database-management system de- signed to allow users to retrieve and report information on the curriculum of an undergraduate pathophygiology course.
A computerized database-management system for curriculum analysis DAVID GOTLIB,* B SC JEAN-PIERRE DESGROSEILLIERS,t MD PETER DOLPHIN,* PH D
This report describes a computerized database-management system designed to allow users to retrieve and report information on the curriculum of an undergraduate pathophygiology course. With the system the user can locate where and in what context a topic is covered in the course and can answer queries and prepare reports concerning, for example, format and duration of sessions, teaching aids used and instructors. The system is a unique tool that can be used to optimize course structure and content. It can easily be expanded to include other undergraduate medical courses, and the techniques can be applied to other disciplines.
Description d'un systeme informatise de gestion d'une banque de donnees permettant de retracer et de reproduire des informations sur le contenu d'un cours predoctoral de pathophysiologie. L'usager est a meme de connaitre l'endroit du cours ou tel sujet est enseigne, dans quel contexte, sous quelle forme, combien de leRons y sont consacrees, qui traite From the University of Ottawa and Dalhousie University, Halifax
*Medical student, University of Ottawa tAssistant dean, Medical Education, Faculty of Health Sciences, University of Ottawa $Associate professor, Faculty of Medicine, Dalhousie University Reprint requests to: Dr. Jean-Pierre DesGroseilliers, Assistant dean, Medical Education, Faculty of Health Sciences, University of Ottawa, 451 Smyth Rd., Ottawa, Ont. KIH 8M5
de ce sujet et a quels moyens didactiques il a recours. Cet outil inedit, qui sert a l'amelioration du plan du cours et de son contenu, pourrait facilement s'etendre a d'autres matieres du programme de medecine, et son principe s'appliquer a d'autres disciplines.
The computer is being used more and more in education to track students' progress and to aid instruction. It can also provide otherwise unobtainable analyses of course content and can help educators optimize their curriculum. We describe this novel application of the tool. The course
"Pathophysiology and special pathology" is a systems-oriented course at the University of Ottawa medical school. It begins in January of the second year and continues through October of the third year. For the course a total of 378 lecture and laboratory hours are allocated to committees representing 12 systems. The Faculty Council Curriculum Committee appoints someone to select and chair each committee, and the committees define educational objectives, select content, determine the method of instruction, and choose lecture and laboratory instructors from appropriate clinical departments.' The problem
Since its inception in 1974-75 the course has been criticized for a number of problems: * Too much material and too many different lecturers. * Lack of structure, such that answering queries from universities
and government agencies about course content and hours devoted to a particular topic is difficult. * Incompleteness, with the Curriculum Committee constantly receiving requests to add material, which in many instances is already being presented in another form. * Unnecessary duplication. Although some problems were recognized within the first few years, the size of the course, the changing lecture content and the varying composition of the Curriculum Committee made it difficult for the committee to develop a detailed understanding of the entire course, a prerequisite to addressing the issues. A system for quality control was felt to be necessary so that the Curriculum Committee could have quick and simple access to data needed for management decisions about the course. The solution
Curry and associates2 had documented the value of computerized storage and retrieval of similar information at Dalhousie University Medical School. Their work served as an initial guide for our solution. One of us (D.G.), a medical student with computer training and experience who had just completed the second-year phase of the course, was hired for a summer to design and implement a computer-based information system for the course. The Dalhousie system, which runs on MICOM word processors, has limited processing and on-line information-storage capacities. For the Ottawa system the SPIRES (Stanford Public Information Retrieval System) database-management program was selected instead. It runs
CAN MED ASSOC J, VOL. 131, OCTOBER 15, 1984
interactively under VM SP/CMS on the University of Ottawa's Amdahl 470-V7A computer and provides more power and versatility. Summary pages For each session (lecture, laboratory or seminar) in the course a summary page was prepared, to serve as a precise checklist of the material covered in the session. It contained identification, or "header", information and "session-content" information, the latter organized into topic, subtopic and subsubtopic. The "header" information consisted of the following: * The system name (e.g., HEMATOLOGY) and a number indicating the position of the session within the series of sessions for that system. * The format of the session (lecture, laboratory, seminar or clinicopathological conference). * The duration (in hours) of the session. * The teaching aids used (slides, overhead transparencies, gross specimens, audio or video tapes, patients). * The instructor(s) and their department and teaching status. * The date that the summary was entered into the computer and the date of the most recent update. * A unique serial number. * A space for miscellaneous notes and comments and for future additions.
