Chapter 10
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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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Chapter 10

Chapter 10

Informational Resources: Computer-Assisted Instruction, Expert Systems, Health Information Online



  • 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

The visible human

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

Computer assisted instruction

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)

Simulation software

Simulation Software

  • Programs using text-ILIAD

  • Programs using graphics-ADAM

  • Virtual reality simulations

    • Surgery

    • Dentistry

    • Bronchoscopy

    • Epidural anesthesia

    • Administer IV

Patient simulators

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

Pediatric hps

Pediatric HPS

(Courtesy of METI)

Hps in the or

HPS in the OR

(Courtesy of METI)

Patient simulators cont

Patient Simulators (cont)

  • Using patient simulators

    • Students can practice:

      • Intubations

      • Needle decompression of pneumothorax

      • Insertion of chest tubes

Simulated environments

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

Distance learning

Distance Learning

  • Learning in an environment where student and teacher are not physically face-to-face

  • Use of Internet resources

Decision support expert systems

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

Health information on the internet

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

Medical literature databases

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

Databases of drug information

Databases of Drug Information

  • MediSpan

  • Clinical Pharmacology


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

Self help on the web

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

Support groups on the web

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

Judging the reliability of information of the internet

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!

Self help software

Self-Help Software

  • Mayo Clinic Family Health Book on CD-ROM

  • Doctor’s Book of Home Remedies

  • Medical Housecall

Computers and psychiatry

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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