[Computer-based training--a new method in surgical education and continuing education]

Computer-Assisted Learning Applications in Health Educational Informatics: A Review

Computer-assisted learning (CAL) as a health informatics application is a useful tool for medical students in the era of expansive knowledge bases and the increasing need for and the consumption of automated and interactive systems. As the scope and breadth of medical knowledge expand, the need for additional learning outside of lecture hours is becoming increasingly important. CAL can be an impactful adjunct to conventional methods that currently exist in the halls of learning. There is an increasing body of literature that suggests that CAL should be a commonplace and the recommended method of learning for medical students. Factors such as technical issues that hinder the performance of CAL are also evaluated. We conclude by encouraging the use of CAL by medical students as a highly beneficial method of learning that complements and enhances lectures and provides intuitive, interactive modulation of a self-paced curriculum based on the individual's academic abilities.

"iBIM"--internet-based interactive modules: an easy and interesting learning tool for general surgery residents

BACKGROUND

The increased use of information technology supports a resident- centred educational approach that promotes autonomy, flexibility and time management and helps residents to assess their competence, promoting self-awareness. We established a web-based e-learning tool to introduce general surgery residents to bariatric surgery and evaluate them to determine the most appropriate implementation strategy for Internet-based interactive modules (iBIM) in surgical teaching.

METHODS

Usernames and passwords were assigned to general surgery residents at the University of Alberta. They were directed to the Obesity101 website and prompted to complete a multiple-choice precourse test. Afterwards, they were able to access the interactive modules. Residents could review the course material as often as they wanted before completing a multiple-choice postcourse test and exit survey. We used paired t tests to assess the difference between pre- and postcourse scores.

RESULTS

Out of 34 residents who agreed to participate in the project, 12 completed the project (35.3%). For these 12 residents, the precourse mean score was 50 ± 17.3 and the postcourse mean score was 67 ± 14 (p = 0.020).

CONCLUSION

Most residents who participated in this study recommended using the iBIMs as a study tool for bariatric surgery. Course evaluation scores suggest this novel approach was successful in transferring knowledge to surgical trainees. Further development of this tool and assessment of implementation strategies will determine how iBIM in bariatric surgery may be integrated into the curriculum.

Multi-School Collaboration to Develop and Test Nutrition Computer Modules for Pediatric Residents

The provision of essential nutrition-related content in US medical education has been deficient, despite efforts of the federal government and multiple professional organizations. Novel and efficient approaches are needed. A multi-department project was developed to create and pilot a computer-based compact disc instructional program covering the nutrition topics of oral rehydration therapy, calcium, and vitamins. Funded by an internal medical school grant, the content of the modules was written by Department of Pediatrics faculty. The modules were built by School of Informatics faculty and students, and were tested on a convenience sampling of 38 pediatric residents in a randomized controlled trial performed by a registered dietitian/School of Health and Rehabilitation Sciences Master's degree candidate. The modules were reviewed for content by the pediatric faculty principal investigator and the registered dietitian/School of Health and Rehabilitation Sciences graduate student. Residents completed a pretest of nutrition knowledge and attitude toward nutrition and Web-based instruction. Half the group was given three programs (oral rehydration therapy, calcium, and vitamins) on compact disc for study over 6 weeks. Both study and control groups completed a posttest. Pre- and postintervention objective test results in study vs control groups and attitudinal survey results before and after intervention in the study group were compared. The experimental group demonstrated significantly better posttrial objective test performance compared to the control group (P=0.0005). The study group tended toward improvement, whereas the control group performance declined substantially between pre- and posttests. Study group resident attitudes toward computer-based instruction improved. Use of these computer modules prompted almost half of the residents in the study group to independently pursue relevant nutrition-related information. This inexpensive, collaborative, multi-department effort to design a computer-based nutrition curriculum positively impacted both resident knowledge and attitudes.

[A web-based e-learning tool in academic teaching of trauma surgery. First experiences and evaluation results]

There are lots of possibilities for universities to offer contents of teaching to students by the Internet. Often the students can download slides or a special lecture note from the intranet of the university. Another way is to make a movie of the lecture and post this lecture movie on the Internet. In the Hanover Medical School we employed an alternative. It was developed by the Trauma Surgery Clinic and the Institute of Medical Informatics at the Hanover Medical School. Our goal was to use just one web-based content resource for the lecture and for the work at home. The Institute of Medical Informatics used a web-based content management system (CMS) Schoolbook to implement this e-learning application.Since October 2005 the Trauma Surgery Schoolbook has been used in the lecture on trauma surgery in all terms, and we evaluated the academic year 2005/2006. The results of the evaluation showed us that the students were very interested in using this e-learning application. The possibility to reinforce the learning material at home is a good chance for the students. Also the organisation of lectures was improved because the materials were all in one place. The lecturer needs to learn several new tasks, but we also got a positive response. Our experiences of the last academic year showed that it was a good way to use one web-based content resource for teaching and learning in the context of a lecture.

