- Email: [email protected]
10-55 Introductory testing of an objective structured clinical examination (OSCE) in radiology for medical students: Correlation with clerkship evaluations
10-53
10-55
Web-based Instruction in Interpretation of the ICU Chest Film Joss D. Fernandez, University of Virginia Health System, Charlottesville, VA, Spencer B. Gay, MD, Raymond C. Rubner, MD, John M. Jackson, MEd, Paul M. Dee, MB Purpose: Rapid interpretation of chest x-rays by radiologists, intensive care physicians, and surgeons is essential when treating critically ill patients. This interactive web site is designed to teach residents and medical students in radiology and intensive care unit specialties to recognize common pathology in the chest. Materials and Methods: This web site was designed using Dreamweaver 2 and contains diagnostic principles based on current radiology literature. Images were selected from the University of Virginia teaching file and as they were encountered during radiology rounds. Each film was scanned using a Vidar film digitizer and enhanced using Photoshop 5.5. Results: This web site employs a unique teaching style that combines the interactive capacity of the web with traditional view box teaching. The information is delivered in a concise fashion, with common chest x-ray findings illustrated in a logical and interactive manner. The user is continually challenged to synthesize information through the use of interactive tools, including multiple-choice questions and "point and click" exercises. Conclusion: This program should enable the user to recognize normal and pathological appearances of portable chest x-rays in the postoperative or ICU patient, as well as common complications of tube and line placement.
Introductory Testing of an Objective Structured Clinical Examination (OSCE) in Radiology for Medical Students: Correlation with Clerkship Evaluations Eyal Morag, MD, Beth Israel Deaconess Medical Center, Boston, MA, Gillian B. Lieberman, MD, Elvira V. Lang, MD Background: There is increasing dissatisfaction with the limited abilities of traditional oral and written examinations to assess clinical skills in a standardized fashion. Therefore OSCEs have been introduced in other specialties. We assessed their value in radiology. Materials and Methods: An OSCE was constructed from 5 cases. Each had 7-10 standardized questions testing, in a set time, perception of essential findings, interpretation, and clinical judgment (maximal score 100). If needed, standardized prompts were permitted. The test was given to incoming 4th-year medical students and was required for graduation. OSCE grades of 113 students were correlated with (a) grades obtained during a one-month compulsory clerkship during which all OSCE-tested diagnoses had been taught, and (b) the time interval between clerkship and OSCE. Grades were high honors = 3, honors = 2, satisfactory = 1, and fail = 0. Results: There was a very weak correlation between the OSCE and clerkship grades (y = 59.7 + 5.9x, p = 0.03, R 2 = 0.08) and no correlation between OSCE grades and time elapsed since the clerkship nor any difference in scores between students who had taken the clerkship and those who had not. Conclusion: The skills needed to succeed in the OSCE may differ from those transmitted and graded in the clerkship. 10-56
10-54 Incorporation of Radiology into the Medical Gross Anatomy Web Site Natalie A. Saunders, BS, University of Michigan, Ann Arbor, MI, Marilyn A. Roubidoux, MD, Thomas R. Gest, PhD, William E. Burkel, PhD Purpose: Radiology is an important part of the first-year medical gross anatomy. Historically, eight lectures have been presented by radiology faculty, accompanied by labeled radiographs for correlative study. In the fail of 1998, the radiology material was made available in the web courseware to improve learning. Thereafter, faculty decided to more extensively correlate radiologic and gross anatomy images. Materials and Methods: During the summer of 1999, we edited our web-based materials via collaboration among a second-year medical student and faculty of the Radiology and Gross Anatomy Departments. This medical student helped to choose images and performed the computer work necessary to incorporate radiologic images into the anatomy laboratory manual on the web site, so students could correlate anatomy with radiology. Plain films, MRI, CT scans, and angiograms were utilized by using Adobe Photoshop® 5.0, Adobe Image Ready TM 1.0, and Dreamweaver programs. Results: Student evaluations and focus-group discussion results will be presented, and the web-based radiology materials will be demonstrated. Conclusion: The incorporation of radiologic images into the first-year medical student instructional materials for gross anatomy is an important method for instruction of gross anatomy. This can be efficiently accomplished by the assistance of second-year medical students to develop and integrate radiologic images into anatomy course materials.
1050
What Next? An Interactive Tool to Improve Radiologi. cal Decision Making Charles Wang, MD, University of Massachusetts Medical Center, Worcester, MA, Chun-Sham Yam, PhD, Thomas M. Cummings, MD, Rodrick A. Williams, MD, Jay M. Colby, MD, Susan A. Afonso, MD, et al Purpose: "What Next" is a multimedia interactive software program for radiologists that is designed to improve clinical and radiologlcal decision-making. The program is embedded in a larger database of reference information and has automatic integration with preselected web-based sources. Materials and Methods: Over 100 cases with approximately 1000 images have been organized into a diagnostic "game." Findings and images are noted together with their clinical scenario, and questions are asked of the user relevant to the appropriate next step ("What Next?"). References to the subjects are provided. The user is scored according to performance, and self-evaluation is readily accomplished. Microsoft Access and Visual Basic Tools represent the programming software. In addition, the program is accessible on the World Wide Web. Conclusion: The computer has brought a new dimension to learning, which allows information to be displayed in a multimedia format which can be highly informative as well as entertaining. "What Next?" is a program that takes full advantage of the computer and web as educational tools. 11-57 Educational and Clinical Uses of the 3COM Palm Pilot in an Academic Interventional Radiology Program Kelly J. Van Epps, MD, Johns Hopkins Hospital, Baltimore, MD, Aravind Arepally, MD, Joseph A. Ronsivalle, DO, F. Nicholas Franano, MA, MD
10-55
Web-based Instruction in Interpretation of the ICU Chest Film Joss D. Fernandez, University of Virginia Health System, Charlottesville, VA, Spencer B. Gay, MD, Raymond C. Rubner, MD, John M. Jackson, MEd, Paul M. Dee, MB Purpose: Rapid interpretation of chest x-rays by radiologists, intensive care physicians, and surgeons is essential when treating critically ill patients. This interactive web site is designed to teach residents and medical students in radiology and intensive care unit specialties to recognize common pathology in the chest. Materials and Methods: This web site was designed using Dreamweaver 2 and contains diagnostic principles based on current radiology literature. Images were selected from the University of Virginia teaching file and as they were encountered during radiology rounds. Each film was scanned using a Vidar film digitizer and enhanced using Photoshop 5.5. Results: This web site employs a unique teaching style that combines the interactive capacity of the web with traditional view box teaching. The information is delivered in a concise fashion, with common chest x-ray findings illustrated in a logical and interactive manner. The user is continually challenged to synthesize information through the use of interactive tools, including multiple-choice questions and "point and click" exercises. Conclusion: This program should enable the user to recognize normal and pathological appearances of portable chest x-rays in the postoperative or ICU patient, as well as common complications of tube and line placement.
