John C. Reid, Ph.D.
University of Missouri--Columbia

Joyce A. Mitchell, Ph.D.
University of Missouri--Columbia

Integrating Computers into Healthcare Education

ABSTRACT

We describe ten years' experience of integrating computers into a medical school curriculum, eight years with a traditional curriculum and two years with a problem-based curriculum. Integration involves (1) identifying where in the curriculum computers can help education, (2) working with administrators, faculty, and students to suggest functions and capabilities, (3) teaching faculty and students basic computer skills as well as training them to use particular software, (4) responding to faculty and students suggestions, (5) providing a solid hardware base, and (6) having helpful and responsive personnel. Keeping accurate usage statistics has helped us make wise fiscal decisions, and conducting research studies has kept us aware of students' needs and processes.

PAPER

Introduction

In 1985, the Dean of the School of Medicine funded a computerfacility to help implement the GPEP (1984) recommendations regarding computer literacy and informatics education for medical students. Since the medical school at Missouri switched to a problembased curriculum two years ago, informatics literacy at MU is now based upon problembased learning. We describe our experiences the last ten years.

Purpose

The goals of integrating computers into the curriculum derive from faculty recommendations, and are threefold:
  1. all students should be able to use computing skills and technology for general tasks as well as in their chosen fields

  2. faculty and student should have access to the most appropriate computing resources for their research and scholarship

  3. computing should be integrated into instructional programs throughout the curriculum
Method

To achieve these goals, we have worked in six areas:

(1) identify where in the curriculum computers can help education, (2) promote standardized vocabularies, presentation models, and interfaces for teaching modules, (3) teach faculty and students basic computer skills as well as train them to use particular software, (4) respond to faculty and students' suggestions, (5) provide a platformindependent system, and (6) have helpful and responsive personnel.

To identify where in the curriculum computers can help, we have obtained outlines of the curriculum and objectives and have identified computerized helps throughout.

To promote standardized vocabularies, presentation models, and interfaces, we are adopting client/server architecture following the Mosaic model, and are holding short courses in hypertext markup language, document markup, and construction.

Since our start in 1985, we have taught students how to use the computer and software packages. In the early years we required students to demonstrate they could use the computer (insert the floppy with this side up). The sophistication of the students has increased over the years; of the current entering class of medical students, half uses the computer at least weekly. We now teach introduction to Windows, office mail, using the internet and Medline searches the first week of class. Later in the semester we offer other classes such as word processing. We also maintain a computer file of helps and tips. Computer lab assistants answer questions throughout the day. We are planning to create a computer learning center where faculty and students in the health sciences can get professional assistance on designing instruction, putting resources on the server, identifying existing instructional modules, digitizing slides, etc. A Computer Advisory faculty committee coordinates the acquisition of software and procures faculty and technical evaluations of all recommended software. We have also held open houses, seminars, short courses, and departmental demonstrations.

We respond to faculty and students' suggestions as we can. For example, we accommodated radiology faculty suggestions to install more radiographs on the server for student instruction, but so far we have not yet been able to accommodate student requests for dialup email from their home.

Initially the library staff checked out software and keys to run the computers; currently, the software is on the server and students access programs directly. Not only are we working toward client/server architecture throughout, we are also working toward interoperability so that students and faculty can access the materials at the health sciences center from a platform they are most comfortable with.

Finally one of our strengths and good fortune is to have had technically expert and helpful personnel. Any organization is judged by the people representing it who serve the public, and good public relations is a requirement of any successful endeavor. Our personnel have three kinds of expertise: (1) a programmer analyst (full time), (2) an electronics technician (part time), and (3) several parttime student assistants to help faculty and health professions students with concerns.

The Future

Five years after starting, we had 160 different software titles; we now have 120 different software titles, the decreased number being due to a weeding out of less effective instructional software programs. We have tracked software usage over time. Word processing has always been the single most popular application among our health professional users.

Last year we introduced an office mail program to one medical student class, and it was so popular that we expanded it to the remaining classes this year. In two years the office mail program has grown from zero to be the second most popular program. Intercommunication among medical students should increase learning, build support groups, and fits with the philosophy of our present problembased curriculum. The third most popular was Medline searching software. Last year (9394) internet uses represented 2% of the total programs used; it will be 1020% this coming year.

Beyond these four applications, other popular software includes:

Spreadsheets
Expert systems (such as Iliad and QMR)
Medical databases and references (such as Stat Ref!, Scientific American, and FREIDA)
Test question banks
Computer assisted instruction such as AI/Learn/Rheumatology
Patient case studies

We have witnessed a dramatically increasing use of software over time: from 40,000 software uses in 199394 to an estimated 85,000 a year later.

Conducting research studies on formative evaluation (Reid & Mitchell, 1991), interfaces, and effectiveness of instructional support systems (Bridges et al., 1992; Reid et al. 1994) has kept us aware of students' needs and cognitive processes.

With the expansion of software, internet resources, and an enlarged facility to help train students and faculty, we look for even greater integration in the coming decade.

References

Reid, J. C., & Mitchell, J. A. The Improvement of Learning in Computer Assisted Instruction. Journal of Educational Technology Systems, 19: 281289, 1991.

Bridges, A. J., Hazelwood, S. E., Reid, J. C., Sharp, G. C., & Mitchell, J. A. Effectiveness of an inpatientbased rheumatology elective. Academic Medicine, 67: 866867, 1992.

Reid, J. C., Minor, M.A., Mitchell, J.A., Patrick, T. B., Griffin, J. Z., Cutts, J. C. III, Morrow, M. & Thompson, N. OARehab: Designing a personalized exercise program for people with osteoarthritis. SCAMC Proceedings 18th Symposium on Computer Applications in Medical Care, 1994, Ed J Ozbolt. Philadelphia: Hanley & Belfus, p 987.

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