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



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.


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.


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.


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.


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.


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