Seifried, Steven E.

eVols at University of Hawaii at Manoa

Medical School HotlineTechnology-Based Delivery of PBLCurricular Elements at JABSOMSteven E. Seifried, PhDAssociate Professor of Physical BiochemistryDepartment of Genetics and Molecular BiologyJohn A. Burns School of Medicine - University ofHawaiiThe Internet browser and related technologies are uniquely suited toProblem Based Learning (PBL) curricula. The anytime, anywhereattributes of web-related resources make an especially strong matchwith the needs of the undergraduate medical student at JABSOM.This article outlines the current philosophy and implementation ofweb technology-based tools available to students during the first twoyears of the medical education program’. One of several visions offuture implementations will be outlined.The MD Program educational website is faculty-authored andadministered. Utilizing UH network ISP services, an in-house NTserver is the web presence provider. Faculty and students generatethe content. Platform- and browser-independent web pages aredesigned for a user with modest computing resources, commonindustry-standard software, and minimal telephone modem Internetservice. This enables access by students at home, internet-accessible clinical settings, and on campus. Expensive dedicatedtelemedicine equipment and high bandwidth access are not required.Three major roles are played by the current implementation of thewebsite: content delivery, communication, and professional development. The latter role is meant to prepare the student for theirfuture work environment. The students not only need to developtheir general computer skills for task tracking, data management,and communication, but they must also be aware of online resourcesand develop research skills. Importantly, the student must alsoaddress ethical issues relating to workplace behavior and computer-accessible patient data.Communication via the website is currently bi-directional andasynchronous. A public forum is maintained as a venue for opendiscussion among faculty and students regarding curricular contentand process, and any organizational business to be transacted in aclass-wide fashion. Administration and faculty post handbooks,schedules, and announcements for use by the students. Thesefunctions may also be carried out via e-mail messaging.A critical communication task is performed by representatives oftutorial groups that process faculty-written health care problems(HCPs). HCPs are the primary driver of the first two years of theJABSOM PBL experience and provide cues or opportunities for thestudents to generate learning issues (LIs). Routine posting of thegroup-defined LIs enables the faculty and administration to maintain quality, generate appropriate student assessment tools, andexamine the effectiveness of the HCPs. By inspecting the posted LIsfrom tutorial groups in the current and previous years studentssimultaneously self-achieve the seemingly disparate goals of reducing student anxiety and maintaining a standard of LI generation thatensures a sufficiently broad scope of content. This is consistent withthe philosophy and practice of the learner-centered PBL philosophyas it exits at JABSOM.The obvious utilization of a website in a PBL curriculum is todeliver content to the student. Images and sounds directly related tothe HCP are provided. Multimedia items add richness to the case,provide a closer approximation to a clinical simulation, and serve indirect support of the paper-based exposition of the HCP. Theseresources are not extensively annotated, and therefore serve thestudent as additional cues for LI generation.The JABSOM MD Program curriculum includes learning opportunities other than the HCP and tutorial process. Slides and notesfrom colloquia and seminars are solicited from presenting facultyfor inclusion on the website. Image-intensive pathology lab notebooks of figures and images are available, as are images of thespecimens encountered by the students in the laboratory. Public-spirited members of the student body often contribute these latterimages. An extensive text and image-laden website is nearingcompletion that contains the entire syllabus of the introductoryanatomy lab. This large resource consists of nearly 1000 linkedimages and is likely to be translated to CD-ROM, which will obviatethe image download wait time.An upcoming enhancement is a website designed to provide themedical or undergraduate