Search capabilities
SPIRES is a program designed expressly for database applications. For our purposes, it gives the user the ability to select, from all the sessions in the course, those satisfying certain criteria. The criteria can be based on any element or combination of elements in the session summary. The two most common modes of use are to search the "header" only and to search the -entire summary. For example, one could key FIND SYSTEM = NEUROLOGY to select only the sessions for which the system name is NEUROLOGY; FIND INSTRUCTOR = CHUCK BARRIS to select only the sessions for which Chuck Barris is an in862
structor; or FIND FORMAT = LECTURE AND DEPARTMENT = PATHOLOGY to select only the sessions that are lectures and are taught by members of the Department of Pathology. All this information is in the header. To address the question of where in the course subject X is taught and in what context, a special subprogram was prepared. It consists of a collection of SPIRES commands invoked by keying a single command, the subprogram's name. The subprogram does the following: * Looks for subject X in the title and summary of each session and selects the sessions for which it is found. * Prepares a short report that lists for each session in which subject X appears the system name and number, the serial number, the title, the instructors and, most importantly, the part of the summary in which X was found (in other words, the subprogram screens out the unrelated parts of the summary). * Searches for the term X in a database of synonyms and informs the user of synonyms that might be used to locate information on X. For example, someone searching for sessions dealing with "pediatrics" would be reminded about "child" and "childhood". The synonym database, which was prepared as the session summaries were being written, is also accessible on its own. All sessions meeting the criteria specified in the search request are noted in a SPIRES list called the R-ESULT.
Report generation
After each search, SPIRES allows the user to custom-design the display of RESULT. The generated report could consist of the following: * The entire summary (both header and session-content information) for each session in RESULT. * Only the header information for each session. * A fixed subset of the header information (for example, the system name and number, the session title and the instructors) for each
header information for the column
titles; one row of the table is devoted
to each
session.
Updating the database Since session content and instrucchange from year to year, and since one justification for this project was the eventual overhaul of the entire course, we needed software that allowed us to modify the database easily. SPIRES provides convenient facilities for such changes. The system can easily be expanded to cover more courses: one simply adds new sessions. In fact, SPIRES allows one to manipulate databases in much more complex ways. Because we wanted computer novices to learn to use the system, it was designed to be operated with only a small subset of the available commands and options. Very little of the program's power and flexibility was lost through this restriction. tors
Training
Although the university's computcentre provides a complete set of SPIRES manuals, these are too detailed to be useful to most faculty members and administrative staff. Therefore, a simple and relevant, yet comprehensive guide to the system was prepared. It comprises the following four manuals, written in layman's language: * A basic manual, which covers SPIRES concepts, search techniques and report generation. * A pocket summary of SPIRES commands. * A manual covering the updating of database content. er
* Miscellaneous technical notes concerned with backup of the database and simple maintenance procedures. The first two manuals are provided to all users, whereas the last two are reserved for database administrators.
An administrative assistant who had some experience with word processors and an interactive computer system learned the system in about 3 hours, but a faculty member who had no practical experience session. with computers needed about 20 * A tabular display, for which hours to become comfortable with the user selects elements from the the concepts and operation.
CAN MED ASSOC J, VOL. 131, OCTOBER 15, 1984
iABDOMINAL PAIN...
Our computer-based information system has been accepted with enthusiasm by faculty members. With it, one can answer in a few moments queries that otherwise would have taken hours to research. We have found that people who have a rudimentary familiarity with computers quickly learn how to use the system effectively, whereas computer neophytes have been observed to ask for and get something quite different from what they wanted. Since the information obtained may be the basis for important decisions in the faculty, it is vital for the user to understand what his or her search request means to the machine. This relatively simple use of an existing program on an available computer facility has greatly simplified the management of difficult problems and has highlighted the desirability of having a full-time computer consultant associated with the faculty. References
Disaccharide. malabsorption must be a major consideration nm the dierealdiagnos. The disaccharide, lactose, is normally digested by the enzme, lactase, iM the.healthy smnal .intestine.. Inad endogenous lactase results in a gastric res.ponseto milk. Lactase deficiency has been demonstrated in. a number of disorders and can be transient or pem ent.
..It can be.of genetic.origin.ad is frequently encou.tered in older persons. Prior to LactAid if your patient demonstrated a lactase ..:deficiency you had only two alternatives: a) Remove milk from the diet 6) Prescribeacaned non-lactose milk analog . Nowyhave.a tird.alternai.ve: Keep the patient on re.gula milk-bt ed wi.th L Aid lacse enzme The patient adds LactAid to milk to convert the lactose into its digestible sugars The level.of conversion is easily controlled by the :amount ..of LactAid used, essentially 100%/o lactose.removal is attained ifdesired. LactAid lactase enzyme is sold in drug . . . and food . Lact.Aid easily and economically modifies fresh, canned or .eonstitutedmilk. LactAid will im fact successfuliy.modify fluid.dairy.product,t including fant formulas. .and tube feedigs. LactAid ayeast-derived .Beta-galactosidase a camer ....of.glycerol and waten Please requs sample, literature and patientinforination/order pad.
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1. THOMPSON WG: University of Ottawa modified systems program. J Med Educ 1977; 52: 3 16-322 2. CURRY L, DOLPHIN PJ, FARRELL S et al: Computerization of undergraduate medical curriculum content. J Med Educ 1984; 18: 71-74
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