Cardiology Curriculum
We have completely updated the UMedic Multimedia Computer Curriculum in Cardiology for all 20 case-based programs. The UMedic programs have been proven to teach bedside skills while providing all elements of the complete patient evaluation and treatment. Bedside skills in UMedic are taught through video demonstrations of "Harvey," The Cardiopulmonary Patient Simulator, a full-size manikin that simulates the findings of essentially any cardiac disease.
Our consortium of cardiologists and educators from 11 medical centers has reviewed each program and updated them to include:
- The most current procedures for patient evaluation
- The most current medical and surgical therapy
- The addition of pulmonary findings for each condition
These findings and updates apply whether you use UMedic:
- As a stand-alone self-learning unit
- With the original "Harvey," The Cardiopulmonary Patient Simulator
- With the new "Harvey," The Cardiopulmonary Patient Simulator
The M.I.A.M.I. Group (The Miami International Alliance for Medical-Education Innovation) of
cardiologists and educators:
modes of use
The UMedic System may be used in the following ways:
- Self-Learning Mode for 1 - 5 learners
- Instructor Mode for teaching unlimited numbers in an auditorium
- Testing Mode
Throughout each patient-centered, self-learning program, the student is guided by a physician-instructor who provides continuity as well as video demonstrations, narrative explanations and feedback. The Instructor Mode provides the instructor with essentially all the data needed to teach, while allowing the flexibility and latitude to choose what to teach and how to teach it.
Additional options include
- Using UMedic as a Stand-Alone System or
- Linked to "Harvey" (if available at a given institution)
- Reviewing the Entire Program or
- The Bedside Examination Only (making it suitable for beginning students).
Curriculum
Four series of UMedic have been developed and updated, each series including five patient-centered programs.
FIRST SERIES
Emphasizes pathophysiology and bedside skills and includes:
- The Normal Patient
- Aortic Stenosis
- Aortic Regurgitation
- Mitral Stenosis
- Mitral Regurgitation
SECOND SERIES
Emphasizes common management problems and includes:
- Angina Pectoris
- Acute Inferior Infarction
- Acute Anterior Infarction
- Cardiomyopathy
- Hypertension
THIRD SERIES
Adds congenital and acquired diseases and includes:
- Atrial Septal Defect
- Acute Pericarditis
- Primary Pulmonary Hypertension
- Acute Mitral Regurgitation
- Hypertrophic Obstructive Cardiomyopathy
FOURTH SERIES
Emphasizes pediatric cardiology and includes:
- Innocent Murmur
- Mitral Valve Prolapse
- Ventricular Septal Defect
- Coarctation of the Aorta
- Tetralogy of Fallot
The content of each program includes the entire patient encounter as outlined below. Laboratory data and treatment are omitted in the "bedside only" option.
HISTORY
BEDSIDE FINDINGS
Presented by an instructor on videos using "Harvey," the Cardiopulmonary Patient Simulator:
- General appearance
- Blood pressure
- Arterial and venous pulses
- Precordial movements
- Cardiac auscultation
- Pulmonary auscultation
DIAGNOSIS
LABORATORY DATA
- CBC & blood chemistries
- Electrocardiograms
- X-rays
- Real-time echo Dopplers
- Other imaging techniques and angiograms
TREATMENT
- This component features videos of interventional therapy and surgery
PATHOPHYSIOLOGY
DISCUSSIONS
- Key teaching points and remediation
- Case reviews by authoritative cardiologists
UMedic Cardiology Demonstration
The following is a demonstration from the UMedic program on Mitral Regurgitation. We have selected excerpts from several sections for this demonstration.
- Mitral Regurgitation (MR)
- Types of MR
- Severe Acute MR
- Severe Chronic MR
- Angiogram
- Surgery
Research - References
National multicenter studies have been carried out to assess the feasibility of implementing a 4-year UMedic computer curriculum and to assess the skills gained by using the UMedic system. The implementation of a four-year UMedic Multimedia Computer Curriculum in Cardiology involved six medical schools: Miami, Emory, Iowa, Illinois, Florida and Duke. A total of 1,586 students reviewed 6,131 programs. The 4-year curriculum was found to be feasible and highly accepted. Success was dependent upon local leadership and a willingness to change.
Another study was carried out to determine if students trained with the UMedic system can acquire and retain core bedside cardiology skills. Five medical centers participated: Duke, Emory, Miami, Mt. Sinai and Northwestern, with a total of 208 senior medical students. Students trained in a clerkship that included UMedic had significantly higher increases in their pre- to post-test bedside skills scores than those trained in a standard clerkship.
Taken together, these studies clearly demonstrate that the UMedic system enhances bedside skills when made part of the curriculum and outcomes are tested.
See below for a list of selected references:
- Scalese RJ, Obeso VT, Issenberg SB. Simulation technology for skills training and competency assessment in medical education. Journal of General Internal Medicine, 23(Suppl 1):46-49, 2008.
