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. • Explorable 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 • Administering 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. • Students can practice intubations, needle decompression of pneumothorax, insertion of chest tubes.

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

8. Distance Learning • Learning in an environment where student and teacher are not physically face-to-face • Use of Internet resources • Virtual Hospital provides online courses for health care professionals

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

10. 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

11. Medical Literature Databases • MEDLARS (Medical Literature Analysis and Retrieval System)—collection of 40 computerized databases maintained by NLM. Free via Internet. Includes • MEDLINE (searchable by PubMed) comprehensive database of articles • SDILINE most recent additions to MEDLINE • AIDSLINE database of information on AIDS • CANCERLIT database of information on Cancer • MEDLINEplus database of health care information for consumers

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

13. 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.

14. 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.

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

16. 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!

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