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Computers in medical education dr. rodolfo rafael

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The goals of medical education are to provide students and graduate clinicians specific facts and information, to teach strategies for applying this knowledge appropriately to the situations that arise in medical practice, and to encourage the development of skills necessary to acquire new knowledge over a lifetime of practice. Students must learn about physiological processes and must understand the relationships between their observations and these underlying processes. They must learn to perform medical procedures, and they must understand the effects of different interventions on health outcomes. Also, the student must learn “softer” skills and knowledge, such as interpersonal and interviewing skills and the ethics of medical care. Medical school faculty employs a variety of strategies for teaching, ranging from the one-way, lecture-based transmission of information to the interactive, Socratic method of instruction. In general, we can view the teaching process as the presentation of a situation or a body of facts that contains the essential knowledge that students should learn; the explanations of what the important concepts and
relationships are, how they can be derived, and why they are important; and the strategy for guiding interaction with a patient.

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Computers in medical education dr. rodolfo rafael

  1. 1. Computers in Medical Education Rodolfo T. Rafael,M.D.
  2. 2. Learning Objectives: • Demonstrate the advantages of computer-aided instruction over traditional lecture-style • Identify the different learning methods that can be implemented in computer-based education. • Discuss how computer-based simulations supplement students’ exposure to clinical practice. • Identify the issues to be considered when developing computer- based educational programs. • Recognize barriers to widespread integration of computer-aided instruction into the medical curriculum.
  3. 3. The goals of medical education are : 1. to provide students and graduate clinicians specific facts and information 2. to teach strategies for applying this knowledge appropriately to the situations that arise in medical practice 3. to encourage development of skills necessary to acquire new knowledge over a lifetime of practice
  4. 4. Students must learn.. • physiological processes and understand the relationships between their observations and the underlying processes. •learn to perform medical procedures, and they must understand the effects of different interventions on health outcomes. •student must learn “softer” skills and knowledge, such as interpersonal and interviewing skills and the ethics of medical care.
  5. 5. A Historical Look at the Use of Computers in Medical Education • Piemme (1988) • 1960 • Ohio State University (OSU) • Massachusetts General Hospital (MGH) • University of Illinois • 1967- Tutorial Evaluation System (TES) • 1969- Independent Study Program • COURSEWRITER III • 1970- TES had a library of over 350 interactive hours of instructional programs
  6. 6. • 1970- Barnett and coworkers at the MGH Laboratory of Computer Science • Simulate clinical encounters • 1971- Harless • Computer-Aided Simulation of the Clinical Encounter (CASE) • 1974 • 362 programs- 23 different languages (BASIC, FORTRAN, and MUMPS to COURSEWRITER III and Programmed Logic for Automated Teaching Operations (PLATO)
  7. 7. • 1972- NLM • MGH, OSU, and the University of Illinois Medical College • 80 institutions • 1983- MGH program offered as (CME) to AMA • By the mid-1980s • 100,000 physicians, medical students, nurses, and other people had used the MGH CBE programs over a network
  8. 8. • PLATO system developed at the University of Illinois • High cost The GUIDON system
  9. 9. Advantages of Using Computers in Medical Education • augment, enhance, or replace traditional teaching strategies • extension of the student’s memory • present rapidly a much larger number of images, static images with sounds, video clips, and interactive teaching modules • Immersive interfaces • “Any time, any place, any pace” learning becomes practical
  10. 10. Modes of Computer-Based Learning
  11. 11. Drill and Practice
  12. 12. Didactic: The Lecture Howard Hughes Medical Institute Web site on teaching genetics
  13. 13. Discrimination Learning
  14. 14. Exploration Versus Structured Interaction • Drill-and-practice programs usually teach important facts and concepts but do not allow students to deviate from the prescribed course or to explore areas of special interest. • Exploratory environment- allow students to choose any actions in any order encourage experimentation and self-discovery