student an interactive and searchabledatabase of research opportunities in the biomedical sciences andpublic health community. This site will be self-maintained byparticipating Principle Investigators via browser-based submissionforms to a back-end database. A broad invitation and instructionswill be forthcoming. Community participation as a student or hostsite is welcomed.The JAB SOM faculty continues to explore additional appropriateand effective computer and web-based technologies for use in itscurriculum. There is great potential, provided technology is balanced by a human component. Students, faculty, and administrationmust remain engaged at a physical and personal level to ensurequality of process, skills development, and content acquisition.Significant opportunities exist to increase the quality and consistency of the teaching and learning at JABSOM.The interactive delivery of an integrated HCP over the web hasmany exciting potentials. Tutorial groups can be exposed to apresentation of a case, complete with supporting multimedia, staticimages, and lab report forms. Students would be prompted to inputprioritized hypotheses and learning issues at appropriate juncturesin the case. Optionally. students could subsequently request preprepared virtual “online consults” that provide immediate expertfeedback on interpretation of images, lab results, and the diagnosticprocess. This mechanism would allow a consistent presentation ofthe case for all students without obviating the role of the tutorialgroup or tutor. Learning issues would still be generated, presented,and integrated into the case by the students with the aid and adviceof the tutor. By allowing the technology to assist in the facilitationof process, the tutor is freed to focus on the integration of biologicalmechanism, clinical skills, and psychosocial issues into the HCP.As the student abilities increase, the linear presentation and groupprocess are reduced; allowing individual sophisticated non-linearprocessing of HCPs in the more clinical years. These virtual cases(Continued on Page 284)HAWAB MEDKDAL JOURNAL, VOL 59, JUNE 2000240News and Notes Henry N. Yokoyama MDLife in These Parts...Recently Gov Cayetano proposed fluoridation ofour water supply.. and Council person ReneMansho voiced opposition.. The issue broughtback memories of 30 years ago when F{MAjoined Manuel Kau (chief, State Dental Officer)in proposing state wide foundation.. Our chiefopponent was “Doctor” Kondo of the HOJUKAI. . . (A popular Japanese lay health movement) Dr. Kondo was a retired English professor(No one made the distinction between professorand physician). We were involved with the HMAJapanese Speakers Bureau and agreed to helppromote fluoridation on Japanese radio and press.One memorable evening, we had Dr. Kau andShigeo Natoni on the KOHO Radio spreading thegospel of fluoridation.. .the telephone questionscame in hot and furious. One elderly lady asked,“If we don’t want fluoridated water, what can wedo?” Shigeo rose to the occasion: “You can digyour own well,” he joked.. .The radio listenerswere stunned.. .Poor Shigeo, for weeks thereafter, he received hate calls at office and home. . . Theanti-fluoridationists were victorious.. .They hadno sense of humor...Potpourri IA San Diego patolman pulled over a driver andtold him that because he was wearing his seat belt,he had won $5000 in a safety competition...“What are you going to do with the money?” theofficer asked.“I guess I’ll go to driving school and get mylicense,” the man answered.“Don’t listen to him,” said the woman in thepassenger seat. “He’s a smart aleck when he isdrunk.”This wakes up the guy in the back seat, who sawthe cop, “I knew we wouldn’t get far in a stolencar.Then there was a knock from the trunk and avoice in Spanish, “Are we over the border, yet?”“Funny Times”“Too many of us worry about the future.” Dr.Smith expained, “Why open the umbrella beforeit starts raining?”Psychiatrists don’t need to worry so long asother folks do.Potpourri IIMany years ago, I was doing my OB rotationwith a colleague who shared my surname, Porter.One night I was busy repairing an episiotomywith the lady in stirrups and in lithotomy position.A nurse looked into the room and said to me,“Mrs. S in Room 4 is bleeding. Will you have alook at her?”“She’ snot one of mine,” I replied, “You’ll haveto ask the other Porter.”My patient shrieked and almost levitated out ofthe stirrups.