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Journal of Medical Systems, Vol. 28, No. 5, October 2004 (
Multimedia Based Medical Instrumentation Course
in Biomedical Engineering
Ayhan Istanbullu1 and İnan Güler2,3
Computer assisted instruction in education, including biomedical engineering education, has been explored and changed dramatically for more than two decades. The
Internet, with its capacity to transmit synchronous and asynchronous audio, text, and
graphics, presents educators with tremendous opportunies for distance education and
independent learning. In this work, we have developed a new educational hypermedia for medical instrumentation courses. It is designed to be suitable for biomedical
and technical curricula where these courses are scheduled. The courseware provides
support for the education of medical instrumentation. The work is presented herein
to provide multimedia course material with animations to assist learning some key
Medical Instrumentation topics on the World Wide Web.
KEY WORDS: Medical Instrumentation; medical electronic; biomedical engineering education; web
based learning; multimedia.
INTRODUCTION
Computer-assisted instruction (CAI) programs based on Internet technologies,
especially on the World Wide Web (WWW), provide new opportunities in biomedical engineering education. Due to the rapid proliferation of the WWW, many educators seek to improve the effectiveness of their instruction by providing innovative
web-based course material to their students and the WWW have provided exciting new possibilities for distributing information to biomedical engineers. In recent
years, Internet and related technology have been used in biomedical engineering
education.(1–4)
Many of these institutions also supplement regular classroom teaching with
additional web-based material. Key features of internet-based learning environments
1 Department of Electronics and Computer Education, Faculty of Technical Education, Mugla University.
48000 Mugla, Turkey.
of Electronics and Computer Education, Faculty of Technical Education, Gazi University,
06500 Teknikokullar, Ankara, Turkey.
3 To whom correspondence should be addressed; e-mail: iguler@gazi.edu.tr.
2 Department
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include: interactivity, global accessibility, availability of online resources, learnercontrolled pace, convenience, nondiscrimination, cost effectiveness, collaborative
learning, online evaluations, etc.
Although the benefits of a web-based education, many of the web-based training
(WBT) programs are poorly designed and do not fully exploit the possibilities of the
medium.(5–7) Thus, students neglect the learning media which could be of great benefit
to them. Kinshuk, has warned that “the freedom and flexibility offered by Internet
can, however, turn into an extensive waste of time, effort and resources, if the nature
of educational processes and the capabilities of educational technologies are not
adequately considered while designing a tutoring system.”(8)
To address these problems in teaching of medical instrumentation, we have developed a generic, web-based, and interactive learning environment WEBES, Web
Based Biomedical Education System. Our web-based biomedical education environment offers a framework for teaching medical instrumentation topics in biomedical
engineering or healthcare area.
Three main objectives guided the development of the learning material:
(1) providing access to the material on the Web, (2) teaching the topics in an interactive, animated manner, and (3) implementing independent, extendable materials.
Courseware module is further subdivided into six chapters such as Human Body,
Medical Instrumentation, Heart and ECG, Electrodes and Transducers, Biopotential
Amplifiers, and Medical Ultrasound. Each chapter includes links to the selected
topics, objectives, animations, test, and related information.
MATERIALS AND METHOD
Designing Hypermedia Learning Courses
A hypermedia document can contain any combination of text, graphics, sound,
animation, and video. In order to develop hypermedia based learning materials,
we need to know human learning processes in general, and how hypermedia can be
used to facilitate learning. For example, in the most fundamental information seeking
stage of the human learning process, hypermedia provides large integrated bodies of
information in alternative representations for users to browse through selectively.(9)
Multimedia applications to education considerably reduce the time devoted to
learning. This is due to the convergence of several factors:(10)
• User–application interactivity, resulting in reinforcement of learning.
• Individual learning, where the student learns at his own pace.
• Several communication channels—text, sound, graphics, animations, and
video. A positive emotional impact is produced in the student.
It is verified that user–application interactivity produces reinforcement, and a
greater and better assimilation in the learning process. Working with multimedia
application widely increases the memorization.
