Computer-based learning in radiology: a hypermedia application in CT

Informatics in Radiology (infoRAD)

The importance of radiologic semiology can be seen from the large number of articles, books, and Web pages dealing with radiologic signs. Recognition of these signs forms an important part of the training process for radiologists. Computer-assisted instruction complements traditional techniques for teaching radiology and provides an appropriate method of collecting, organizing, and presenting radiologic signs. A computer application that includes more than 350 radiologic signs has been created with Microsoft PowerPoint (version 2002 for Windows). The user can navigate freely to see the signs from a menu that provides access according to anatomic region or from an interactive dictionary that includes 779 terms. From the presentation of each sign, the user can access one or more representative images, information about the examination wherein the sign appears, an explanation of the meaning of the sign and the corresponding diagnosis, additional comparative images (pathologic or normal), and relevant references. This album of radiologic signs is a useful tool for training in radiologic semiology and also allows a quick consultation based on the name of the sign. Although designed for interns and residents, it will also be useful in pregraduate teaching of radiology, as a reference, and in continuing medical education.

Development and evaluation of a computer-aided learning package for minor oral surgery teaching

'Aspects of Minor Oral Surgery' is a highly interactive software program that was commissioned by the Department of Health, England, as part of the continuing education opportunities of general dental practitioners. The content of the program is also suited to the education of senior clinical dental students. The beta (pre-release) version was evaluated by 67 general dental practitioners, who completed a questionnaire on aspects of the program's functionality. Responses on its usefulness as an educational tool were 78% positive and 4% negative. In comparing the program to other educational media on the same subject, 77% felt it was better than video, 69% said it was better than textbooks, and 80% preferred it to journals. Its main strengths were judged to be the high level of interactivity, the ease of navigation and use, and the quiz section. The quality of the images of surgical procedures displayed in the slide shows was judged to be a weakness, and this problem was addressed in preparing the final version. Ten UK academic and four health service senior oral surgeons were also asked to give feedback on the program's content, and these points were also incorporated in the final text. More than 1,600 copies of the program have been taken up by general dental practitioners so far. The program may be downloaded for evaluation via the internet.

Radiographic skills learning: procedure simulation using adaptive hypermedia

The design and development of a simulation tool supporting learning of radiographic skills is reported. This tool has by textual, graphical and iconic resources, organized according to a building-block, adaptive hypermedia approach, which is described and supported by an image base of radiographs. It offers interactive user-controlled simulation of radiographic imaging procedures. The development is based on a commercially available environment (Toolbook 3.0, Asymetrix Corporation). The core of the system is an attributed precedence (priority) graph, which represents a task outline (concept and resources structure), which is dynamically adjusted to selected procedures. The user interface imitates a conventional radiography system, i.e. operating console, tube, table, patient and cassette. System parameters, such as patient positioning, focus-to-patient distance, magnification, field dimensions, tube voltage and mAs are under user control. Their effects on image quality are presented, by means of an image base acquired under controlled exposure conditions. Innovative use of hypermedia, computer based learning and simulation principles and technology in the development of this tool resulted in an enhanced interactive environment providing radiographic parameter control and visualization of parameter effects on image quality.

An integrated approach to senology education: combination of a hypermedia program with a multimedia archive

The aim of this work was to demonstrate the computerized system on senology, which combines a hypermedia application to a multimedia didactical archive, integrated with a radiological information system. These applications have been developed on Macintosh computers using the softwares Supercard and 4th Dimension. The hypermedia application deals with basic principles of anatomy as well as the radiologic semeiology and pathology through different imaging techniques in order to illustrate basic principles. Thus, students can modify their learning pathways and the timing as they wish. Limitations are related to time consumption in preparing the programs and technical difficulties in expanding them. Multimedia archive allows to classify a large number of difficult and uncommon clinical cases, creating an easily updatable teaching file in digital format which considerably improves access to stored image data, also reducing loss of films and film degradation. From initial experiences we conclude that these systems are valid devices in information and up to date for physicians dedicated to the study of breast pathology.

A learning tool in medical imaging: using procedure graphs in radiographic process simulation

Teaching the procedural elements of imaging protocols and understanding the interrelationships and interdependencies of diagnostic X-ray system parameters and their effects on image quality, are among the main objectives of medical imaging training programs. A teaching tool is designed and implemented to support these goals. Tool design is influenced by hybrid learning system architectures and it is based on a graph approach, which is described. Implementation is carried out using a hypermedia development environment (Toolbook) coupled with a database (Paradox). The core of the system is an attributed priority graph, capable of supporting the organization of the domain knowledge, monitoring of user-machine interaction and managing the user-system dialogue. Use of this approach resulted in an interactive simulation tool, which provides computer aided learning support, to radiology related personnel, such as radiologists and radiographers. The potential value of the tool is not restricted only to didactic tasks, but may include trouble-shooting and documentation.

Digital video applications in radiologic education: theory, technique, and applications

Computer-assisted instruction (CAI) has great potential in medical education. The recent explosion of multimedia platforms provides an environment for the seemless integration of text, images, and sound into a single program. This article discusses the role of digital video in the current educational environment as well as its future potential. An indepth review of the technical decisions of this new technology is also presented.

A radiology hypertext system for education and clinical decision making

Hypertext is a computer-based means of organizing information that allows one to explore the connections among related subjects. FACT/FILE is a hypertext computer system that provides access to a wide variety of information of interest to radiologists and radiology residents. Information is presented as notecards, or frames, which can contain textual information about relevant anatomy, physiology and pathology, as well as differential diagnosis "gamut" listings. More than 800 frames are available. Users can choose frames from an alphabetical index produced automatically from key words in each frame's title, or from a hierarchically organized subject index. Links between frames allow users to explore related frames and then return to the original frame. Physicians can add new frames to the system, so that specialized knowledge can be shared. This system has been implemented as a module of the radiology information system at the University of Chicago Medical Center.

The use of graphic design in an interactive computer teaching program

The widespread diffusion of affordable computers into the scientific and educational community has provided the opportunity to design medical and scientific teaching programs illustrated either by hand or by utilizing commercially available software and manipulating existing computer generated images. The medical illustrator can provide the ideal aesthetic link between text format information and the visual representation of such knowledge in a concise presentation format. The availability of interactive multimedia programs has given the medical illustrator an environment to create and enhance Hypermedia designed specifically for the purpose of medical education. This paper will focus on the incorporation of illustration and screen design into "CT The Game," an experimental medical teaching program currently being developed in the Johns Hopkins Body CT Imaging Laboratory. The program is designed to provide an enjoyable approach to learning Computed Tomography (CT), and is directed toward an audience of medical students, residents, and fellows.