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Chapter 10

Chapter 10. Informational Resources: Computer-Assisted Instruction, Expert Systems, Health Information Online. Education. Computers have been used in medical education for more than 40 years Drill-and-practice software teaches skills requiring memorization

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Chapter 10

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  1. Chapter 10 Informational Resources: Computer-Assisted Instruction, Expert Systems, Health Information Online

  2. Education • Computers have been used in medical education for more than 40 years • Drill-and-practice software teaches skills requiring memorization • Simulation software puts the student in the situation and requires some action

  3. The Visible Human • The Visible Human is a computerized library of human anatomy at the National Library of Medicine (NLM) • From Data to Knowledge—users can see and feel anatomic flythroughs on the Web • Exlorable Virtual Human—in development • Includes authoring tools to build anatomical models • Virtual Human Embryo—images of embryos sectioned and sliced

  4. Computer-Assisted Instruction • Drill-and-practice for skills requiring memorization • Simulation software simulates a complex process • Using text • Using graphics, sound, animation • Using haptics (sense of feel)

  5. Simulation Software • Programs using text-ILIAD • Programs using graphics-ADAM • Virtual reality simulations • Surgery • Dentistry • Bronchoscopy • Epidural anesthesia • Administer IV

  6. Patient Simulators • Human patient simulators • Programmable mannequins • Inhale and exhale • Eyes dilate • Heart and lung sounds • Pulse, blood pressure • Can react to medication (bar-coded) • Can simulate allergic reactions

  7. Pediatric HPS (Courtesy of METI)

  8. HPS in the OR (Courtesy of METI)

  9. Patient Simulators (cont) • Using patient simulators • Students can practice: • Intubations • Needle decompression of pneumothorax • Insertion of chest tubes

  10. Simulated Environments • To make practicing on human patient simulators more real, simulated environments are created • Emergency rooms, with constraints of space and noise • Operating rooms

  11. Distance Learning • Learning in an environment where student and teacher are not physically face-to-face • Use of Internet resources

  12. Decision Support: Expert Systems • Expert systems—attempt to make a computer an expert in one limited field • Expert systems in medicine • MYCIN • Internist • POEMS • Databank for Cardiovascular Disease

  13. Health Information on the Internet • Information is of varying quality • Code of conduct suggested by health care professionals • Disclose sponsorship • Distinguish between science and advertising • Allow feedback

  14. Medical Literature Databases • MEDLARS (Medical Literature Analysis and Retrieval System)—collection of 40 computerized databases maintained by NLM; free via Internet. Includes: • MEDLINE—complete database of articles • SDILINE—recent additions to MEDLINE • AIDSLINE—database of information on AIDS • CANCERLIT—database of information on Cancer • MEDLINEplus—database of health care information for consumers

  15. Databases of Drug Information • MediSpan • Clinical Pharmacology • ClinicalTrials.gov

  16. E-mail • Patients want it as a way to communicate with their own health care providers • Few health care providers make it available • Problems of privacy, liability, time

  17. Self-Help on the Web • Innumerable sites offer help for any medical or psychiatric condition, many with disclaimers that they are not responsible for the accuracy of the information • Sites offering prescription drugs

  18. Support Groups on the Web • Starbright World for seriously ill children • Allows virtual communities to develop, which support people with very rare conditions, making face-to-face support impossible

  19. Judging the Reliability of Information of the Internet • Is there information about the author? • Is the author reliable? • Are the sources reliable? • Are the sources of funding revealed? • Are there conflicts of interest? • Is the information current? • Read critically!

  20. Self-Help Software • Mayo Clinic Family Health Book on CD-ROM • Doctor’s Book of Home Remedies • Medical Housecall

  21. Computers and Psychiatry • Computers are used in diagnosis and treatment • CIDI (Composite International Diagnostic Interview) screens for depression and anxiety • CIDI-Auto—self-administered using a computer • Several programs are used to treat anxiety and depression • Internet-based therapy (Interapy) for post traumatic stress disorder

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