Asthma/Allergy from the Core Curriculum in Primary Care Series - Evaluation

Journal of Family Practice, April, 1997 by Michael Grusenmyer, Robert B. Kelly

Version 1.0 (10/95), Silver Platter Education, Inc, 100 River Ridge Dr, Norwood, MA 02062-5043; Telephone 800-343-0064. Fax (617) 769-8763; $49 (suggested retail).

DOCUMENTATION: No manual or book.

HOW SUPPLIED: 1 CD ROM.

HARDWARE REQUIREMENTS: For Macintosh: 8MB RAM, system 7.0 or later, CD-ROM player, color monitor. For Windows PC: 8MB of RAM, Microsoft Windows, Version 3.1, MS DOS 5.0 or later, hard disk with 4MB free space, MPC standard CD-ROM player, 640 x 480 display with 256 colors, sound blaster compatible sound card and speakers, 486 PC or higher.

MOUSE SUPPORT: Yes.

CUSTOMER SUPPORT: User support available at toll-free 800 number plus on-screen help.

DEMONSTRATION DISKS: NO.

MONEY-BACK GUARANTEE: 30-day money-back guarantee.

The Core Curriculum in Primary Care Series is a series of nine CD-ROM continuing medical education discs. Each disc runs for approximately 4 hours and contains two to four topics. The major focus of the series is outpatient medicine. Some of the combinations of topics packaged on a single CD seem conceptually linked, such as "Pain Management" and "Rational Treatment of Anxiety and Depression." Other combinations of topics ate less related, such as "The Red Eye--Differential Dx and Rx," and "Evaluation of Dementia."

For this review, we evaluated the Asthma/Allergy CD-ROM. Installation was simple on both PC and Mac platforms. The software requires a full 8MB of RAM; running any other application, such as word processing, concurrently requires additional RAM. The CD contains four related lectures by separate speakers. The topics are "Asthma--The Importance of indoor Allergens," "New Developments in the Pharmacologic Treatment of Asthma," "Allergic Rhinoconjunctivitis," and "Evaluation and Treatment of Urticaria and Anaphylaxis." These topics ate conceptually logical for inclusion in one program.

Each of the four topics consists of a recorded lecture, the transcript of the lecture, and the sequence of slides used in the lecture. Each slide is linked to an associated segment of lecture and its transcript. The user can listen to the lecture segments, read the associated transcripts, and view the slides in any combination or order. Advancing to the next slide can be either manual or automatic; controls exist to jump back and forth among the slides. Slides can be selected, reordered, and saved in a "carousel" along with their accompanying lecture and transcript segments. This allows the user to create custom lectures using a subset of the material. Slides can also be printed. Unfortunately, because of a programming error confirmed by the vendor, transcripts cannot be printed. On request, the vendor will send users a hard copy of the transcripts. The disc also contains a "newsletter" describing each of the four lectures and "questions and answers" that might follow the lecture. These can all be printed. Only one to two references for further reading are listed for each topic.

The content of the lectures is generally good. The initial speaker on allergens, Dr O'Connor, discusses some less-than-helpful topics, such as spraying a mattress with liquid nitrogen to suppress dust mites, before getting to the practical pointers for helping patients. Dr Hollingsworth, speaking on pharmacologic developments, gives a useful stepwise approach to treating asthma by degree of severity before going on to a practical "show and tell" session on the various medication delivery systems, such as the InspirEase and Aerochamber. The entire lecture is helpful and practical. Dr Saryan, speaking on allergic rhinoconjunctivitis, initially gives a nice breakdown of the different entities involved, such as allergic, vasomotor, infectious, and cosinophilic rhinitis, along with their definitions. He then describes the history, physical examination, skin testing, RAST (radinanergosothent) testing, complications, and treatment. The lecture is well organized and the discussion on the medications is particularly good. Dr Bernardo gives the last lecture, a rather wandering talk on urticaria and anaphylaxis. He mixes particular patient cases with other topics, such as laboratory tests, to the detriment of the other topics.

The lectures flow naturally from one to the next, and each speaker appears aware of the topics covered by the other speakers. Each of the four lectures has a very simple set of self-test questions, and the entire program carries 4 hours of AMA Category 1 or AAFP prescribed continuing medical education (CME) credit. CME credits are obtained by taking a "Quiz" based on lecture content, then printing and mailing in the results.

It is not clear to us what type of user might be most interested in this type of material. Its most positive feature is that the viewer can spend as much time or as little time as desired on any given slide and its accompanying transcript, giving a user much greater control than in an actual lecture. Teachers may want to use the carousel feature or slide printing to develop conferences for residents or students. In terms of personal CME use, our experience was that listening to the recording took significantly more time than reading the transcript. The use of transcript rather than recording to assimilate the material unfortunately requires toggling back and forth between slide and transcript views, which we found to be an unnecessary and irritating design.