“Stop!” She commanded, “I want a doctor to dothis not a prir.”(Dr. Alan Porter, Victoria)Medical Tidbits...Estrogen & the Woman’s Heart: Most womendon’t have heart attacks till after menopause, butsupplemental estrogen doesn’t always protect theheart after menopause. At the American CollegeofCardiology Meeting in Anaheim, David Harrington of Wake Forest University School of Medicine reported on a study of 309 women with heartdisease. Estrogen by itself or in combination withprogestin had no effect on the plaques in women’scoronary arteries. (ie for 3 or 4 years.. .A largerstudy on the effects of estrogen will becomeavailable in 5 more years) The latest studies showthat estrogen actually increases heart problems inwomen during the first year and the heart benefitsbecome apparent only after three years...Good Reason to Ouit: A new study of 34 men whohad radiation for prostate cancer found that noneof the patients who smoked were potent 6 yearsafter treatment while 2/3 of those who didn’tsmoke remained potent.(This month’s News and Notes column has beencondensed due to space restraints.)Classified NoticesTo place a classified notice:HMA members—Please send a signed and typewritten ad to the HMA office. As a benefit of membership, HMA members may place a complimentary onetime classified ad in HMJ as space is available.Nonmembers.—Please call 536-7702 for a non-member form. Rates are $1.50 a word with a minimumof 20 words or $30. Not commissionable. Paymentmust accompany written order.Office SpaceALA MOANA BLDG.—PHYSICIANS WANTED to sharespace and support services. Interest in physical rehab.preferred. We have flexible rental arrangements starting at one half-day per week. Run your practice with nofixed overhead. Contact Dr. Speers, REHABILITATION ASSOCIATES, 955-7244.KAPIOLANI MEDICAL CENTER.—OFFICE SPACEavailable to share in the Kapiolani Medical Center. CallD. Venu Reddy, MD at 944-2002 or 942-7702.WantedPSYCHIATRIST.— Kaneohe residential Program foradolescents seeks consultanttwo half-days per month.Schedule, duties, compensation negotiable. ContactAdministrator: RAINBOW HOUSE 239-2399.(Medical School Hotline continued from p. 240)would decrease the impact of a limited or variable patient base during clinical rotations.The recordation of the group- or student-input learning issues, hypotheses and diagnosesallows for ongoing quantitative assessment of the student and the HCP. Because of thestudent-centered nature of the PBL philosophy, each student has a personal curriculum thatcould be described by the interactive submissions made during the online processing of theHCPs. This learning issue tracking would be a means for the student and advisor to assessthe individual’s coverage of material over the four years of school. Furthermore,administration can look at individual, inter- and intra-class learning issue distributions forquality assurance purposes.In recognition of the ever-increasing potentials of the Internet, JABSOM will expand itspresent use of digital technologies in an effective, efficient, user-friendly fashion toimprove the quality of its graduates.Reference1 This article does not address the significant graduate medical or telemedicine projects at JABSOM, norwill it detail the current or future versions of the JABSOM informational website at http:/fhawaiimedhawaiLedu.HAWAII PERMANENTE MEDICAL GROUP.— KaiserPermanente. Hawaii’s most established multi-specialty group of 300 physicians recruiting for:• BC/BE internal medicine hospitalists, staff andLocum Tenen positions available, servicing all hospitalized patients in 200-bed Kaiser hospital on Oahu,position(s) immediately available.• BC/BE general internist for busy outpatient clinic,inpatient duties (CCU/ICU/ventilator management) andcall, practice based in Kona on the Big Island (affiliatedwith Kona Community Hospital.) Position availablemid-August 2000.Applicants must have a commitment to quality care,patient advocacy, and involvement in patient andprofessional education, We offer competitive salary,comprehensive benefits, relocation assistance andmore.Send CV to: Physician Recruitment, HPMG, 3288Moanalua Road, Honolulu, HI 96819 or Fax (808)834-3994. EOEHAWAII MEDEDAL JOURNAL, VOL 59, JUNE 2000284

Technology-based delivery of PBL curricular elements at JABSOM.

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Technology-based delivery of PBL curricular elements at JABSOM.

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