IntelliTeaching - High Impact Learning

Author:

Pagogh Cho, Education Specialist

Contributors:

James Gutierrez, Anne LeMaistre, M.D., Cameron Payne, Russell Pruitt, Charlotte Wilcox.

Delivery of Educational Material from a World Wide Web Server

The University of Texas Medical School at Houston, Department of Pathology and Laboratory Medicine.

Primarily, the incorporation of images both microscopic and gross must be linked directly to specific lecture topics and sections. Also, difficult pronunciation of pertinent medical terms and metaphors must be readily available. Additionally, interrelated course material covering other subject matter in other areas of specialization must have the ability to be referenced. Finally, accessibility to the information must be made available to all students whether it be from a local computer lab or from home.

By no means does the above list represent all possible concerns faced by institutions who are involved in or desire to develop such a project. Various technical issues need to be addressed with regard to all academia in attempting similar electronic curriculum.

We find ourselves in an age where technology at times leads creation. Where we are offered a new venue for pursuing what was once traditional/conventional means, we find faster, more exciting replacement methods. Replacement not as a global substitution, but as a complementary association or cooperative supplement.

Of course, I speak primarily of the infusion of the World Wide Web and its rapidly advancing future. In a technocentric arena where buzzwords, acronyms, and abbreviations abound, education becomes the primary task of creators in order to fully saturate society with the knowledge of use, advantages, and applications. What other venue can offer such a vast information base to be utilized by patriots all over the globe? It is, of sorts, an electronic melding of minds, where the desire to educate and inundate society with information takes precedence everywhere simultaneously.

Education is an individual responsibility. Today, we find more restrictions preventing us from pursuing desired education due to financial, geographic, and time restraints. Additionally, educational requirements may not necessitate a degree specific curriculum when seeking general information about particular topics. For the most part, unfortunately, the term "education" connotes a return to the academic environment pursuing endless add/drops, registration procedures, and late night studying. Seldom do we associate learning a trade as education. Learning to change the oil on my car may be a hobby, but as a form of education will improve the long term longevity of my car. Could not the same general information usage apply to industry specific associations?

Specifically, I am talking about medicine. The academia of medicine relates to a very visually intense and information rich concentration. Traditional material utilizes microscopic glass slides, anatomic specimens, tools and equipment with which to view and manipulate such material such as microscopes and slide projectors, and written text. In order to bring all this media together, the creation component of creating one information source it vital. Such is the necessity of instructional design. Many considerations must be made which differ significantly from current multimedia development; "current multimedia development" defined as packageable kits and programming tools used to create today's CD-ROM and single user based interactivity. Issues such as bandwidth, access time, storage, and compression need to be evaluated when considering the potential and obvious competition which may develop when entering the mainstream of today's computer users. Information accessibility must appear as transparent as if using a local CD or hard drive. Eve local network considerations need to be addressed. Granted with the tremendous progress being made in the area of information transfer with respect to ATM, fiber optics, and baud rate technologies, to name a few, there will still be much concern for developing that effortless access to remote server sites.

However, aside from physical hardware limitations which can be predicted as virtually disappearing as technologies continue to develop, let us investigate the usage of the content based on the real life scenario of medical education, keeping in mind that education is not so restricted as a term associated with academia.

With current health care issues and adjustments at the forefront of the medical community's mind, of which we, as potential patients, play an intrinsic role, let us consider the following uses.

The Medical Student

Centralized information bases generating educational curricula. Within our medical school, our department alone interacts with over 500 medical students ranging from first to fourth year post baccalaureate students. As an example, let's look at the first year course of Histology, the study of tissue on the microscopic level. Students are given a written syllabus composed of over 1000 pages of information for just one semester of study. They are also given two microscopic glass slide boxes containing some two hundred specimens. Additionally, they have a microscope assigned to them which they can use at their leisure to view these slides. They are given 24 hour access to these microscopes, but keep in mind that they must use them in one of four designated student laboratories. Add to this copious amount of material carousels of photographic review sets in volumes to account for more than 1000 transparent film slides to be used for their review and study purposes. Once again, the physical limitation of checking them out to only be used on site.

