedia effectively facilitates acquisition of surgical skills and was associated with significant improvement in technical skills and cognitive skills. The aim of this project was to design and develop a multimedia educational tool in anterior resection surgery and evaluate the effectiveness of this tool in teaching and assessment of cognitive surgical skills. Methods: An online multimedia application was developed by filming multiple procedures; editing films into key procedural steps using cognitive task analysis; and integration onto a navigational interface platforms. All steps were supplemented with animation, text and voiceover. A randomised control trial was conducted to evaluate the effectiveness of online multimedia in comparison to conventional teaching in cognitive surgical skills acquisition. All trainees were assessed before and after the study period. Results: Of 59 trainees recruited, 52 completed pre-test assessments. Data from 43 trainees was available for final analysis. Baseline pre-assessment scores were similar in both groups. Senior trainees achieved significantly higher pre-test mean scores compared to junior trainees (p<0.01). Post-test scores improved significantly in both groups and the mean change in scores in the multimedia group was higher (6.60, SD 5.10) compared to the control group (4.89, SD 3.66) was not statistically significant (p=0.21). In the multimedia group 67% strongly agreed the tool was a useful adjunctive educational resource. 67% and 88% of trainees felt their cognitive surgical skills improved. Conclusions: Multimedia is an effective self-directed learning resource for cognitive skill acquisition in colorectal surgery and is well accepted as a training tool outside the operating room

Multi media applications in medical education : evaluation of an interactive CD-ROM on practical skin wound management for medical undergraduate learning

Thesis (M.S.) -- University of Adelaide, Dept. of Surgery, 199

Instruction with 3D Computer Generated Anatomy

Research objectives. 1) To create an original and useful software application; 2) to investigate the utility of dyna-linking for teaching upper limb anatomy. Dyna-linking is an arrangement whereby interaction with one representation automatically drives the behaviour of another representation. Method. An iterative user-centred software development methodology was used to build, test and refine successive prototypes of an upper limb software tutorial. A randomised trial then tested the null hypothesis: There will be no significant difference in learning outcomes between participants using dyna-linked 2D and 3D representations of the upper limb and those using non dyna-linked representations. Data was analysed in SPSS using factorial analysis of variance (ANOVA). Results and analysis. The study failed to reject the null hypothesis as there was no signi cant di fference between experimental conditions. Post-hoc analysis revealed that participants with low prior knowledge performed significantly better (p = 0.036) without dyna-linking (mean gain = 7.45) than with dyna-linking (mean gain = 4.58). Participants with high prior knowledge performed equally well with or without dyna-linking. These findings reveal an aptitude by treatment interaction (ATI) whereby the effectiveness of dyna-linking varies according to learner ability. On average, participants using the non dyna-linked system spent 3 minutes and 4 seconds longer studying the tutorial. Participants using the non dyna-linked system clicked 30% more on the representations. Dyna-linking had a high perceived value in questionnaire surveys (n=48) and a focus group (n=7). Conclusion. Dyna-linking has a high perceived value but may actually over-automate learning by prematurely giving novice learners a fully worked solution. Further research is required to confirm if this finding is repeated in other domains, with different learners and more sophisticated implementations of dyna-linking

Building capacity in climate change policy analysis and negotiation: methods and technologies

Capacity building is often cited as the reason “we cannot just pour money into developing countries” and why so many development projects fail because their design does not address local conditions. It is therefore a key technical and political concept in international development. Some of the poorest countries in the world are also some of the most vulnerable to the impacts of climate change. Their vulnerability is in part due to a lack of capacity to plan and anticipate the effects of climate change on crops, water resources, urban electricity demand etc. What capacities do these countries lack to deal with climate change? How will they cope? What steps can they take to reduce their vulnerability? This innovative and high-profile research project was part of a larger project (called C3D) and conducted with non-governmental organisations in Senegal, South Africa and Sri Lanka. The research involved several participatory workshops and a questionnaire to all three research centres

HAPTIC AND VISUAL SIMULATION OF BONE DISSECTION

Marco AgusIn bone dissection virtual simulation, force restitution represents the key to realistically mimicking a patient– specific operating environment. The force is rendered using haptic devices controlled by parametrized mathematical models that represent the bone–burr contact. This dissertation presents and discusses a haptic simulation of a bone cutting burr, that it is being developed as a component of a training system for temporal bone surgery. A physically based model was used to describe the burr– bone interaction, including haptic forces evaluation, bone erosion process and resulting debris. The model was experimentally validated and calibrated by employing a custom experimental set–up consisting of a force–controlled robot arm holding a high–speed rotating tool and a contact force measuring apparatus. Psychophysical testing was also carried out to assess individual reaction to the haptic environment. The results suggest that the simulator is capable of rendering the basic material differences required for bone burring tasks. The current implementation, directly operating on a voxel discretization of patientspecific 3D CT and MR imaging data, is efficient enough to provide real–time haptic and visual feedback on a low–end multi–processing PC platform.

Educational hypermedia resources facilitator

Se analiza el impacto que la enseñanza en web ha tenido en la educación superior y las distintas herramientas que permiten la creación de documentos hipertexto como recursos de enseñanzaWithin the university the introduction of computers is creating a new criterion of differentiation between those who as a matter of course become integrated in the technocratic trend deriving from the daily use of these machines and those who become isolated by not using them. This difference increases when computer science and communications merge to introduce virtual educational areas, where the conjunction of teacher and pupil in the space-time dimension is no longer an essential requirement, andwhere the written text is replaced (or rather complemented) by the digital text. In this article a historical defence is made of the presence of this new standard in the creation of digital educational resources such as the hyperdocument, as well as the barriers and technological problems deriving from its use. Furthermore, HyCo, an authoring tool, is introduced which facilitates the composition of hypertexts, which arestored as semantic learning objects, looking for that through of a simple and extremely intuitive interface and interaction model, any teacher with a minimum knowledge of computer science has the possibility of transforming his or her experience and knowledge into useful and quality hypermedia educational resources

Information Interface - Volume 30, Issue 1 - January/February 2002

News and information about Himmelfarb Health Sciences Library of interest to users

Distant Operational Care Centre: Design Project Report

The goal of this project is to outline the design of the Distant Operational Care Centre (DOCC), a modular medical facility to maintain human health and performance in space, that is adaptable to a range of remote human habitats. The purpose of this project is to outline a design, not to go into a complete technical specification of a medical facility for space. This project involves a process to produce a concise set of requirements, addressing the fundamental problems and issues regarding all aspects of a space medical facility for the future. The ideas presented here are at a high level, based on existing, researched, and hypothetical technologies. Given the long development times for space exploration, the outlined concepts from this project embodies a collection of identified problems, and corresponding proposed solutions and ideas, ready to contribute to future space exploration efforts. In order to provide a solid extrapolation and speculation in the context of the future of space medicine, the extent of this project's vision is roughly within the next two decades. The Distant Operational Care Centre (DOCC) is a modular medical facility for space. That is, its function is to maintain human health and performance in space environments, through prevention, diagnosis, and treatment. Furthermore, the DOCC must be adaptable to meet the environmental requirements of different remote human habitats, and support a high quality of human performance. To meet a diverse range of remote human habitats, the DOCC concentrates on a core medical capability that can then be adapted. Adaptation would make use of the DOCC's functional modularity, providing the ability to replace, add, and modify core functions of the DOCC by updating hardware, operations, and procedures. Some of the challenges to be addressed by this project include what constitutes the core medical capability in terms of hardware, operations, and procedures, and how DOCC can be adapted to different remote habitats