Usually, education on the net may be categorized into two main classes: on-line
or synchronous and off-line or asynchronous education. Synchronous instruction
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Fig. 1.
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Asynchronized learning model architecture.
requires the simultaneous participation of students and instructors with a real-time
interaction: for this reason, audio and video are strongly used to create a sense of
“telepresence.” On the contrary, in asynchronous education the students do not need
to be present at the same time.(11) The course materials can be requested from the
server anytime on this client/server architecture system. Figure 1 shows the asynchronized learning model architecture.
The advent of WWW, e-mail, file transfer, and on-line database permit new interaction opportunities for asynchronous mode and encourage students and instructors
to share their idea and findings.
First, browsers are available for all types of hardware and software platforms,
and many are free. Second, the hypertext languages in which the information is
represented, generically referred to as HTML (Hypertext Markup Language), are
subject to standards and are reasonably uniform and consistent. In practice, this
means that there are specifications for core HTML enabling documents to be written
which can be viewed correctly on all conformant browsers. Third, both of these are
continually being developed and upgraded with the addition of new capabilities and
functionality, but within existing constraints.(11)
Hardware
The development platform for the learning material was a Pentium III 600 MHz
computer running Windows XP with 192 MB of RAM. These machines were also
equipped with 16 bit sound card, 15 in. high resolution monitors, and video cards
with 4 MB of video memory.
Software
Dreamweaver MX. Dreamweaver is a professional visual editor for creating
and managing web pages. This product was particularly helpful in two regards. First,
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the visual interface simplified the creation of lesson pages and helped in designing
the layout of the pages. Second, Dreamweaver supports proprietary templates that
make site-wide changes possible by editing a single template. This feature was indispensable because the learning modules contain over 100 web pages and required
regular updates during development.
Fireworks MX and Paint Shop Pro 6.0. Both of these programs are graphic
editors. Fireworks is optimized for the design of web graphics (i.e., GIF and JPEG
formats) while Paint Shop Pro is more general and supports a wider range of formats.
The primary use of these tools was the design of graphics embedded in module lessons
and the design of images used in various interactive components.
Flash MX. Flash is a tool for creating interactive, web-based animations. Interaction is achieved through the use of Flash’s scripting language. This language makes
it possible for animations to detect user input such as mouse or keyboard events and
respond with scripted actions. This tool was the primary technology we used to create
interactive components.
It has a user-friendly and comprehensive on-line tutorial with plenty of examples and explanations available. Moreover, its familiar interface resembles the icons
found in other widely used computational packages. Flash enables users to create
attractive animations, to apply several visual vectors, and to make use of MP3 audio
format, which adds to sound quality and reduced file size. Files generated by Flash
are referred to as movies and are relatively compact in size. The key to size reduction is in the ability of the tool to work with vector-format images created through
a mathematical operation performed by the computer.(12) As Flash has possibilities
of script programming, there is an increased potential for promoting interactivity
between user and software.
The Educational Context of the Study and Results
The Web based training system covers the medical instrumentation and has been
prepared by Guler.(13) The content is based on a series of lectures which have been
delivered by Guler for a number of years to senior students from a range of medical instrumentation courses, e.g. BSc in Electronic Engineering, BSc in Biomedical
Engineering, and BSc in Electronics and Computer Technology. It was designed to
include features that would allow reinforcement of certain points as might happen in
a typical lecture to help students to understand the information and may be used for
both primary learning, revision, and as a remedial teaching resource. It would occupy
students for approximately 8–12 h of fairly intensive study. The exercise sections may
also be useful for self-assessment.
The intended audience for our work consists of the graduate/undergraduate/
polytechnics EE/BME students, students minoring or taking courses in EE, and
anyone who is interested in learning key Medical Instrumentation topics.
Each module consists of a set of lessons and review questions with embedded interactive components implemented as Flash animations, Javascripts, or Java applets.
These objects enable educators to provide a learning environment beyond the
bounds of the classroom either to supplement their in-class teaching or as part of a
distance learning course. The module topics and their contents are selected based on
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Fig. 2.