Introductory Testing of an Objective Structured Clinical Examination (OSCE) in Radiology for Medical Students: Correlation with Clerkship Evaluations Eyal Morag, MD, Beth Israel Deaconess Medical Center, Boston, MA, Gillian B. Lieberman, MD, Elvira V. Lang, MD Background: There is increasing dissatisfaction with the limited abilities of traditional oral and written examinations to assess clinical skills in a standardized fashion. Therefore OSCEs have been introduced in other specialties. We assessed their value in radiology. Materials and Methods: An OSCE was constructed from 5 cases. Each had 7-10 standardized questions testing, in a set time, perception of essential findings, interpretation, and clinical judgment (maximal score 100). If needed, standardized prompts were permitted. The test was given to incoming 4th-year medical students and was required for graduation. OSCE grades of 113 students were correlated with (a) grades obtained during a one-month compulsory clerkship during which all OSCE-tested diagnoses had been taught, and (b) the time interval between clerkship and OSCE. Grades were high honors = 3, honors = 2, satisfactory = 1, and fail = 0. Results: There was a very weak correlation between the OSCE and clerkship grades (y = 59.7 + 5.9x, p = 0.03, R 2 = 0.08) and no correlation between OSCE grades and time elapsed since the clerkship nor any difference in scores between students who had taken the clerkship and those who had not. Conclusion: The skills needed to succeed in the OSCE may differ from those transmitted and graded in the clerkship. 10-56
10-54 Incorporation of Radiology into the Medical Gross Anatomy Web Site Natalie A. Saunders, BS, University of Michigan, Ann Arbor, MI, Marilyn A. Roubidoux, MD, Thomas R. Gest, PhD, William E. Burkel, PhD Purpose: Radiology is an important part of the first-year medical gross anatomy. Historically, eight lectures have been presented by radiology faculty, accompanied by labeled radiographs for correlative study. In the fail of 1998, the radiology material was made available in the web courseware to improve learning. Thereafter, faculty decided to more extensively correlate radiologic and gross anatomy images. Materials and Methods: During the summer of 1999, we edited our web-based materials via collaboration among a second-year medical student and faculty of the Radiology and Gross Anatomy Departments. This medical student helped to choose images and performed the computer work necessary to incorporate radiologic images into the anatomy laboratory manual on the web site, so students could correlate anatomy with radiology. Plain films, MRI, CT scans, and angiograms were utilized by using Adobe Photoshop® 5.0, Adobe Image Ready TM 1.0, and Dreamweaver programs. Results: Student evaluations and focus-group discussion results will be presented, and the web-based radiology materials will be demonstrated. Conclusion: The incorporation of radiologic images into the first-year medical student instructional materials for gross anatomy is an important method for instruction of gross anatomy. This can be efficiently accomplished by the assistance of second-year medical students to develop and integrate radiologic images into anatomy course materials.
1050
What Next? An Interactive Tool to Improve Radiologi. cal Decision Making Charles Wang, MD, University of Massachusetts Medical Center, Worcester, MA, Chun-Sham Yam, PhD, Thomas M. Cummings, MD, Rodrick A. Williams, MD, Jay M. Colby, MD, Susan A. Afonso, MD, et al Purpose: "What Next" is a multimedia interactive software program for radiologists that is designed to improve clinical and radiologlcal decision-making. The program is embedded in a larger database of reference information and has automatic integration with preselected web-based sources. Materials and Methods: Over 100 cases with approximately 1000 images have been organized into a diagnostic "game." Findings and images are noted together with their clinical scenario, and questions are asked of the user relevant to the appropriate next step ("What Next?"). References to the subjects are provided. The user is scored according to performance, and self-evaluation is readily accomplished. Microsoft Access and Visual Basic Tools represent the programming software. In addition, the program is accessible on the World Wide Web. Conclusion: The computer has brought a new dimension to learning, which allows information to be displayed in a multimedia format which can be highly informative as well as entertaining. "What Next?" is a program that takes full advantage of the computer and web as educational tools. 11-57 Educational and Clinical Uses of the 3COM Palm Pilot in an Academic Interventional Radiology Program Kelly J. Van Epps, MD, Johns Hopkins Hospital, Baltimore, MD, Aravind Arepally, MD, Joseph A. Ronsivalle, DO, F. Nicholas Franano, MA, MD