Hypermedia and Educational Systems. Systems for Enhancing Medical Education: The Clinical Problem-Solving Exercise: An Orthogonal Approach to Organizing Medical Knowledge

摘要

Clinical problem-solving exercises have long been used as a way of providing simulated experience with clinical medicine. Multimedia capabilities now available extend the potential for realism of these exercises. In addition, with the use of hypermedia methodologies, it is now possible to link components of a clinical case — e.g., the tests, the images (or sounds, or tracings) of the actual results, or the textual descriptions of findings — with other related information. This information can amplify on the tests themselves, the range of possible results that could alternatively have been obtained, the differential diagnosis of any particular finding, or the profiles of diseases in the differential, and can provide discussions and references about the diseases. Thus the case problem-solving exercise may have potential for more than providing practice with making clinical judgments; it may offer an alternative paradigm for accessing much of the same medical content traditionally delivered in didactic lectures and in textbook presentations. We have implemented an authoring environment for case problem-solving exercises that enables access to multimedia presentation of clinical results, and related clinical and pathophysiologic content material. Case simulations designed with this approach are currently being used in teaching first-year medical students in the HST track of the Harvard Medical School.