Smith PK, Fardon M, Stoll P, Martin A, Lines D, Forsyth KD
Fardon M, Stoll P, Martin A
CAL unit, School of Medicine
Flinders University, Bedford Park, SA 5042
Smith PK, Lines D, Forsyth KD
Department of Paediatrics and Child Health,
Flinders University, Bedford Park, SA 5042
The Childhood Seizures CD-ROM is a National Multimedia project; developed at Flinders University, Australia. The program covers the areas of Neurophysiology, Electroencephalography, Neuroradiology, Seizure Types, Investigations, Management, and Neuropharmacology. This CD-ROM contains two novel forms of student self-evaluation. The first is ëSeizure Managerí, an interactive simulation where the student assumes the role of a doctor in an emergency department. The student has to make management decisions under the pressures of time, an animation of a fitting child and video interjections from the mother and a nursing sister. Personalised video analyses are created from management choices selected. The second form of self evaluation occurs in the form of quizzes selected from random banks of questions. These provide rapid feedback and encourage revision to improve upon quiz marks.
Important outcomes of this project have been to provide simulated
emergency management experience and to create educational multimedia
that is both entertaining and stimulating.
Keywords Seizure, Epilepsy, CD-ROM,
Evaluation, Multimedia, Education
DESCRIPTION
The Childhood Seizures CD-ROM is a comprehensive multimedia resource
of basic and clinical sciences related to seizures in children.
It contains sections on neurophysiology, electroencephalography,
radiology, seizure types, investigations of seizures, management
of seizures, pharmacology of anticonvulsants and a simulation
ìSeizure Managerî, where the student assumes the
role of a doctor, looking after a fitting child. In the simulation,
the program tracks the management paths taken by the student and
generates individualised video feedback based on their choices.
The program is modular in design and provides the student with
opportunities to self evaluate as they complete topics.
The CD-ROM has been developed with the support of all 10 Medical
schools in Australia and was distributed to them free of charge
in February 1996. The developers are not aware of any previous
national collaborations in medical education Most centres are
using the program as an augmentation to clinical teaching. At
least one University has replaced a traditional lecture with the
program. The program allows students to save individual bookmarks
and an educator can select a tour for students by compiling a
list of bookmarks from within the notes section. At Flinders University
it is available in the computer assisted learning suite. Approximately
25% of the program use is out of traditional teaching hours.
PEDAGOGY
Well-constructed multimedia can improve the effectiveness of learning
(Fletcher 1990, Janson 1992), with better recognition and recall
of events compared to paper-based learning (Goldstein 1994). We
have developed multimedia educational software for paediatrics.
The Childhood Seizures CD-ROM was initiated after surveying student
opinions of topics which they would like multimedia resources
developed. ìChildhood Seizuresî was structured to
allow students to control the direction of their learning, in
a mixed linear-hierarchical manner which is ideal for effective
interactive learning (Laurillard 1993). The multimedia software
allows students to use their preferred sensory modes for learning
(Oblinger 1993) and the CD-ROM has the expertise of specialists
from around Australia. Flexible learning allows students to selectively
access information. This is a feature of adult learning principles
and also can be used to reinforce clinical experiences. Immediate
feedback to questions enables students to become their own evaluators.
In the conventional treating methods less than 10% of students
see a seizure during their training, let alone get the experience
to manage one. A ërole-playí simulation was incorporated
into the software to provide practice in management skills under
the pressure of an emergency. Students feedback that this type
of simulation is highly valued.
Evaluation surveys indicate 100% of students agree their knowledge
of Childhood Seizures has increased by use of the program. Multicentre
quantitative evaluation is still in progress. Local studies of
a clinical examination related to seizure recognition, investigation
and management has shown an improvement in student exam performance
from 68.0% to 84.4% (Paired t = P<0.05, N = 18 each group)
since the availability of the program (Figure 1) Long term information
retention and multicentre evaluation is in progress.
Figure 1: OSCE (Objective Subjective Clinical Examination) scores
Pre and Post availability of the Childhood Seizures CD-ROM for
teaching in Paediatric Epileptology.
STUDENT USE
The program was developed for medical students. A deficiency of
medical education in teaching the basic sciences is that the information
which needs to be imparted frequently refer to clinical conditions.
An example of this is seizure types. Students learning about the
neurophysiology or drugs used to treat certain seizures may not
even know the characteristics of the various types of seizures.
Students can learn about seizure types from exploring this program.
The program is designed to be available for use across the curriculum.
Most use of the program is currently in the clinical attachment
to Paediatrics. At Flinders University students doing Physiology
and Pharmacology are directed to the program. The program is comprehensive
and contains more information than the medical student is required
to learn. The rationale from this has been to allow students to
obtain information about conditions which they may wish to learn
more about later in their medical training. The program also is
useful for postgraduate education because of itís depth.
Childhood Seizures contains information which may be useful to
nursing and allied health courses.
DEVELOPMENT
The program was initially developed after personally discussing
development details with all the paediatric departments of medical
schools in Australia. Comments, criticisms and the best resources
were obtained. The programming was done at Flinders University
School of Medicineís CAL unit by Michael Fardon in Supercard
2.5. Digitisation, sound and video editing was done by Paul Stoll.
High speed digitisation was done by Graeme Smith. The program
was produced by Dr Pete Smith a paediatrician at Flinders University.
Professor Kevin Forsyth and Ms Anne Martin were involved in the
management team. Childhood Seizures has vignettes from 38 specialists
from around Australia.
There are over 200 movies within the program. Thorough use of
the program takes over 6 hours. The program consumes 560 Mb of
a CD-ROM. The resources are external to the program, so they may
be easily updated or modified at a particular site to suit local
ideas or purposes. All seizure videos have been digitised at 25
frames per second as movement is important, and have also been
stored at 30 FPS, full screen for subsequent DVD formatting. The
seizures have been selected from across Australia on the basis
of demonstrating the seizure type and quality of the video.
The program is networkable, with server paths built in and also
runs well across double ISDN lines for teleconferencing.
TIMETABLE
Work on the project was commenced September 1994 and the Beta
version was completed in February 1996. refinements to the beta
version are being continually implemented. The refinements are
based on comments received from the beta version and include converting
the program to run on an IBM as well as the Macintosh platform.
REFERENCES
Fletcher JD, The effectiveness of interactive videodisc instruction
in defence training and education. 1990, Arlington, VA.
Goldstein MK, Clarke AE, Michelson D, Garber AM, Bergen MR and
Lenert LA, Developing and testing a multimedia presentation
of a health-state description, Med Decis Making. 1994 Oct-Dec;
14(4): 336-44.
Janson JL, Simulation program helps Coast Guard sink training
costs. PC Week Special Reports: Graphics. 1992. January:
91-93.
Laurillard DM, Rethinking University Teaching: A Framework
for the Effective Use of Educational Technology. London, Routledge,
1993.
Oblinger D, Multimedia in instruction. 1993. Chapel Hill
NC: The Institute for Academic Technology.