From: <abstracts@gsm

DEMONSTRATION

 

Interactive Visual Tools for Procedural Training

 

Grace Huang, Michael Parker, Harvard Medical School, Boston, Mass., USA

 

ABSTRACT:

 

While medical education has been built on time-honored methods such as didactic lectures, primary literature reading, case-based instruction and hands-on training, the technological age is altering the way that medicine is learned and therefore taught.

 

One area ripe with potential for improvement is that of teaching students and house staff how to perform inpatient and ambulatory procedures. The majority of the data on procedural training arises from surgical publications, and well-controlled studies on trainee’s technical skills and observed complication rates are lacking in the current literature. Traditionally, the process of learning these skills is embodied by the motto, "See one, do one, teach one."  As a result, potentially life-saving techniques such as central venous line placement are often poorly standardized and inadequately rehearsed, and the fidelity of certain well-subscribed methods can become lost in the verbal transmission of knowledge, possibly leading to adverse outcomes.

 

As part of MyCourses (http://mycourses.med.harvard.edu), the curriculum management web portal at Harvard Medical School, interactive visual tools are created using Macromedia Flash technology to illustrate commonly performed procedures for medical students and house officers. These visual aids are animated with vector-based graphics, which are readily transferred to handheld computers at reasonable file sizes compared to bitmap graphics and therefore portable for immediate reference on the wards and in office practice where appropriate.

 

In the example, which would be provided on a Macromedia Flash Player-enabled handheld, a lumbar puncture is demonstrated, with a discussion of indications and complications. Methods for identifying appropriate bony landmarks, insertion of the spinal needle, measurement of opening pressure, and collection of the specimen are illustrated.

 

Procedure instruction is best suited for animation given the necessity for visualization and the importance of anatomy. In comparison, concepts in physiology are more readily illustrated with text and static images. In addition, availability of newly designed interactive visuals from any computer or handheld provides context specificity, which will enhance learning and address practical needs for urgent information in a timely fashion. The creation of interactive visual tools for computer and handheld instruction focuses on a need in the current curriculum for procedure instruction as medical students and house staff train on the wards.

 

BENEFIT TO PARTICIPANTS ATTENDING SESSION:

 

We are creating interactive visual tools on handheld computers to illustrate commonly performed bedside procedures at the point of care. Examples include arterial blood gas sampling, lumbar puncture, paracentesis and thoracentesis. The interactive component is self-directed, and the user is able to select links to relevant anatomy and physiology in parallel with the animation. The teaching of procedures is well suited for animation given the goals of visualizing technique and understanding anatomy.

 

Grace C. Huang, MD

Shapiro Institute for Education and Research

330 Brookline Avenue, E/ES-212

Boston, MA 02215

Phone: 617-667-8413

Fax: 617-667-9122

mailto:ghuang@bidmc.harvard.edu

 

CO-AUTHORS:

Michael J. Parker, MD

Harvard Medical School

260 Longwood Avenue, TMEC 158

Boston, MA 02215

Phone: 617-432-0680

Fax: 617-432-0425

mailto:michael_parker@hms.harvard.edu