Medical Education

We are taking steps to increase the availability of electronic communication and instruction during the third and fourth year. Our office has worked closely with Information Services to open the network link with the Jacksonville campus for student use. We also supervised the installation of computers in the fourth floor student lounge at Shands. Students now have access to electronic mail, the World Wide Web, and Medline from these locations. We expect to bring several other sites on-line over the next year.

Over the past four years we have captured over 36,500 instructional images. Approximately half of these have been digitally modified or annotated. To make these images available to students, we have produced a series of ten laserdiscs. Dr. Rathe has developed several generations of software for faculty to author interactive programs using these discs. The next section highlights twelve of our most successful projects.

Undergraduate

Authors - Linda Lanier, MD; Richard Rathe, MD; Jon Seymour, MD

Description - This award winning program is the primary text for our "Anatomy by Diagnostic Imaging" course in the first semester of medical school. It combines hundreds of radiographs with text describing the significant structures visible on each image. The program is completely self paced, allowing students to customize their path through the material. A sophisticated self evaluation module provides on-demand quizzing with immediate feedback.

Status - Radiologic Anatomy is currently being used in over half of US medical schools. Fourteen schools have purchased site licenses and 31 plan to use the program as a primary resource in their curricula. The program has also been approved for 32 hours of continuing education credit by the American Society of Radiologic Technologists. Radiologic Anatomy is published by Gold Standard Multimedia, Inc. of Gainesville, FL. Institutions Using Radiologic Anatomy are summarized in the following table:

A demonstration is available on the World Wide Web at:

http://www.med.ufl.edu/medinfo/rademo/raintro.html

Authors - Kyle Rarey, PhD; Lynn Romrell, PhD; Wojciech Pawlina, MD; Richard Rathe, MD; Jason Rosenberg, MD

Description - Based on a manual of dissection developed for our students, Human Anatomy combines thousands of cadaveric images with step-by-step instructions for studying the human body. Students are able to select images and figures relevant to each laboratory session by clicking on colored links within the text. The program includes self evaluation quizzes, practice practical exams, and graded exercises that can be customized by the faculty.

Status - Human Anatomy is currently being used at a third of US medical schools. Nine schools have purchased site licenses and 15 plan to use the program as a primary resource in their curricula. The program has also generated considerable interest from schools of Occupational and Physical Therapy. Human Anatomy is published by Gold Standard Multimedia, Inc. of Gainesville, FL. Institutions Using Human Anatomy are summarized in the following table:

Microscopic Anatomy

Description - This interactive program contains 1000 high quality images taken directly from the glass microscope slides. Students find the program useful to preview material before lab, confirm what they are seeing during lab, and review for exams. The collection also contains 100 electron-photomicrographs and an annotated 1500 item question bank for self-evaluation quizzes.

Status - This program has been in use for five years by our freshman medical students. It is the final part of an "Anatomy Suite," covering gross, microscopic, and radiologic anatomy. It is currently being converted to CD-ROM format by Gold Standard Multimedia, Inc. of Gainesville, FL.

Microbiology ("Bugs")

Description - As part of the reorganization of the Microbiology course, we have produced a series of interactive cases that illustrate microbiologic concepts as well as a "Bugs" database on the most common bacteria, viruses, and parasites. The students are able to work through these cases as well as bacteriologic unknowns to test their mastery of the material.

Status - The program has been used by second year medical students for the past three years. Students also use the "Bugs" database to review for Step One of the National Board Examination. Dr. Duckworth is currently polishing the program in preparation for publication.

Radiologic Pathology

Description - This program consists of 800 abnormal radiographs linked to explanatory text and figures.

Status - The program has been used by second year students for the past four years in parallel with systemic pathology.

General and Systemic Pathology

Description - At the present time we have assisted faculty with the creation of 2500 images to support pathology instruction. Dr. Hardt has also produced a program on GYN pathology that utilizes a portion of these images.

