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UMass Stroke Curriculum Flourishes on the Web

Most educational multimedia applications have carefully prescribed goals: to reinforce ideas covered in class, to deliver content interactively and asynchronously, or to simply capture the imaginations of students.

The ideal technology tool d'es all of this and more, addressing a pedagogical need in an innovative, creative way and ultimately enriching the learning experience for students.

That appears to be the case with StrokeSTOP, a new stroke curriculum developed at the University of Massachusetts Medical School. Scientists, educators, and technologists at UMass have collaborated with the American Stroke Association, a division of the American Heart Association, to create the first online stroke curriculum for medical students.

Among Americans, stroke is the third most likely cause of death—and one of the most common ways in which people become seriously disabled. Strokes claim the lives of more than 150,000 Americans a year.

Despite the prevalence and impact of strokes, most medical students receive little or no training in stroke risk and prevention in their first year of study. It’s only later, when their studies become more specialized, that some will study strokes in depth.

However, most physicians, regardless of their specialty, have opportunities to provide stroke-related care to their patients. New risk-assessment methodologies and intervention strategies have made comprehensive stroke education even more important.

Sue Billings-Gagliardi, StrokeSTOP director and professor of cell biology and neurology at the UMass Medical School, thought there was a need to teach about stroke in the first-year neuroscience curriculum.

“Before we created StrokeSTOP,” she notes, “stroke was addressed differently with first-year students. The focus was not on prevention. We wanted to reduce the chance of stroke by teaching our students about identifying and modifying patients’ risk factors as well as about new post-stroke interventions that could make a difference in how stroke patients fare.”

The project started with written materials, but student feedback made it clear that the stroke curriculum would make an ideal interactive Web-based tool. With the support of the American Stroke Association, other medical school faculty, and the school’s technology department, StrokeSTOP was born.

The result is a set of modules focusing on the blood supply of brain structures, stroke pathology, risk assessment, prevention, diagnosis, and after-care. The modules consist of instructional text, radiographs and scans, diagrams, case studies, self-tests, and patient videos. All of the material is interactive. Students are asked to evaluate risk factors and identify affected parts of a stroke victim’s brain. Six modules are online now; eventually there will be 11 complete modules.

Says Lyn Riza, the project’s multimedia director based in Information Services, “We wanted to develop a clinical approach to the subject, where students would work with real patient cases. We made sure to include a ‘sandbox area’ where students could interact with the material.”

Recognizing that students learn in different ways, the team developed multiple opportunities to learn. The architecture is student-driven. Riza points out that students worked on the project as well, doing usability testing that led to a number of improvements and even working as videographers.

Student James Bath was in the first class to receive the Web-based stroke curriculum and gives it high marks. “The language is very easy to understand,” he says. “As first years, we had a very limited medical vocabulary, and the site was careful not to talk over our heads. The animation and pictures are especially helpful when learning routes of blood flow and locations of critical structures in the brain—much more helpful than standard diagrams found in textbooks.”

New to the project is the Stroke Risk Detective, an interactive video case bank created with Macromedia Inc.’s Flash Web development application. Using the detective tool, students work with excerpts from patient videos to study risk factors and determine counseling strategies that will likely generate the best possible result for the patient. Students determine what risk factors to address, and StrokeSTOP delivers the patient response.

“In a clinical setting, physicians have to make choices, to prioritize the management of multiple risk factors in a patient,” Billings-Gagliardi says. “So one of the goals of StrokeSTOP is to give students experience working with real patient situations, where there may be a lot of different risk factors and they have to determine what makes sense for each patient.”

At the end of the exercise, students can view the actual physician’s decisions and compare them to their own. Exposure to the counseling experience gives first-year students additional opportunities to develop their patient interviewing skills.

UMass faculty use StrokeSTOP in class and assign it for outside study. “Learning the program was not a requirement per se, but was the best means of learning about stroke,” Bath notes.

He especially appreciated the program’s flexibility. “The program can be as easy or as in-depth as one needs it to be, depending on your goals,” he says. “For students, it not only provides an excellent overview of stroke and its causes, it provides many learning tools to test our knowledge throughout the course.”

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