- Email: [email protected]
Website in brief
DISSECTING ROOM
Rheumatology on a disk Interactive Rheumatology Tutor A Multimedia Guide to Clinical Rheumatology Ray Armstrong. Port Chester, NY: Cambridge University Press. 1997. $190. ISBN 0-521-62914-4 or most rheumatologists there are the standard textbooks like those of Kelly, Klippel, McCarty and others and we use these books to answer questions regarding multiple clinical problems, terms unfamiliar, or methods of treatment. In building a differential diagnosis, good physicians consult these large tomes, or they consult the accompanying CD-ROM that is not much different than the source book. The Interactive Rheumatology Tutor is a CD-ROM but it is different. It is not a comprehensive textbook, but rather a simply designed practical tutor designed for the student, house officer, family practitioner, and possibly even the specialist rheumatologist. It is fun to use and a rich source of basic material. The tutor is a CD-ROM that contains a wealth of material in both archival and interactive form. There are tutorials, case histories to choose from, and quizzes for which the reader is graded. There are audio and video clips which are especially pleasing that instruct the novice on clinical procedure. The audio presentation is clear and the films are clear and very instructive. There is also a database of important articles to supplement the curious physician’s knowledge of particular subjects. Most importantly the CD is easy to use and will take less than 15 minutes to master, even for those with limited experience or confidence in personal computers. The interactive aspect of this CDROM is the feature that sets it apart from the CDs that are part of large textbooks. It forces the user to focus and concentrate. A “first time user” box is an excellent introduction to the contents of the CD. A table of contents gives the user a complete idea of the scope and depth of the entire program. In the original screen there is something called a “microcosm” that also gives one the entire picture of the CD disk, terms and definitions in easy form. The glossary is complete and quite instructive since it explains key facts about musculoskeletal disease unfamiliar to the novice and is a source of trivia so vital to the student. Like the case-history section, this was an addictive aspect of the disk. The key-word search is a guided tour of the British literature over the past several years and all can be retrieved. The major problem
F
THE LANCET • Vol 352 • September 5, 1998
is that only the British literature is reviewed. Finally there is the omnipresent and welcome “help” icon which makes use of the entire disk a breeze. This reviewer’s biggest problem was exiting the disk when one had to leave in the middle of a case—a problem common in the non-cyber world. The clinical cases read like board questions. There are multiple choices with explanations of the correct and non-correct manner in which to proceed. There are reflexive plans for management of cases that are quite good. The medication lists are quite thorough. There is a section called “modes of presentation” which is separate and really gives an inexperienced practitioner a taste of the manner in which certain conditions might clinically present. The illustrations of entities like rashes, nail changes,eye pathology, and skeletal deformities are all superb. The movies which are not part of the case presentations are designed to show the practitioner how to inject joints like the ankle, or do a careful locomoter system examination such as “examining the wrist.” The true strengths of this CD are in the basics. In a section called the “Arthritis Expert” the user is asked to give actual signs and symptoms to the computer, which then suggests a diagnosis. I found the pattern of which questions were asked more important and useful than the actual resulting diagnosis. I though that the diagnoses were too vague, but this was a good try. In a section called the “management of joint disease” one finds a compendium of therapeutic modes inclusive of orthotics, occupational therapy, and even orthopedic surgery. Lastly, there are the wonderfully challenging exams with are graded instantly with feedback to the student. Short of a professor on the telephone, this is the best way to learn. The drawbacks of the CD are apparent but do not destroy the true value of the program. The biggest problem is the “British” nature of the program. Problems naturally result from this parochial approach to rheumatology. One of the greatest of these problems is the mention of drugs that are foreign to North America and other parts of the world. These drugs are used throughout the program in all forms and are mysterious to this reviewer. There is
also the curious use of terms like “trolley”, &c. Laboratory results are also given in different units, as examples, haemoglobin and albumin are given in grams per litre. Beside the problem of cited papers becoming quickly outdated, they are all from the British literature. I suppose it would be difficult to be all inclusive of great papers in rheumatology, but the current approach is rather narrow. Finally, there is wasted disk space for a notebook included for personal notes and comments. I have never found this mini-word processing approach very helpful since I would be unlikely to leave myself notes in my tutorial program. In summary, the CD-ROM Rheumatology Tutorial is an enjoyable adventure in cyber instruction. It is the best tutorial for this subspeciality that I have seen. It suffers from being very British in its presentation and is in parts incomprehensible to North American physicians who have little time to define European drugs. That notwithstanding, it is particularly good for house officers and non-rheumatologists, probably too much for students, and simply fun for specialists. It is reasonably priced since it is better than an introductory text and the knowledge gained is remembered long after you exit the program.
