Module 1 Activities
Purpose: These activities support instruction provided for COUMADIN® QuickLearn Module 1: Pathophysiology and Epidemiology
of Thrombus Formation
Screen prompt: Unless otherwise noted the screen prompt should be “Click Next to continue.”
Knowledge check screen prompt:: KC prompts are as indicated on storyboard; each KC prompt should be REPLACED by the
standard prompt once the user has clicked Done. First / Second prompts are indicated as follows (slash between them): “Answer
each question, then click Done. / Click Next to continue.”
Navigation availability:
Prev/Next are always available and go to the previous or next sequential storyboard, respectively, unless otherwise noted.
Graphics: All graphics requested that come from outside published sources should be redrawn “based on” the
photocopies or files provided (“stock” accelera graphics may be used as a basis for animations and building of other
graphics).
Button operation:
Unless otherwise indicated:
– Next goes to the next screen
– Prev goes to the previous screen
– Done returns feedback on the student’s response. If student clicks Done before answering question (or all of question’s
elements), show pop-up box: “You must answer all parts of the question before clicking Done.”
– Exit closes the program (show dialog prompt with Yes/No response to question “Do you really want to exit the program?”).
Common Audio
Standard/Common Audio:
clicknext1.wav: Click Next to try the next activity.
clicknext2.wav: Click Next to continue. [NEEDED for BMS?]
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_010
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics: c1_010.jpg
Module Introduction (1 of 2)
Graphics Specs: Grab coumadin.gif from home page of
http://www.coumadin.com (or coumadin_com.gif from
rawgraphics folder provided. Remove “Welcome” and
resize to fit right pane.
Programming Specifications:
onEnter: display c1_010.jpg and play c1_010.wav
AUDIO / VIDEO
SCREEN PROMPTS
c1_010.wav: Welcome to Pathophysiology and Epidemiology of
Thrombus Formation, the first module in the COUMADIN®
(Warfarin Sodium) training series.
The first section of this module covers Pathophysiology,
including how blood is circulated, how blood clots normally form
and dissolve, and abnormal clotting, known as thrombosis.
Click Next to continue.
BRANCHING
The next section provides background on the clinical
implications of thrombus formation, reviewing the epidemiology,
symptoms, and diagnosis of typical disorders.
4/13/2015
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 3
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_020
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics: c1_020.jpg
Module Introduction (2 of 2)
Graphics Specs: Stock photo of Pharm Rep interacting
with doctor. Altering image for each Module (e.g.,
female/Doctor for Module 1 and male/doctor for Module 2-different docs and nationalities).
Programming Specifications:
onEnter: display graphic and play c1_020.wav
Stock photo of Pharm Rep (Professional)
having a discussion with Doctor.
AUDIO / VIDEO
c1_020.wav: Knowledge about the processes involved in
thrombus formation will help you understand the mechanism of
action of COUMADIN® and the implications for its use in a
variety of medical conditions and situations.
This knowledge will be valuable when discussing the
advantages of using COUMADIN® with physicians and other
healthcare professionals and when comparing COUMADIN® to
competitive agents.
SCREEN PROMPTS
Click Next to continue.
BRANCHING
Click Next to begin reviewing the first section of this module,
Pathophysiology of Thrombus Formation.
4/13/2015
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 4
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_030
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics: c1_030.jpg
Section 1: Pathophysiology of Thrombus Formation
Graphics specs: resize/use existing Accelera graphic
c1_hemo.jpg showing Thrombus Formation (see raw
graphics folder)
This section covers the following
topics:
• The Circulatory System
• The Coagulation Cascade
Programming Specifications:
• Thrombus Formation
OnEnter play audio, display graphic; sync text display to
audio as indicated
AUDIO / VIDEO
c1_030.wav: [a] In section 1, we begin with a review of the
anatomy and physiology of the circulatory system, which will be
helpful in understanding the process of hemostasis.