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The WEBES user interface.
the authors’ interests and the available project resources. The list of modules above is
not intended to be comprehensive and their contents are not intended to be complete.
Some virtual experiments’ applications of Biopotential amplifiers are described
here. These applications include the inverting amplifier, the noninverting amplifier, the follower, multi input amplifier, differentiator amplifier, instrumentation
amplifier.
Whenever a student enters the Biopotential unit, objectives page pops up first
(see Fig. 2). Then, theory page animation that is explained by a voice recording related
to the topic starts (see Fig. 3). After this narrative, a virtual experiment related to
the topic is performed (see Fig. 4).
On virtual experiments, amplifier’s input voltage feedback and input resistance
can be adjusted with the arrows on it. After all, a test page which consists of questions
related to random values assigned and having various connections of biopotential
amplifier circuits comes next (Fig. 5)
Figure. 6 shows, one of the most used connection types on Medical Instrument,
the instrumentation amplifier.
In addition to the domain knowledge, the courseware also contains pop quiz,
which will require trials, observations, comparisons, and self-examinations before a
reasonable solution can be revealed. Through such provocation, students can shed off
their deeply rooted question-and-quick-solution type of reflective learning style, and
start the evolution into a seasoned engineer who would test, observe, incubate, and
innovate. After all, engineering education is not so much of some limited amount of
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Fig. 3.
Screen shot of Inverting Biopotential Amplifier animation.
domain knowledge, but, more importantly, a lifelong learning habit and the intrinsic
motivation to innovate and to excel for better humanity.
CONCLUSION
Web-based education environment proposed for development as learning/
teaching aid for biomedical engineering education. Additional educational support
should be provided if the CAI application is to be used to support distance learning.
A prototype electronic textbook, Medical Instrumentation, is prepared and
available on the WWW. It contains six chapters—Human Body, Medical
Instrumenttation, Heart and ECG, Electrodes and Transducers, Biopotential
Amplifiers and Medical Ultrasound—suitable for an overview course in medical
instrumentation.
Fig. 4.
Screen shot of inverting amplifier virtual experiment.
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Fig. 5.
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Screen shot of biopotential amplifier problems.
Each chapter includes links to selected topics, instructional objectives, and illustrated animations. Instructional objectives indicate what students expected to have
learned after completing the associated material for each chapter. Tests give students
an opportunity to test what they have learned and to receive feedback privately.
In conclusion, we would like to say a word about the goal of this work to improve the effectiveness of learning for the following three reasons: (1) accessibility
of materials, (2) level of student engagement, and (3) student responses.
The first reason we believe the modules improve the effectiveness of learning is
their accessibility. Because the six learning modules are always accessible to students
via the WWW, they can review information and learn at their own pace outside class.
Fig. 6.
Screen Shot of Instrumentation Amplifier virtual experiment.
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Consider the problem of teaching biopotential amplifier. During a lecture session, the professor has a limited amount of time in which to explain and illustrate
the rules of biopotential amplifier. Our experience shows that many students will
not understand the example problems that the professor works in class. Often these
students will ask for the problem to be repeated, a request that may not be practical
given the time constraints. The module on biopotential amplifier provides a practical
solution to this problem. This module includes six simulations illustrating different
configurations of biopotential amplifier (inverting, noninverting, follower, multiple
input, differential, and instrumentation amplifier). Thus, what was unreasonable in
class is now very reasonable through animation technology.
The second reason we believe the modules improve the effectiveness of learning
is the opportunity for greater student engagement during study. Many of the lessons in
the modules present the material with interactive components that are more engaging
than traditional textbook reading.
The third reason we believe the modules improve the effectiveness of learning
is the informal responses we have received from students using the modules. Twenty
four undergraduate students enrolled in Medical Instrumentation course were asked
for their opinion of the module which was accessible from the class web site. The
students unanimously agreed that the lessons and animations explaining the biopotential amplifier and the inverting amplifier model were more helpful than reading
the textbook alone.
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