E.T. Avramescu1, R. Traistaru2, G. Antonopoulos3, O. Lupescu4, M. Dragomir1

1University of Craiova (ROMANIA)
2University of Medicine and Pharmacy craiova (ROMANIA)
3Metropolitan Rehab (SWEDEN)
4Clinical Emergency Hospital (ROMANIA)
Until now it is recognised that distance courses for medical education are more suitable for theoretical concepts, most online resources being scripts and textbooks. Practice is essential for a doctor but development of practical skills in multinational environments takes time and costs for mobility. The present paper is offering solutions for stimulating resident learning by new approaches, as the development of an innovative e-training method that is able to provide the trainees with a range of case studies and an advanced training curriculum. This will function as an interactive multimedia database system containing full reports on patients receiving orthopedic/rehabilitation treatment - real clinical case studies using digital imaging (Ultrasound, Magnetic Resonance Imaging, Tomography) and computational gait analysis data.The trainee must choose the right surgical or rehabilitation protocol and adapt them based on the particularities of the case study (patient-focused interventions). The training material is accessed via a standard web browser, which provides an integrated multilingual on-line learning environment. The presentation tier is adapted to include additional data provided by specific modern investigation methods, including medical imaging, video files of motion analysis, graphs of forces, muscle and joint reactions, numerical data, contact pressure diagrams, etc.

Case studies will be in the form of full reports on patients in orthopedic/rehabilitation department (medical history, clinical signs, paraclinical evaluations), associated with one or more visual content objects (i.e. 2D, 3D images as acquisition outputs of Ultrasound, Magnetic Resonance Imaging, Tomography, plantar pressure graphs and video), starting with preoperative radiological images, description of surgery, and the outcome of the procedure (postoperative and further follow-up X-rays, MRIs, physical findings, contact pressure pattern of the patient gait) - 60 case studies. The system will provide a feedback by showing students the correct diagnosis and how to arrive at it with minimal cost.

The trainer takes ownership of maintaining a case study with the ability to update it online with timely or relevant information. Students as part of the curriculum are required to view individual profiles, brainstorm ideas proposed within them, evaluate key discussion points and draw conclusions from those discussions.

Assesment will be done by multiple choice test and case studies that will be solved by the trainees. Interactivity allows trainees to test their knowledge and provides immediate feedback using images and cases that they could encounter in clinical practice. In this way educators will no longer serve mainly as the distributors of content, but will become facilitators of learning; learners will have control over content, learning sequence, pace of learning, time, and often media, allowing them to tailor their experiences to meet their personal learning objectives. The tagging of multimodal and interdisciplinary content is appropriate for the completion of realistic cases and will allow the users to perform most clinical decision-making procedures in a simulated environment, in natural language.