[b]Next, we’ll examine the roles of clotting factors, focusing on
how the body’s release of clotting factors initiates a series of
events that trigger the platelet cascade and the clotting cascade,
known collectively as the “coagulation cascade.”
SCREEN PROMPTS
Click Next to continue.
BRANCHING
[c]Finally, we take a look at the how the coagulation cascade
affects thrombus formation and dissolution.
Let’s review our objectives.
4/13/2015
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 5
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_040
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics:
Learning Objectives
After completing this section, you should be able to:
•
•
•
•
•
•
Describe the path of blood circulation to and from the heart
Define Virchow’s Triad and discuss its significance
Delineate the steps involved in hemostasis
Discuss the roles of various clotting factors
Describe the coagulation cascade
Differentiate the roles of intrinsic and extrinsic pathways in the coagulation
cascade
• List the medical conditions that result in altered hemostasis
• Explain the process that leads to thrombosis
Programming Specifications:
onEnter play audio, display first line of text.
Sync text display to audio as marked.
AUDIO / VIDEO
c1_040.wav: After completing this section, you should be able to:
[a]Describe the path of blood circulation to and from the heart
·[b]Define Virchow’s Triad and discuss its significance
·[c]Delineate the steps involved in hemostasis
·[d]Discuss the roles of various clotting factors
·[e]Describe the coagulation cascade
·[f]Differentiate the roles of intrinsic and extrinsic pathways in the
coagulation cascade
·[g]List the medical conditions that result in altered hemostasis
·[h]Explain the process that leads to thrombosis
SCREEN PROMPTS
Click Next to continue.
BRANCHING
We’ll begin by reviewing the circulatory system.
4/13/2015
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 6
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_050
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics: c1_050.swf
The Circulatory System
Graphic Specs: Figure 1-1 (animation: arrows moving in
directions indicated and blood moving through--style to
match other module graphics [see c1_hemo.jpg]): Blood
Flow through the Arterial and Venous Systems1 [based on
Goldhaber, continuous flow of blood through heart, through
arteries to body, through veins back to heart] [1/Goldhaber,
p. 1437]
Programming Specifications:
Figure 1-1 (animation): Blood Flow through the Arterial and Venous
Systems1 [based on Goldhaber, continuous flow of blood through heart,
through arteries to body, through veins back to heart] [1/Goldhaber, p.
1437]
onEnter, play audio, play animation (blood flow in
continuous motion) continuously
AUDIO / VIDEO
SCREEN PROMPTS
c1_050.wav: Blood circulates within the body through the
circulatory system, an elaborate network of arteries,
arterioles, veins, venules, and capillaries that transports
nutrients throughout the body to provide nourishment to the
tissues.
Click Next to continue.
BRANCHING
Blood also carries wastes away from the tissues for
excretion.
4/13/2015
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 7
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_060
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics: c1_060.jpg
Major Pathways
Graphic Specs: see raw graphics folder for c1_060.jpg,
resize
Programming Specifications:
onEnter, play audio, display graphic. Sync display of a
“highlight” of the title of each section with audio as marked
(highlight = yellow “glow” behind bold head? Pick
something to use throughout modules)
Sync points =
[a] Systemic circulation
[b] Pulmonary circulation
[c] Coronary Circulation
AUDIO / VIDEO
c1_060.wav: The circulatory system has three major pathways:
[a] In systemic circulation, arteries carry oxygenated blood and
nutrients from the left side of the heart to the body tissues, and
the veins carry deoxygenated blood and carbon dioxide (CO2)
back to the right side of the heart.
[b] In pulmonary circulation, deoxygenated blood and CO2 are
carried from the right side of the heart to the lungs, where blood
is oxygenated and CO2 expelled, then oxygenated blood is
returned to the left side of the heart.
[c]Coronary circulation carries blood through the arteries of the
heart, supplying heart muscle with oxygen and nutrients while
carriying deoxygenated blood and wastes back to the right side
of the heart.
4/13/2015
SCREEN PROMPTS
Click Next to continue.
