A Multimedia Educational System to Teach Epidemiology
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1 284 A Multimedia Educational System to Teach Epidemiology Marianna Diomidous Department of Public Health, Faculty of Nursing, University of Athens, Greece Abstract An educational system has been developed which consists of a module to help both teachers to design courses with different levels of knowledge regarding epidemiology and students to get acquainted with the field of epidemiology. The software development product Director was used to develop the software application. The capacity required to install the software is 130MB although each individual component is not greater than 1.2 megabytes in order to facility its handling. The user interface of the system employs colour, text, complementary voices and animation. Moreover, exercises have been designed to facilitate the learning process and to allow students and teachers to interchange information with it. The system has been evaluated by a number of 65 students both graduate and undergraduate. Half of them were attending the undergraduate course in Nursing. The rest were graduate students attending a Master s Course in Health Informatics and Health Management. The first group of students had some prior knowledge of Epidemiology. The latter group had different levels of knowledge (none, little prior knowledge or an intermediate level of knowledge), of Epidemiology. The scope of this research is to prove the efficiency of Multimedia in teaching the rather difficult subject of Epidemiology. Keywords: Epidemiology, Education, Multimedia 1. Introduction The description of multimedia by Professor Stephen Heppeli is note worthing for its attention on the potential for choice Multimedia is a single word invented comparatively recently to describe the possibility that a computer might finally deliver all the elements that we take for granted during our everyday lives such as speech, text, graph, video, music, sounds, and data [1].. The term multimedia describes the opportunity to use a choice of media delivered via a range of information and communication technologies including electronic networks, touch screen, CD-ROM s, cable and satellite [2],[3]. Educational multimedia is not a new concept. However, it has only become a realistic means of delivering educational materials over the last few years. Technology is now sufficiently powerful and appropriately priced to deliver multimedia to desktop and portable computers. Multimedia presents great opportunities for education and holds much more potential than merely providing access to large quantities of information. It can be used to support the
2 285 process of learning by engaged learners in two-way communication with the computer that is driven by personal learning needs. Multimedia can also help visualize and relate information in new ways to increase depth of understanding and the communication of ideas and concepts. At best, interactive multimedia offers an individual not threatening environment in which learners can question, offer solutions and test and develop ideas. This type of multimedia and be used for formal and informal education for both children and adults of all ages. Therefore, educational multimedia can provide to learners, access to a wide range of learning resources through the internet and CD-ROM. Thus learners can use multimedia programs to: Monitor personal preferences and progress Learn new material Brainstorm ideas and real-life clinical scenarios Take self-assessment tests Develop learning agendas related to personal strengths and weaknesses Communicate with other students/tutors from around the world Graphically map learning needs and plans (i.e. using initial maps) Manage organize and plan learning Based on the above mentioned assumptions and the importance of informing health professional of current practice future opportunities, a multimedia educational system has been developed in the Laboratory of Health Informatics at the Faculty of Nursing of the University of Athens. The main scope of the system developed consists of an effort to prove that education with the use of multimedia voices and animation is more efficient than the traditional way of teaching with a single tutor. The educational software developed, has been designed to provide and intermediate level of knowledge in epidemiology both to undergraduate and to graduate students in the field of Health Care Sciences and to help teachers to design courses with different levels of knowledge regarding Epidemiology. With the developments of this system the following objectives can be achieved: To describe the structure and the characteristic of a population and its relationships with a health problem. To compute simple analysis of morbidity and mortality according to gender, race, place and time. To compute different types of ratios by age and gender. To investigate different types of hypotheses, different aspects of causality and a variety of diagnostic processes. To study the different types of epidemiological designs and results of epidemiological research To read epidemiological and medical/nursing publications in order to identify possible bases with methodology and data analysis. 2. Characteristics of the System Director was used to develop the application software. The capacity required to install the system is 130 MB although each individual component is not greater that 1.2 Megabytes in order to facilitate it s handling. The system has more than two hundred screens voices and animations. The screens have different kinds of fonts and styles of letters in order to distinguish different aspects. As a matter of fact, bold letters were used to emphasize same
