Enhancing Physical Examination Skill Instruction with Digital Learning Objects: Using Technology to Build the Basics

Timothy J. Cain, Christopher A. Fish, Christopher N. Finneran, Curtis Stewart, Cynthia Kreger, Douglas Knutson and Larry Gabel, 2md :: Medical Multimedia Design, College of Medicine & Public Health and Departments of Internal and Family Medicine, The Ohio State University, Columbus, Ohio, USA

ABSTRACT:

While some disciplines lend themselves to the tools and techniques of the modern digital classroom (e.g., anatomy, embryology, pathology, etc.), others challenge the innovative skills of educators and developers. One such core set of mastery skills that has proven challenging to simulate in an engaging, Web-accessible fashion is the fundamental techniques of the physical examination.

Each year, 210 medical students matriculate at the Ohio State University. As in most medical school programs, students are introduced to the basic principles and techniques of clinical medicine through a combination of didactic instruction, patient simulations, and one-on-one mentoring by physician preceptors. Facilitating student mastery of exam techniques and ensuring exposure to common exam findings can be challenging when faced with coordinating the activities of large and diverse groups of students and physician preceptors. To help overcome these challenges, we have developed an interactive, multimedia-rich application to augment traditional learning strategies. Focusing on seven primary content areas ( head and neck, pulmonary, cardiovascular, abdominal, musculoskeletal, neurological, male and female genitalia) we have integrated Macromedia Flash, Cold Fusion and streaming technologies to create interactive learning objects that allow the learner to practice selected skills (e.g. taking a blood pressure, listening to breath or heart sounds or performing a funduscopic exam). SMIL was also used to enhance and annotate digital video demonstrations of key clinical procedures and techniques. The modular nature and underpinning technologies of our approach allow the adopter to select appropriate deployment strategies (i.e., CD-ROM and Web).

Preliminary feedback gathered from a pilot group of second-year medical students was favorable, with students reporting a noticeable increase in self-confidence. 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:

The multimedia tools, techniques and deployment strategies that were used to create this modular and portable application may be of general interest. Participants interested in the following should plan to attend: (1) Using Macromedia Flash to create engaging interactivity that mimics hands-on experiences. (2) Incorporating synchronized multimedia integration language (SMIL)-based technologies to enhance and annotate digital video vignettes. (3) Applying database middleware solutions (i.e., Cold Fusion/SQL) to develop and facilitate content authoring and management.

Timothy J. Cain

2md :: Medical Multimedia Design

College of Medicine & Public Health

The Ohio State University

3187 Graves Hall, 333 W 10th Avenue

Columbus, OH 43210

Phone: 614.292.4125

Fax: 614.292.7659

Email: mailto:tcain@2md.osu.edu

Website: http://2md.osu.edu

CO-AUTHORS:

Christopher A. Fish, Christopher N. Finneran, Curtis Stewart, Cynthia Kreger,* Douglas Knutson** and Larry Gabel** 2md :: Medical Multimedia Design,

Departments of Internal* and Family Medicine,** College of Medicine & Public Health

The Ohio State University

3187 Graves Hall, 333 W 10th Avenue

Columbus, OH 43210

Phone: 614.292.4125

Fax: 614.292.7659

Email: mailto:cfish@2md.osu.edu, mailto:cfinneran@2md.osu.edu