Computer assisted learning in medicine: a long-term evaluation of the 'Practical Training Programme Dermatology 2000'

In recent years, numerous computer assisted learning (CAL) programmes based on new teaching methods, as for example the principles of cognitive apprenticeship and problem based learning, have euphorically been developed for various medical fields. However, many of these programmes failed due to either low acceptance, economic inefficiency, or, most seriously, problems with the implementation and evaluation in medical curricula. In 1999, the practical training course 'Dermatology 2000', an interactive multimedia programme for dermatological education, was developed and completely integrated into the regular dermatological curriculum of five German medical schools. The formative evaluation of an implemented relational database revealed contemporary information about the programme's quantity of use. So far, 3050 students have participated in 6557 lessons. The evaluation of two online questionnaires showed a high learner acceptance regarding the programme's instructional design, ergonomics, and didactical presentation and, after completion of Dermatology 2000, an increased interest in medical education software. A comparison of the objective learning outcome illustrated that Dermatology 2000 students (n = 31) not only outperformed non-participants (n = 7) but also showed a (10%) lower rate of errors in a conventional knowledge test. Additionally, single-case studies demonstrated the increased ability of participating students to apply the acquired knowledge to diagnostic problems. We conclude that the implementation of CAL in present medical curricula can contribute to reformations of medical education. The instructional design of Dermatology 2000 is well accepted and suitable to provide both theoretic biomedical knowledge and clinical skills.

Developing computer-based training for age-related competencies

Competency in adapting care to the developmental needs of patients is not only a clinical expectation but also a requirement of regulatory agencies. Training programs on age-specific care competencies vary widely in format, content, and method. This article describes the process used by the authors to develop computer-based training (CBT) programs on age-specific care competencies and the process used to develop traditional self-paced learning modules on age-specific care competencies. The conversion of these printed modules to CBT is described and reports are given on the pilot test experiences of using CBT with clinical staff. Also included are lessons learned since organization-wide CBT deployment for age-specific care competency and other mandatory training.

Live interdisciplinary teaching via the internet

The independence of teachers and students is one of the main advantages of teleteaching. Specialties considered unsuitable for combined lessons are manageable using the internet. This study outlines simultaneous communication with students and lecturers over long distances between the anatomical dissection laboratory, the operating theatre, and the lecture hall. In several three-directional on-line lectures, different equipment was used. Students could also participate using personal computers from other locations. During the presentations, the participants have the opportunity to discuss problems with any lecturer. It was possible to demonstrate sufficient transmission capability for real-time application with the use of the new internet technology. No important qualitative differences can be reported between: hardware and software based solutions; or commercial and free offers. Although it is often difficult to reconcile the timetable of surgeries and lectures, multimedia on-line teaching via the internet provides new potential for interdisciplinary medical education.

[New paths for Internet generated learning in anatomy]

For the purposes of a functioning information and knowledge based medicine the conditions for the medical education are crucial. Although multimedia based courses and tutorials via the Internet seem to serve best for a more effective teaching and new didactics, respective anatomical offers in Germany are scarce and thus practice and experience are limited. Only simple digital equivalents of conventional contents and methods can be found, whereas the potencies of the new media are not realized in didactic concepts. Substantial advantages of web based tutorial systems are an intensive use of the feedback possibilities, the opportunity for continuous updating of the contents, the favourable distribution, and faster utilization of improved techniques. This paper introduces the adaptation of different techniques and the development of concepts and notions of modern Internet based teaching by the way of three different events in anatomical education for medical students and doctors. HistoNet 2000 was developed as an interface of lectures, seminars and practical courses in microscopy. The online transmission of a microscopical course as an interactive practical teleteaching was performed by the way of asymmetric data transfer via the ADSL-technology. Multicasting was used as well and has also been applied for the third project. In this multimedial online teaching different specialties were joined together for interdisciplinary courses via the Internet. These new technologies lead to enhanced efficiency in teaching and enlarge the educational offer. Specific Internet adapted teaching and learning projects have to be developed.

Multimedia to teach urology to medical students

OBJECTIVES

To test the hypothesis that an interactive multimedia-based computer application may be used to teach urology to undergraduate medical students.

METHODS

Third-year medical students rotating on their urology clerkship were studied. Student knowledge was measured with a multiple choice test administered in a pretest-post-test experimental design. The educational intervention was a multimedia-based application that presented a clinical module on hematuria, using natural language-like entries. Student attitudes toward the multimedia application were assessed by a survey.

RESULTS

Twenty-three consecutive third-year medical students participated. Mean pretest and post-test scores +/- standard deviation were 35%+/-11% versus 74%+/-17%, respectively, P<0.0001. Student questionnaire responses indicated highly positive opinions that the multimedia-based module was easy to use, was fun, provided natural patient responses, had clear exercises, provided immediate feedback, was educational, and had a nonthreatening format, and that the multiple choice questions were clear and fair.

CONCLUSIONS

Multimedia-based education may be used to teach urology to undergraduate medical students.

Development of an interactive multimedia-CBT-program for dental implantology and using tests of a program prototype

The aim of the study was the development of a teaching program for dental implantology designed to improve student education as well as further training in this area. Initially, the computer equipment of German dentists was evaluated. Then, the contents of a teaching program "implantology interactive" were defined. A fully functional program prototype was developed in co-operation with a medical publishing house. Subsequently, the program was tested and statistically evaluated by 70 dental students and 40 dentists for the purpose of quality assurance. The program received extremely positive ratings with regard to design and functionality. Furthermore it was found to be clearly arranged and easy to comprehend. Even computer illiterate test persons had no problem working with the program. The biggest problem discovered during the test run was that 21% of the test persons lost their orientation while working with the program. The results of the study were used to optimize the program. For example, a graphic orientation tree was integrated, thereby improving the orientation within the program. The extremely positive reactions of the test persons leads us to expect that the introduced CBT-project will be successful. The use of the program in the student education in the dental clinic in Heidelberg and a publication in a medical publishing house are to be expected in the near future.