Consider the following: Limited copies to share among over 200 classmates; Rare specimens of which only a restricted number can be available; Damaged or lost material; Or malfunctioning equipment such as microscopes or slide projectors.

In comparison, consider placing all the above material in a cohesive and comprehensive on-line format using the web. Students will no longer have to fight traffic and parking availability in order to come onto school grounds and study location specific material. Students will no longer have to wait their turn to gain access to a limited quantity of review carousel. The will no longer have to be concerned with damaged or missing material or equipment. Primarily, they can access all forms of this information from home - together as a group at a classmates' or anytime at a computer lab. Add to this the capability of offering on-line pronunciation for difficult or new terminology, procedural animations or video clips outlining movement and method, or testing capabilities to review what they have studied. They will no longer have to compete for the best material because it will be available to them all, equally and instantly.

The Health Care Professional

Now, let us consider the environment tied more closely to actual physician practice, the laboratory. Laboratory proceeding and policies are constantly updated and reviewed. Medical technology is moving at as rapid a pace as the computer industry often times paralleling and intertwining such growth. With this constant forward progress, documented procedural techniques are gathered together in a comprehensive laboratory manual. The manuals outline and describe procedures and protocols detailing what test are performed or how results are attained. With revisions remaining constant, what may have been current last month, may be outdated within a week due to scientific breakthroughs or discovery. Laboratories are constantly evaluating methods and practices in enhancing cost-effective measures and results orients procedures through what is called "utilization reviews." Once again, what may have been the best use of evaluation criteria, chemical components, and testing procedures may instantly be revised to produces a lower cost and more efficient means of achieving a diagnosis or finding.

If this information access and update inquiry were to be centralized to a laboratory base web site, many advantages would become clearly evident. Laboratory personnel would not have to be concerned with having the latest in clinical findings and procedures. Test methods can be learned and applied immediately once a breakthrough is made. A laboratory can instantly take advantage of the most efficient findings discovered through utilization reviews. Once again, the information is available to all laboratory personnel equally and instantly.

The Physician

As we approach the actual role of physician usage, consider the emphasis currently being places on managed care and primary care physicians. The role of the physician is changing due to the requirement being placed on internists, general practitioners, and other non-specialist related experts. I speak primarily of pathologists. What may have been unnecessary in the previous role of primary care physicians due to external consultation or in house specialists, is now a deciding factor in having knowledge of such specific information available. They may have to research pathological findings or construct their own comparisons of abnormal versus normal tissue samples. As the role of the specialist diminishes in the subject matter expert, centralizing their vast information and knowledge for ready retrieval will play a prominent role.

From his desktop, the physician can compare tissue samples acquired from a patient to an archive of healthy or diseased versions on screen. He will also be able to extract case sensitive studies and topic related findings from pages dedicated to cardiovascular or respiratory abnormalities. What may have taken hours in a research facility or journal specific query, can now be accessed instantly from a web related information archive. The focus once again is on availability and access.

As education is one of the primary driving forces leading multimedia development, the benefits of creation are little known to a new age of end-users. On-line instantaneous production is a relatively new component with regard to the increasing number of previously absent computer aficionados. Where they may be familiar with today's information software packages available on various disk formats, the conceptualization of centralized information retrieval may be more technically taxing. In a time where educating the masses, or re-educating in many cases, becomes an important task for both a cost effective and easily accessible means for the delivery of material, the World Wide Web offers a comprehensive and current process of achieving that goal.

Pagogh Cho

As a native of Houston, Texas, I received my Bachelor of Arts in Business from Southwestern University in Georgetown, Texas in 1992.

e-mail address: cho@casper.med.uth.tmc.edu