P&S Journal: Fall 1995, Vol.15, No.3
Plugging P&S into the:Technological Age: by Doug Brunk
Outside the classroom, a massive-and still growing-network of information now dwarfs even the largest traditional library collection. Exploiting the technology is enhancing the medical education experience.
Tami Smith'98 studies for a final exam by viewing "slides" in a laserdisc histology atlas accessible through a laserdisc player projecting to a video monitor. Laserdisc technology works well for large image collections. A 12-inch laserdisc can hold 54,000 "slides" (analog video images, not strictly digital images). By contrast, a CD-ROM can hold only about 600 digital images.
But not everyone who walked the corridors of Bard Hall learned in the same way today's students are learning. Now, more than ever, the physicians of tomorrow "surf" the Internet and other computer-based online information sources to supplement their studies, communicate with faculty and peers through e-mail instead of dropping notes into mailboxes, and view histology slides from a computer monitor, not just through the lens of a microscope.
Efforts to computerize P&S are taking a big leap forward. By the fall of 1996 technicians will supply Bard Hall and the Georgian Building with access to CPMCnet-the Internet and World Wide Web connection developed and maintained by the Center for Academic Information Technology at the Health Sciences Library. To borrow a phrase P&S Dean Herbert Pardes used in the spring to describe this computer movement, "every pillow will be wired."
These developments are part of a massive plan to help faculty, staff, and students keep pace with the expanding vault of information online. One goal of the Columbia Health Information PerspectiveS project (CHIPS), for example, is to create an electronic curriculum that enables students to control how, when, where, and in what sequence they learn. Because computers are playing an increasing role in the diagnosis, treatment, and administration of patients, the P&S computerization plan is also meant to provide a realistic tool for the practice of medicine. Today's physicians need to know how to use the computer to look up the latest recommendation on prescribing Prozac, for instance, or the National Cancer Institute's guidelines on mammograms for women under 40.
"The instrument is so essential to the practice of medicine right now that we have to develop something that forces students to use it," says Dr. Herbert Chase Jr., associate professor of clinical medicine. "It has to mimic what they're going to be using."
Using CPMCnet's 24-hour access, Dr. Chase and others are crafting a system that will do much more than transfer printed course materials to the computer. They envision a resource tool that integrates information from a variety of mediums in one place, so students can wave goodbye to stacks of textbooks and journals, piles of scribbled notes, and repetitive information delivered by faculty in lectures.
CHIPS is an extension of the campus-wide curriculum revision project that began in 1991. The main purpose of that project was to make learning more interactive and self-directed for students at P&S. "We also realized that there is too much to teach in the classroom," says Pat Molholt, assistant vice president and associate dean for scholarly resources. "By allowing faculty the lecture time to set the stage, to talk about the principles and concepts, but leave the details to technology-where the students can deal with it independently-it's going to be a better use of everybody's time."
The CHIPS curriculum model currently focuses on medicine, but its developers hope it will eventually extend to the schools of dentistry, nursing, and some aspects of public health. Although full implementation of the medical model is at least two years away, faculty are now reviewing stacks of curriculum materials and making suggestions on what to transfer from the lecture environment into the electronic environment.
Four years ago Dr. Chase designed and implemented the integrated and multidisciplinary course, Science Basic to the Practice of Medicine. This course, required of first-year P&S students, is a 325-hour effort involving 75 faculty members who provide the basic medical science that serves as a foundation for understanding the human body in health and in disease.
Last year Dr. Chase received a grant from the U.S. Department of Education Fund for the Improvement of Postsecondary Education to establish an electronic basic medical science core curriculum. This system will direct students from a core faculty-driven electronic syllabus to advanced sources of information such as histology slides, textbooks, journal articles, and video presentations.
"The goal is to create something that is unique, that cannot be mimicked in hard copy. It will have a search engine, for example, to look up glossary words. Wherever you are, you can go someplace else by linking. It will have crisp color micrographs of all the anatomical support of all the issues that we're teaching, unlike most books. It will have real-time renditions of a beating heart and other organs. A student could create an environment like this by sitting at his or her desk, opening up 50 books, and manipulating a video cassette player, but it will be much more efficient to do it on the computer."
Dr. Chase has selected abstracts from Science, Nature, the New England Journal of Medicine, and the Journal of Clinical Investigation for students to search and retrieve.
"The faculty will provide the advanced material and choose which articles students should read, along with an explanation of why the best are the best," he says.
Columbia ranks among the leaders in its effort to integrate curriculum material and make it accessible with the click of a computer mouse. "We're one of the few institutions to offer an integrated first-year course and probably the only one that's trying to put this online," Dr. Chase says.
Students will be able to access resources beyond the campus such as Medline, NIH databases, and material created by other colleges and universities. The reverse will be true, too. Anyone who dials into CPMCnet from outside the campus will be able to search Columbia-generated information designed for public access.
|| New generation of computer-literate medical students includes, from left, Yoav Gershon, Ellen Whalen, Debbie Ganem , and Ajay Kirtane
Ellen Whalen'98, a student representative on the curriculum committee, sees advantages in an online curriculum. "It won't be this paper trail that we deal with every day trying to find the right notes," she says. "Because the syllabus is constantly evolving it will be easier to make changes, too. What's most exciting is that it will have video clips like a beating heart. We spent a couple weeks doing cardiac physiology this year, and for me it was very difficult. I had to put the whole heart in extremely slow motion in my mind to see what was beating when and how the pressures were changing. To have one good video clip for a couple of minutes would probably alleviate a lot of that effort."
Prototypes of the renal system and the pulmonary system and an introduction to the central nervous system already exist on CPMCnet. These tutorials were designed largely by Jeff Zucker and his colleagues in the Center for Academic Information Technology.
"It's a challenge to take the content materials that the instructors provide and, in a sense, do them justice in this medium," says Mr. Zucker, coordinator of online publishing and Internet services, who also has 20 years of experience in curriculum design. "By juxtaposing different kinds of information, students gain new insight. We're trying to include a number of features that will allow users to customize their view of the materials, keep track of what part they have seen already. We're also going to install a note system so the user can cut and paste from the electronic version into their own notes and highlight important areas."