Teaching and Learning Technology Resource

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Kim Kirsner
Department of Psychology

DESCRIPTION OF INNOVATION:

DADA (Diagnosis, Assessment and Decision Aid) is a case-based, multi-media, instruction system that was designed to meet three objectives: first, facilitate the acquisition of diagnostic expertise by students in clinical and behavioural science and, more particularly, Speech Pathology and Clinical Psychology; second, provide a platform for anchored instruction for theoretical knowledge about cognitive processes, language production and cognitive neuropsychology and; third, overcome the case-access bottleneck that so severely limits access to cases and, therefore , expertise where behavioural and cognitive disorders are concerned.

The package consists of a multi-media database where students can see and hear many cases and disorders, observe patients responding to clinicians under both formal and informal conditions, review behavioural, performance and neurological test data, monitor the behavioural cues and procedures used by experts during diagnosis, examine a rich data-base of cases, make provisional diagnoses about specific cases, and obtain feedback about those decisions.

DADA provides a solution to a critical problem in clinical training namely, first hand access to that body of case knowledge and experience which underpins clinical expertise.

DADA will consist of an instruction system supported by two databases and a user manual. The first or multi-media database will consist of approximately five 20 to 30" vignettes from each of 25 cases, where the cases are drawn from the family of acquired neurogenic communication disorders, including dysarthria, dysphasia, dyspraxia, right hemisphere syndrome, and dementia. The second or statistical database includes the results from a broad range of paramedical and neurological tests for this group of patients, and an additional set of about 100 people with similar disorders when tested about ten years ago.

The multi-media database includes some people from the original statistical database and some new cases, all interviewed and recorded during 1995 and 1996. The multi-media case material is easy to describe. Each vignette consists of a 20 to 30" vignette of a patient exhibiting one or more critical features typical of his or her disorder, as recorded and edited from the 30 minute interview.

The training package (written in Supercard & therefore portable to PC) provides a context and guide for professionals and students who need to be familiar with the acquired neurogenic communication disorders that typically accompany stroke. The package includes:

  • two modes of training consisting of an unstructured mode for novices and unstructured mode for expert users of the package
  • a menu for case selection
  • a decision scaffold to guide students in their approach to each case, where this includes a series of questions or steps associated with each vignette
  • a series of cue cards including generic descriptions of the symptoms typically associated with each disorder
  • an interface for viewing the statistical data about each case including the results of the medical and paramedical tests
  • a procedure for discovering and viewing analogous cases from the statistical and - if available - the multi-media databases
  • a cognitive model of language production identifying the critical components that are vulnerable to brain damage associated with stroke.
  • a neurological model providing information about arterial distribution, the cognitive and linguistic processes typically associated with dysfunction for each artery, and the relationship between arterial distribution and the acquired neurogenic disorders.
  • a procedure for testing hypotheses about the relationships between components in the cognitive-linguistic model on the one hand, and the neurological models on the other.
  • a procedure for providing students with an opportunity to test themselves, and obtain feedback from an expert.

The package is suitable for presentation to paramedical (eg. speech pathologists, nurses, occupational therapists, physiotherapists) and medical students as well as health-care workers (eg. ambulance drivers, casualty staff) who are likely to be the first point of contact for people following stroke.

DADA is not an electronic textbook. Development involved a group of scientists with expertise in cognitive science, human factors (knowledge elicitation), computer aided instruction and acquired neurogenic communication disorders. The package exploits a number of procedures that can only be achieved using multi-media resources.

The overall design includes provision for the following features:

1. A Case-Based Engine so that users can:

  • Review the structural basis of classification
  • Refer new cases for classification

2. A Rehabilitation interface so that users can determine:

  • The tests required for narrow differential diagnosis for eacb case
  • The treatment procedures that might be applied to each case

REASONS FOR DEVELOPMENT/INTRODUCTION OF THE INNOVATION:

  • Overcome case access problem in training in clinical skills in domains involving human patients with behavioural and cognitive disorders
  • Develop platform for research into case based instruction methods

TEACHING/LEARNING AIMS:

  • Improve diagnostic skills among students
  • Provide students with case based anchors for theoretical learning

DESIGN PRINCIPLES:

DADA incorporated principles based on the ‘cognitive apprentice’ in regard, to access to resources, provision of feedback and so on. The design is appropriate for any context involving clinical training and behavioural or cognitive disorders.

USE:

The application is used as an integral element in both third year instruction in Speech and Hearing Science at Curtin and Cognitive Science at UWA.In each case it is an extra resource, providing training that could not otherwise be offered.

STUDENT SUPPORT:

Tutorial and Lecture support is provided in each case

ASSESSMENT:

Regular coursework assessment

EVALUATION:

Qualitative evaluation is routinely implemented with all groups

EFFECTIVENESS:

Qualitative comment has been very positive, with strong support for the use of the programme prior to rather than as an adjunct to clinical training. Students are excited by the prospect of viewing lots of cases prior to clinical training

HINDRANCES TO DEVELOPING INNOVATION:

Lack of financial support. Project staff have put in hundreds of hours of voluntary time on the project.

ENABLERS TO DEVELOPING INNOVATION:

Material on the Cognitive Apprentice was discovered relatively late in the developmental process but provided useful insights into the design principles adopted by us.

COST/BENEFITS:

$48,000 from CAUT, $10,000 from Speech and Hearing Science at Curtin, $10,000 from Psychology at UWA. Approximately 600 hours of academic staff time and approximately 600 hours of free time by programmers. Five people were involved in project development. The investment has not been worth it except as an intellectual exercise.

LESSONS LEARNT:

That substantial CAIL initiatives need significant institutional support.

The University of Western Australia

Contributors

The following staff have been active in developing teaching and learning technology for use with students at this university. They are not necessarily all 'experts' in the use of technology but are prepared to provide incidental advice to others, drawing on their practical experiences in developing teaching and learning materials

Paul Abbott
Physics
Jane Bellemore
Classics and Ancient History
Roberta Bencini
Animal Science
Noelene Bloomfield
European Languages
Felicity Browne
Information Management and Marketing
Bob Bucat
Chemistry
Stuart Bunt
Anatomy and Human Biology
Roger Hacker
Graduate School of Education
Werner Hennig
Animal Science
Janelle Hocking Edwards
Animal Science
Helene Jaccomard
European Languages
Jackie Johnson
Accounting & Finance
Terry Judd
Faculty of Agriculture
John Kinder
Faculty of Arts Multimedia Centre
Kim Kirsner
Psychology
Jane Klobas
Graduate School of Management
Nicholas Letch
Information Management and Marketing
Richard Lockwood
Human Movement
Bill Loneragan
Botany
Moira Maley
Pathology
Charter Mathison
Geology and Geophysics
David Pannell
Agriculture and Resource Economics
Mark Pegrum
European Languages
Jeff Rohl
Computer Science
Gary Sigley
Asian Studies
Nathan Scott
Mechanical and Materials Engineering
Laurence Spencer
Mechanical and Materials Engineering
Brian Stone
Mechanical and Materials Engineering
John Taplin
Information Management and Marketing
Jane Talbot
General Practice
Michele Teague
General Practice
Richard Thomas
Computer Science
Roberto Togneri
Electrical and Electronic Engineering
Esta Ungar
History
Jingbo Wang
Physics
Karl-Heinz Wyrwoll
Geography

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