  15. 15. Constrained Versus Unconstrained Response •The use of a predefined set of responses has two disadvantages: • It cues the student (suggests ideas that otherwise might not have occurred to him) • it detracts from the realism of the simulation. •Unconstrained • free to query and to specify actions
  16. 16. Construction http://cyber-anatomy.com/product_CAHA.php
  17. 17. Simulation Static Dynamic
  18. 18. Feedback and Guidance
  19. 19. Intelligent Tutoring Systems
  20. 20. Current Applications
  21. 21. Preclinical Applications
  22. 22. The Digital Anatomist, at the University of Washington, Seattle
  23. 23. The Visible Human Male and Female
  24. 24. HeartLab
  25. 25. Clinical Teaching Applications
  26. 26. Continuing Medical Education
  27. 27. Consumer Health Education
  28. 28. Distance Learning
  29. 29. Design, Development, and Technology
  30. 30. Design of Computer-Based Learning Applications • Structured Content • Query, Retrieval, and Indexing • Authoring and Presentation
  31. 31. Application Development • Definition of the Need • Assessment of the Resources • Prototyping and Formative Evaluation • Production • Integration in the Curriculum • Maintenance and Upgrades • Standards
  32. 32. Technology Considerations • cost and availability of the final teaching product • Web client • Windows or the Macintosh operating system. • Internet versus processing on a local machine.
  33. 33. Evaluation 1. The reaction of the student population to the new teaching method and how well the method is assimilated into the existing process of teaching. 2. The usability of the teaching program. 3. Measures whether the new teaching method actually had any impact on what the students learned. 4. Measures whether the new method results in behavioral change because, in the final analysis, content and procedures learned by students should affect how they practice medicine.
  34. 34. Reaction and Assimilation • Questionnaires • subjective reports • measurement of actual usage
  35. 35. Usability and Cognitive Evaluation Transition graph showing how one student moved between different types of information in the neuroanatomy program BrainStorm. Of the 900 transitions, almost one-half were from one cross-sectional image to another. Even though there were a large number (345) of text screens, with many available hyperlinks between the screens, there was little movement from one text screen to another. Analyses such as these clarify usage and suggest program design strategies.
  36. 36. Knowledge Acquisition • Is this computer program more effective than traditional methods of teaching the same material? •In what ways is computer-based learning different from traditional methods of learning? •Can computers enable learning in ways never before possible? •Can computers perform evaluations of knowledge acquisition that would be impossible using traditional written or oral examination techniques?
  37. 37. Problem Solving and Behavioral Change
  38. 38. Conclusion • CBE systems have the potential to help students to master subject matter and to develop problem-solving skills. • The barriers to success are both technical and practical.
  39. 39. Reference: • Biomedical Informatics: Computer Applications in Health Care and Biomedicine by Edward H. Shortliffe and James J. Cimino
  40. 40. Suggested Readings • Chueh H.C., Barnett G.O. (1997). “Just in time” clinical information. Academic Medicine, 72(6):512–517. • Gaba D.M. (1997). Simulators in anesthesiology. Advances in Anesthesia, 14:55–94. • Kirkpatrick D.L. (1994). Evaluating Training Programs. San Francisco: Berrett-Koehler. • Lyon H.C., Healy J.C., Bell J.R., O’Donnell J.F., Shultz E.K., Moore-West M.,Wigton R.S., Hirai • F., Beck J.R. (1992). PlanAlyzer, an interactive computer-assisted program to teach clinical problem solving in diagnosing anemia and coronary artery disease. Academic Medicine, 67(12):821–828. • Pugh C.M., Youngblood P. (2002). Development and validation of assessment measures for a newly developed physical examination simulator. Journal of the American Medical Informatics Association, 9:448–460. • Vosniadou S., DeCorte E., Glaser R., Mandl H. (1996). International Perspectives on the Design of Technology-Supported Learning Environments. Mahwah, NJ: Lawrence Erlbaum. • Westwood J.D., Hoffman H.M., Stredney D., Weghorst S.J. (1998). Medicine Meets Virtual Reality. Amsterdam: IOS Press.

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