The Center for Biomedical Informatics
State University of Campinas, Brazil

Research Abstracts

The use of computers in Health Sciences education by means of individualized instructional programs offers many pratical and pedagogical advantages, and has been increasing exponentially in recent years, in all over the world. Among its applications. the simulation of clinical cases through computers has found an increased application in the training of students of Health Sciences, particularly in the area of decision-making and patient management problems. This consists of a dialogue between the computer and the student, as the computer presents a real or fictitious clinical case in some area of Medicine, Nursing, etc. The case progresses according to the answers given by the students to questions and decision points posed by the program; with relation to the hypothetical diagnosis, therapeutic intervention, patient management, etc.; this simulating the clinical encounter (e.g., patient-physician) and the methodology of clinical problem solving. In the present work, we relate an undergoing development project at the School of Medical Sciences at the State University of Campinas, Brazil, with the aim to build and apply a large set of clinical simulations in microcomputers, in undergraduate and graduate medical education. All the work involving the design, coding and testing of simulation courseware is carried out by several teams composed by medical and nursing students, led by a member of the faculty in his(hers) area of specialization. Each small group choses a delimited thematic area and develop computer-based tutorials, questionnaires and simulations around that theme. In order to facilitate training and development time, we have developed a generic authoring system for computer-based learning, named MEDTEST I, which is ideally suited to the building and presentation of all kinds of interactive case simulations. The program was written in compiled Turbo BASIC (Borland) for IBM/PC-compatible microcomputers, and can be used by any teacher, even those with little computer experience. The cases are simply written into a "script" file, using any ASCII-oriented text processing program. MEDTEST reads and processes this text, managing its presentation to the student according to command lines embedded by the case writer into the script file. There are ca. 30 easy-to-use commands, constituting a simple command language, with mnemonic words available simultaneously in three idioms: English, Portuguese and Spanish. The program allows also for ca. 15 'environmental' commands, which are used to specify the control structures during execution, such as: allowance for repetition of wrong answers, immediate or delayed review of correct answers and comments, scoring, student identification and storage of student performance, etc. Conditional and inconditional jumps from frames and questions can also be programmed. In addition to presentation frames and 5 different types of multiple-choice and open questions, the program allows for static graphic screens (PIC or PCX standards), sounds, etc. Finally, MEDTEST I has the capability of running external programs of any kind, as long as they fit in memory, as subroutines. Thus, external procedures can be used to enhance the presentation, such as animated graphs, tools, numerical simulations, etc. The MEDTEST I program is completed and fully documented and is available for free for accredited schools in the health sciences, from the author nursing schools, as well.

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Last Updated: March 2, 1996

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