This grant request seeks to purchase computer hardware and software to be used for the development of World Wide Web and CD based medical educational materials. Specifically, it is the intent to develop and implement interactive clinical, case-based problems designed for use by second year medical students in the IU medical education system. Internet accessibility will obviously allow students at other institutions to make use of these teaching aids as well.

As many involved in medical education and health care delivery know, the field today is relying to an ever increasing extent on computer-based and "distance" educational programs (Anderson, 1997; Cross and Shutt, 1998). Beyond the element of convenience, computer-based educational programs allow for concurrent self assessment, thereby shortening the learning span for new and complex material (Mooney, et al, 1998). Furthermore, it stands to reason that as greater constraints are placed on the physician-educator's time, we will see an even greater need for computer based educational media. And, given obvious medical-ethical considerations, "computer-based" patients for the beginning student seem most desirable.

Until recently limitations of file size and delivery speed effectively precluded the use of video recordings in web applications. The development of streaming technologies for large files and the availability of high performance network connections, will now permit the incorporation of these important features in educational materials. This is especially crucial to web-based medial education as it will allow the learner to conduct mock patient interviews, participate in diagnostic choices and even see the videoed results of procedures such as endoscopy and angiography.

The requested funding for this project will be used to purchase a dedicated computer along with specialized video capture equipment and software needed for movie processing; an Internet server capable of rapidly delivering files of 50 megabytes or more; two cameras plus the necessary software for authoring interactive educational materials.

Beyond the direct educational experience of the clinical problems themselves, producing the cases here at Indiana University offers yet another opportunity for both students and faculty. Those interested in production would have the local opportunity to participate in all aspects of development of these teaching aids, from the filming of patient interviews and authoring the exercise to preparation of files for delivery over the Internet.

Another important element of this undertaking will be evaluating student comprehension of the content material to see if the computer-based medium is a more effective means of presentation than the standard text-based exercises. Currently available testing applications will be incorporated into the clinical problems, allowing the scoring of a student's success at solving the diagnostic exercises. Furthermore, since all of the case-based problems will be available in the traditional paper, "text" format, It will be possible to do cohort studies to compare comprehension, as well as student satisfaction. Findings will be published in a journal such as Academic Medicine.