Teaching physical examination skills can be challenging when faced with coordinating the activities of large and diverse groups of medical students and physician teachers. Two hundred and ten medical students matriculate each year at the Ohio State University College of Medicine & Public Health where they select experiences and approaches that fit their individual learning styles and career goals. During their first two years they select one of the three learning tracks (Lecture/Discussion, Problem-Based Learning, or Independent Study). Students are introduced to clinical medicine through didactic and student-preceptor experiences. Ensuring that this large and diverse group of students is exposed to a common set of normal and abnormal physical exam findings and hands-on techniques has always been logistically challenging.

To help overcome these challenges we have developed an interactive, web-based primer to introduce medical students to the fundamental principles, techniques, and findings of the physical examination. Focusing on seven primary content areas: head and neck, pulmonary, cardiovascular, abdominal, musculoskeletal, neurological, and urogenital. We have integrated Macromedia Flash, Cold Fusion, and streaming technologies to create a resource that will supplement the traditional learning strategies in the physical exam course. Examples will be shown to illustrate the types of development and deployment strategies employed to assemble this multimedia-rich, highly modular site. Specifically, we will show how Flash was used to mimic taking a blood pressure, simulating a pulmonary assessment, and performing a funduscopic exam, among other techniques. In addition examples will be shown illustrating how synchronized multimedia integration language (SMIL) was used to enhance short digital video demonstrations of common exam techniques. Support for this project comes from the U.S. DHHS Bureau of Health Professions, HRSA (1-D05-PE-80150), the Department of Family Medicine, and the College of Medicine & Public Health at The Ohio State University.

BENEFIT TO PARTICIPANTS ATTENDING SESSION: Can you really teach medical students fundamental physical examination techniques using the Web? The multimedia tools, techniques and deployment strategies that we undertook with this multiyear project may be of general interest. Specifically, participants will see examples of how Macromedia Flash, Cold Fusion and SMIL have been used at Ohio State to create engaging, multimedia elements that are designed to mimic hands-on experiences. In addition, a brief overview of the development team dynamics will be presented to illustrate the workflow model that we developed to streamline the development process and empower the physician content specialists.

Timothy J. Cain
2md - Medical Multimedia Design
College of Medicine and Public Health
The Ohio State University
3184 Graves Hall, 333 West Tenth Avenue
Columbus, OH 43210
Phone: 614-292-4125
Fax: 614-292-7659
Email: cain.2@osu.edu
Website: http://medicine.osu.edu/2md

CO-AUTHORS:
Christopher A. Fish, Christopher N. Finneran, Curtis Stewart, Cynthia Kreger*, Douglas Knutson** and Larry Gabel**
2md - Medical Multimedia Design, Departments of Internal Medicine* and Family Medicine,**
College of Medicine & Public Health, The Ohio State University, Columbus, OH 43210
Phone: (614)292-4125
Fax: (614)292-7659
Email: 2md@medicine.osu.edu,
kreger.1@osu.edu
knutson.1@osu.edu
Website: http://medicine.osu.edu
http://medicine.osu.edu/exam