- Issenberg SB, Scalese RJ. Best evidence on high-fidelity simulation: What clinical teachers need to know. The Clinical Teacher, 4:73-77, 2007.
- Issenberg SB. Michael S. Gordon and the Center for Research in Medical Education. Simulation in Healthcare, 1(4):233-237, 2006.
- Issenberg SB. The scope of simulation-based healthcare education. Simulation in Healthcare, 1(4):203-208, 2006.
- McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. Effect of practice on standardized learning outcomes in simulation- based medical education. Medical Education, 40(8):792-797, 2006.
- Hatala R, Kassen BO, Nishikawa J, Cole G, Issenberg SB. Integration of simulation technology in The Royal College of Physicians and Surgeons of Canada's internal medicine specialty examination: A descriptive report. Academic Medicine, 80:554-556, 2005.
- Issenberg SB, McGaghie WC, Petrusa ER, Gordon DL, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Medical Teacher, 27(1):10-28, 2005.
- Obeso VT, Gordon DL, Issenberg SB, Baker J, et al. A multi-center study to provide evidence of construct validity in computer-based outcome measures of neurology bedside skills. Academic Medicine, 80(Suppl 10):S71-S74, 2005.
- Millos RT, Gordon DL, Issenberg SB, Reynolds PT, et al. Development of a reliable multimedia computer-based measure of clinical skills in bedside neurology. Academic Medicine, 78(10):S52-S54, 2003.
- Issenberg SB, McGaghie WC, Gordon DL, et al. Effectiveness of a cardiology review course for internal medicine residents using simulation technology and deliberate practice. Teaching and Learning in Medicine, 14(4):223-228, 2002.
- Issenberg SB, Gordon MS, Gordon DL, et al. Simulation and new learning technologies. Medical Teacher, 23(1):16-23, 2001.
- Issenberg SB, Gordon MS, Stewart GM, Felner JM. Bedside cardiology skills training for the physician assistant using simulation technology. Perspectives on Physician Assistant Education, 11(2):99-103, 2000.
- Gordon MS, Issenberg, SB, Mayer JW, Felner JM. Developments in the use of simulators and multimedia computer systems in medical education. Medical Teacher, 21:32-36, 1999.
- Issenberg SB, McGaghie WC, Hart IR, Mayer JW, et al. Simulation technology for health professional skills training and assessment. JAMA, 282:861-866, 1999.
- Issenberg SB, Petrusa ER, McGaghie WC, Felner JM, et al. Effectiveness of a computer-based system to teach bedside cardiology. Academic Medicine, 74(Suppl):S93-S95, 1999.
- Petrusa ER, Issenberg SB, Mayer JW, Felner JM, et al. Implementation of a four-year multimedia computer curriculum in cardiology at six medical schools. Academic Medicine, 74:123-129, 1999.
- Waugh RA, Mayer JW, Ewy GA, et al. Multimedia computer-assisted instruction in cardiology. Archives of Internal Medicine, 155:197-203, 1995.
- Sajid AW, Ewy GA, Felner JM, et al. Cardiology patient simulator and computer-assisted instruction technologies in bedside teaching. Medical Education, 24:512-517, 1990.
System Requirements
The UMedic Multimedia Computer Curriculum in Cardiology features high-quality video generated by software compatible with current multimedia PCs or laptops. Software for installation on local area networks is provided at no cost.
Client Stations (UMedic run from CD-ROM or Server*)
- Windows 2000 or later required
- 500 MHz CPU or faster
- Minimum 128MB RAM
- 50MB hard drive space
- 16 bit color at 640 x 480
- 16 bit compatible sound card
- 10/100 Network Interface Card
- *Read permissions to location of server files
- *Two multimedia speakers (Headphones are advised for optimal fidelity of heart sounds and murmurs.)
Server System
Pentium® III 800 MHz + 256MB RAM 3.5 GB (per series of UMedic) free drive space visible to profiles that the client software is to be installed, 10/100 switched LAN
Cost Effectiveness
The cost-effectiveness of UMedic is due to its ability to effectively teach bedside skills to so many different populations and levels of learners. Site licenses allow unlimited numbers of learners to use UMedic on a local area network. This means many hundreds of learners can be trained each year at a typical medical center. This includes medical students, residents, fellows, practicing physicians, nurses and physician assistants. UMedic has specifically been integrated into all years of medical, nursing and physician assistant schools at multiple institutions.
Additional important factors include self-learning that reduces instructor time and the cost and inconvenience (sometimes impossibility) of finding patients with certain bedside findings at any given time in the academic year and at any given clinical location. If an institution has "Harvey," the Cardiopulmonary Patient Simulator, UMedic may be linked to "Harvey" and save additional instructor time.
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