3 286 concepts, grey characters to indicate a voice animation or additional information in other chapters etc. The fonts used have been brush script to display concepts and Helvetica narrow to display examples. The advantages of the system are to facilitate the learning process through text, colours, complementary voices animation. Moreover, exercises have been designed to allow students to interchange information with it. (1). Future plans include the following: a. design a www version to allow students to manage this system through internet. b. design a virtual reality classroom to allow people to follow a regular course from the workplace or from home. The virtual classroom teaching can be completed with a discussion by using a list of different subjects and with an interchange of information and ideas with professionals and other specialists in the field of Epidemiology and Public Health. 3. Interface of the system: the multi-windows environment This interface is justified for: a. providing a powerful interface to let users to handle easily and quickly the system b. separating different tools of the system since all components are not necessarily presented simultaneously c. making use of the size of monitors since it is possible to display some windows thus increasing visualization surface 4. The Electronic Book The electronic book has three components: Index Chapters Glossary Index I Chapters of the Electronic Book of Epidemiology: 1) The definition of Epidemiology 2) Causation in Epidemiology 3) Prevention in Epidemiology 4) Statistics in Epidemiology 5) Indices in Epidemiology (Measuring Health and Disease) 6) Design of Epidemiological Research 7) Data Collection 8) Data Analysis 9) Biostatistical methods for comparing the results of different epidemiological studies 10) Possible errors in the results and methods to avoid them 11) Validity, generalization and confidentiality 12) Clinical Epidemiology In each chapter, there are sub-chapters and sub-topics. For example in chapter 5 indices in Epidemiology five sub-topics and five windows with suitable animations are presented. These include the following:
4 287 a. Definitions of Health and Disease b. Measures of disease frequency c. Use of available information d. Comparing disease occurrence e. Study questions 5. Glossary The Glossary has three areas sensible to mouse. The big one is a scrolling field where a list of terms is displayed. When one of them is selected, section numeric i.d. it appears at the items column then section title at the bottom line, and with a double click is possible to go to the selected section. 6. Bibliography module This module is compounded of two databases. These are the following: a. Description of a main book and journals of Epidemiology and Public Health b. References used to develop each chapter of the electronic book. 7. Additional Modules The system has two additional modules: one with exercises that help the students to understand the theoretical part and acquire hands on experience, and the other is a help module. 1. There have been designed numerous exercises and different methods have been used to explain the concepts presented in each chapter. In some of them students were able to use their own data. 2. A help module to explain the different aspects of the system: types of characters, text-styles, buttons, etc, has also been developed. The contents of window 5.2, for example, include the following: Population at risk Prevalence and incidence Prevalence rate Incidence rate Cumulative incidence rate Case fatality Interrelationships of the different measures Mortality Mortality before and just after birth Life expectancy Standardized rates Morbidity Disability Comparing disease occurrence Risk difference Attributable fraction Population attributable risk Relative comparison In each step users are able to join any part of the chapters with a double click.
5 Evaluation The system developed has been evaluated in the use of a questionnaire with 43 questions by 65 undergraduate and graduate students. The first section of the questionnaire was comprised of 23 questions and was focused on the evaluation of the level of knowledge and the general understanding of the concepts and principles of the subject of Epidemiology. The rest of the questions had their main focus on the friendliness and the general usability of the educational system developed. Chi-square, F-test and analysis of variance were used to statistically analyse the results of the data collected.
6 289 Figure 2 - Global structure of a chapter From the analysis of the data the following results were recognized: a. The use of computers and especially the use of multimedia in the teaching process may enable a great deal the understanding of the concepts and principles of the difficult subject of Epidemiology. b. The existence of prior knowledge of the above mentioned subject was a major plus for the conceptualization of the basic ideas and principles of Epidemiology. c. There was little or no difference between the undergraduate and the graduate students in terms of understanding the basic concepts of Epidemiology. d. The existence of prior knowledge of the use of computers was helpful but not determinant factor. e. Correspondingly there was little or no difference between the two categories of students in terms of being able to use efficiently the system. f. The software used for the development of the educational system was proved to be user friendly and interesting to work with. g. Finally, the majority of the students (85%) expressed the opinion that the educational system developed helped them a great deal to understand the subject presented even without the presence of a tutor in the classroom. 9. Conclusions A multimedia system teaching epidemiology has been developed and evaluated by a number of students with positive results concerning the usability of the software package. Further study is under development to evaluate the usefulness of the application for teachers. 10. References [1] Carlos de Castro, J.A Ramos, Dormido S, Open Hypermedia System for Automatic Control Teaching, ELDEN, 94 [2] Mean M., Roger M., Dannenberg B,, Multimedia Interface Design, ACM. Press Frontier Series [3] Schank R.C.Active Learning through Multimedia, Multimedia, Spring 1994, Address for correspondence Department of Public Health, Faculty of Nursing, University of Athens, 123, Papadiamantopoulou Street, Goudi, GR Athens, Greece, Tel:
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