Rober t G Lahita Columbia University College of Physicians and Surgeons, St Luke’s Roosevelt Hospital, 432 West 58th Street, New York, NY 10019, USA
Website in brief Gorging on nutrition information This Australian-based site offers a splendid compendium of nutrition resources worldwide, prepared under the direction of Tony Helman, a physician who has chaired various nutrition, education, and advisory committees, and who teaches nutrition to family physicians. A vast database of annotated links covers general, clinical, and applied nutrition, food science, and issues related to the food industry, and includes sites in Spanish, Portuguese, German, and English. A weekly e-mail “Update” with abstracts of current clinical nutrition research and commentary is available free to health professionals by sending an e-mail to [email protected] (Arbor Nutrition Guide http://aborcom.com) Marilynn Larkin [email protected]
827
Rheumatology on a disk Interactive Rheumatology Tutor A Multimedia Guide to Clinical Rheumatology Ray Armstrong. Port Chester, NY: Cambridge University Press. 1997. $190. ISBN 0-521-62914-4 or most rheumatologists there are the standard textbooks like those of Kelly, Klippel, McCarty and others and we use these books to answer questions regarding multiple clinical problems, terms unfamiliar, or methods of treatment. In building a differential diagnosis, good physicians consult these large tomes, or they consult the accompanying CD-ROM that is not much different than the source book. The Interactive Rheumatology Tutor is a CD-ROM but it is different. It is not a comprehensive textbook, but rather a simply designed practical tutor designed for the student, house officer, family practitioner, and possibly even the specialist rheumatologist. It is fun to use and a rich source of basic material. The tutor is a CD-ROM that contains a wealth of material in both archival and interactive form. There are tutorials, case histories to choose from, and quizzes for which the reader is graded. There are audio and video clips which are especially pleasing that instruct the novice on clinical procedure. The audio presentation is clear and the films are clear and very instructive. There is also a database of important articles to supplement the curious physician’s knowledge of particular subjects. Most importantly the CD is easy to use and will take less than 15 minutes to master, even for those with limited experience or confidence in personal computers. The interactive aspect of this CDROM is the feature that sets it apart from the CDs that are part of large textbooks. It forces the user to focus and concentrate. A “first time user” box is an excellent introduction to the contents of the CD. A table of contents gives the user a complete idea of the scope and depth of the entire program. In the original screen there is something called a “microcosm” that also gives one the entire picture of the CD disk, terms and definitions in easy form. The glossary is complete and quite instructive since it explains key facts about musculoskeletal disease unfamiliar to the novice and is a source of trivia so vital to the student. Like the case-history section, this was an addictive aspect of the disk. The key-word search is a guided tour of the British literature over the past several years and all can be retrieved. The major problem
F
THE LANCET • Vol 352 • September 5, 1998
is that only the British literature is reviewed. Finally there is the omnipresent and welcome “help” icon which makes use of the entire disk a breeze. This reviewer’s biggest problem was exiting the disk when one had to leave in the middle of a case—a problem common in the non-cyber world. The clinical cases read like board questions. There are multiple choices with explanations of the correct and non-correct manner in which to proceed. There are reflexive plans for management of cases that are quite good. The medication lists are quite thorough. There is a section called “modes of presentation” which is separate and really gives an inexperienced practitioner a taste of the manner in which certain conditions might clinically present. The illustrations of entities like rashes, nail changes,eye pathology, and skeletal deformities are all superb. The movies which are not part of the case presentations are designed to show the practitioner how to inject joints like the ankle, or do a careful locomoter system examination such as “examining the wrist.” The true strengths of this CD are in the basics. In a section called the “Arthritis Expert” the user is asked to give actual signs and symptoms to the computer, which then suggests a diagnosis. I found the pattern of which questions were asked more important and useful than the actual resulting diagnosis. I though that the diagnoses were too vague, but this was a good try. In a section called the “management of joint disease” one finds a compendium of therapeutic modes inclusive of orthotics, occupational therapy, and even orthopedic surgery. Lastly, there are the wonderfully challenging exams with are graded instantly with feedback to the student. Short of a professor on the telephone, this is the best way to learn. The drawbacks of the CD are apparent but do not destroy the true value of the program. The biggest problem is the “British” nature of the program. Problems naturally result from this parochial approach to rheumatology. One of the greatest of these problems is the mention of drugs that are foreign to North America and other parts of the world. These drugs are used throughout the program in all forms and are mysterious to this reviewer. There is
also the curious use of terms like “trolley”, &c. Laboratory results are also given in different units, as examples, haemoglobin and albumin are given in grams per litre. Beside the problem of cited papers becoming quickly outdated, they are all from the British literature. I suppose it would be difficult to be all inclusive of great papers in rheumatology, but the current approach is rather narrow. Finally, there is wasted disk space for a notebook included for personal notes and comments. I have never found this mini-word processing approach very helpful since I would be unlikely to leave myself notes in my tutorial program. In summary, the CD-ROM Rheumatology Tutorial is an enjoyable adventure in cyber instruction. It is the best tutorial for this subspeciality that I have seen. It suffers from being very British in its presentation and is in parts incomprehensible to North American physicians who have little time to define European drugs. That notwithstanding, it is particularly good for house officers and non-rheumatologists, probably too much for students, and simply fun for specialists. It is reasonably priced since it is better than an introductory text and the knowledge gained is remembered long after you exit the program.
Rober t G Lahita Columbia University College of Physicians and Surgeons, St Luke’s Roosevelt Hospital, 432 West 58th Street, New York, NY 10019, USA
Website in brief Gorging on nutrition information This Australian-based site offers a splendid compendium of nutrition resources worldwide, prepared under the direction of Tony Helman, a physician who has chaired various nutrition, education, and advisory committees, and who teaches nutrition to family physicians. A vast database of annotated links covers general, clinical, and applied nutrition, food science, and issues related to the food industry, and includes sites in Spanish, Portuguese, German, and English. A weekly e-mail “Update” with abstracts of current clinical nutrition research and commentary is available free to health professionals by sending an e-mail to [email protected] (Arbor Nutrition Guide http://aborcom.com) Marilynn Larkin [email protected]
827