Status - The image collection has been used in our curriculum for the past four years. Dr. Hardt's program has been used for the past two years. Over the past summer a medical student prepared the entire image collection for publication on CD-ROM and the World Wide Web.

Geriatric Education ("Geri Ann")

Description - This our first educational program produced entirely for the Internet. It consists of five cases covering major topics in geriatrics. Interactive questions punctuate each case to stimulate student interest. We make extensive use of hypertext links for definitions, images, and cross references.

Status - Student volunteers are currently testing the program for completeness and relevance. It is initially targeted at second year students for use during their "Introduction to Clinical Medicine" block. We plan to expand the program over time to include basic science and advanced clinical topics. "Geri Ann" is available on the World Wide Web at:

http://www.med.ufl.edu/medinfo/geri/geri.html

Authors - William Enneking, MD; Richard Rathe, MD; Gene Cornwall; et al

Description - This is an ongoing project with three major components. The first is to archive hundreds of cases and thousands of images in the musculoskeletal pathology collection at UF. The second is to create a computer-assisted course in musculoskeletal pathology for students, residents, and practicing orthopedists. The third is to prepare the entire project for distribution via interactive videodisc, CD-ROM, the World Wide Web, and traditional textbook.

Status - To date, we have captured approximately 20,000 images representing more than 1800 cases. The software and images have been used in various national and international settings over the past four years. We anticipate completing the project and submitting it for publication within the next year. A demonstration is available on the World Wide Web at:

http://www.med.ufl.edu/medinfo/ortho/ostsarc.html

Description - Medical students working with Dr. Ros have collected and edited a large number of images related to liver and pancreatic tumors. Based on this collection, interactive programs have been developed covering all aspects of the pathology and diagnostic imaging of these tumors.

Status - Radiology residents and students on rotation have used this suite of programs for the past three years.

Obstetric Ultrasound

Description - This program serves as a beginners guide to diagnostic ultrasound. The program makes use of a large number of full motion video clips stored on laserdisc. In addition to demonstrating normal exams, cases of various malformations are presented and diagnostic strategies are discussed.

Status - The program has been part of a major obstetrical continuing education conference for the past two years.

Head and Neck Imaging

Description - This program consists of fifty unknown cases, which serve as the basis for a continuing education course on evaluating head and neck disorders.

Status - The complete set of cases will be available during the course this fall.

Other Projects

Description - Hypertext Markup Language (HTML) is the format used for all World Wide Web documents. We have designed a simplified markup format called "MTX" to help automate HTML document production.

Status - Although this is a work in progress, we have already used MTX to create courseware, case presentations, newsletters, and conference proceedings. MTX related materials are available on the World Wide Web at:

http://www.med.ufl.edu/medinfo/mtx/

Description - Our curriculum now includes multiple, performance-based Objective Standardized Clinical Exams or OSCEs. During these exams, students are expected to interview and examine standardized patients while being videotaped. In order to test student proficiency with diagnosis and management we include inter station exercises on computer. The system supports complex questions with multiple correct answers to test such things as differential diagnosis and workup strategy. Results are automatically recorded for subsequent analysis and grading.

Status - The system has been part of the fourth year OSCE for the past two years.

Radiologic Neuroanatomy

Description - We are developing a sequel to Radiologic Anatomy that will include a complete set of axial, coronal, and transverse MRI scans of the brain; a series of detail views of the temporal bone; and various conventional, digital subtraction, and MRI angiograms.

Status - This is a work in progress.

Mental Status Examination

Description - The department of Neurology, due to its small size, is unable to spend enough time with each student going over the complete mental status exam. The availability of patients with neurologic findings is also highly variable. We have begun to develop instructional media to overcome these difficulties. Video clips demonstrating each part of the exam have been correlated with pathologic examples taken from the neurology department's large videotape collection. These materials will be combined into an interactive program for use by second and third year medical students.

Status - This is a work in progress.