Implementation of a four-year multimedia computer curriculum in cardiologyat six medical schools

The pressures of a changing health care system are making inroads on the co mmitment and effort that both basic science and clinical faculty can give t o medical education, A tool that has the potential to compensate for decrea sed faculty time and thereby to improve medical education is multimedia com puter instruction that is applicable at all levels of medical education, de veloped according to instructional design principles, and supported by evid ence of effectiveness. The authors describe the experiences of six medical schools in implementing a comprehensive computer-based four-year curriculum in bedside cardiologis ts developed by a consortium of university cardiologists and educational pr ofessionals. The curriculum consisted of ten interactive, patient-centered, case-based modules focused on the history, physical examination, laborator y data, diagnosis, and treatment. While an optimal implementation plan was recommended, each institution determined its own strategy. Major goals of t he project, which took place from July 1996 to June 1997, were to identify and solve problems of implementation and to assess learners' and instructor s' acceptance of the system and their views of its value. A total of 1,586 students used individual modules of the curriculum 6,131 t imes. Over 80% of students rated all aspects of the system highly, especial ly its clarity and educational value compared with traditional lectures. Th e authors discuss the aspects of the curriculum that worked, problems that occurred (such as difficulties in scheduling use of the modules in the thir d year), barriers to change and ways to overcome them (such as the type of team needed to win acceptance for and oversee implementation of this type o f curriculum), and the need in succeeding years to formally assess the educ ational effectiveness of this and similar kinds of computer-based curricula .