BRANCHING
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 8
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_070
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics:
Knowledge Check
Graphic Specs:
1.
In systemic circulation, which side of the heart are oxygenated blood and nutrients
carried from?
 left  right [answer = left]
2.
Systemic circulation returns deoxygenated blood and carbon dioxide (CO 2) back to the
which side of the heart?
 left  right [answer = right]
Display “answer all” dialog: “You must answer all parts of
the question before clicking Done.” if user clicks done
before choosing answers for each.
3.
In pulmonary circulation, which side of the heart are deoxygenated blood and CO 2
carried from?
 left  right [answer = right]
Feedback (Display on click of Done):
4.
Pulmonary circulation returns oxygenated blood to the which side of the heart?
 left  right [answer = left]
5.
Coronary circulation supplies heart muscle with oxygen and nutrients and carries
deoxygenated blood and wastes back to which side of the heart?
 left  right [answer = right]
Programming Specifications:
onEnter, play audio.
Program radio buttons for left vs. right choices; both
unselected by default.
Correct = That's correct.
Incorrect = Incorrect. The correct answers are (1) left, (2)
right, (3) right, (4) left, and (5) right.
Please review Major Pathways, then try again.
DONE
AUDIO / VIDEO
SCREEN PROMPTS
c1_070.wav:Let’s review.
Answer each question, then click Done. / Click Next to continue.
For each of the following statements about the circulatory
process, click the button before left or right to indicate the
correct direction of blood flow.
BRANCHING
Answer each question, then click Done.
4/13/2015
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 9
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_080
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics: c1_080.swf, c1_080.jpg
Hemostasis (1 of 2)
Graphic Specs: c1_080.jpg = Play Animation button
c1_080.swf = Take file c1_hemo.jpg from raw graphics
folder; see also c1_hemo2.jpg. Crop to use TOP of graphic
and animate (1) to show blood cells flowing through the
artery (no clump at bottom), (2) small break in vessel, (3)
white and red cells start to clump at the break (others keep
flying by), (4) yellow fibrin appears/threaded through clump
to hold it together, (5) dissolve clump piece by piece and fill
in break in vessel wall, (6) end with blood flowing freely [as
in Step 1].
Programming Specifications: onEnter, play audio, play
animation once then stop.
Play Animation
AUDIO / VIDEO
SCREEN PROMPTS
cl_080.wav: In a normal, healthy individual, the process of
blood coagulation is delicately balanced. Blood remains fluid
as it flows through the vessels, but clots rapidly when the
vessels are injured.
When an injury causes a break in a blood vessel wall, it
triggers hemostasis, the process of clot formation and
dissolution.
4/13/2015
Click Next to continue.
BRANCHING
onClick of Play Animation: replay c1_080.swf
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 10
Module 1: Pathophysiology and Epidemiology of
Thrombus Formation
Bristol-Myers Squibb
COUMADIN® QuickLearn
GRAPHICS/PROGRAMMER NOTES
Storyboard # C1_090
ON-SCREEN TEXT AND IMAGE LAYOUT
Graphics:
Hemostasis (2 of 2)
Graphic Specs:
Programming Specifications: onEnter, play audio;
display first line of text. Sync display of numbered items to
audio as marked.
Hemostasis involves a series of four major events that occur in order:
1. Vascular constriction
2. Platelet adhesion, activation, and aggregation
3. Formation of a clot, or thrombus
4. Dissolution of the clot
AUDIO / VIDEO
SCREEN PROMPTS
cl_090.wav: Hemostasis involves a series of four major
events that occur in a particular order:
·
[a] Vascular constriction
·
[b] Platelet adhesion, activation, and aggregation
·
[c] Formation of a clot, or thrombus, and
·
[d] Dissolution of the clot.
Click Next to continue.
BRANCHING
Each event is described in greater detail in the next topic,
The Coagulation Cascade.2 [2/King,/p. 1]
4/13/2015
Developed for BMS | by Accelera Corporation
Proprietary and Confidential
Page 11