Current Techniques in Surgery. Open Repair of Inguinal Hernia (Adult); Laparoscopic Cholecystectomy. A Multi-media Step-by-step Approach to Surgical ProceduresBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7113.959 (Published 11 October 1997) Cite this as: BMJ 1997;315:959
- Gordon L Carlson, lecturer in surgery, Department of Surgery,
- Sir Miles Irving, professor of surgery
Current Techniques in Surgery. Open Repair of Inguinal Hernia (Adult)
Ed Michael Edwards SilverPlatter Education, £129.25 ISBN 1 57276 0214
Laparoscopic Cholecystectomy. A Multi-media Step-by-step Approach to Surgical Procedures
Ed Michael Edwards, Silver Platter Education, £129.25 ISBN 1 57276 0346
The incorporation of text, video, and sound within a software package provides almost limitless educational opportunities. The recommended minimum hardware requirements for these two CD ROMs—of a 386 compatible PC, 8 Mb RAM, and at least 10 Mb hard disc space—should be within reach of everyone who has bought a computer within the past three years. A sound card and speakers are required to achieve the full multimedia experience. Unfortunately, although the equipment used for review easily exceeded the minimum specifications, the programs ran rather slowly and at times jerkily. The software was easy to install, but it crashed occasionally and ran comfortably only on a system with an extremely high specification.
The CDs provide an interactive environment in which the user is taken in a stepwise manner through elective open repair of inguinal hernia and laparoscopic cholecystectomy. The introductory screens claim that the programmes are aimed at everyone involved in the operations concerned, from the theatre nurse to the experienced surgeon. In this respect, the CD on hernia repair was particularly apt for the senior of the two reviewers, who hoped to learn the principles of the now favoured Lichtenstein repair.
While the text is well written and clear, the hallmark of good multimedia rests in the quality of the sound, illustrations, and video, and these CDs are sadly lacking in this respect. In the hernia programme the sound is of patchy quality, varying in clarity and amplitude. The illustrations in the hernia package are also of poor quality and generally difficult to comprehend. The video footage is even worse. Although there are no less than 19 segments of video in the hernia CD and 15 in the cholecystectomy package, the image quality is poor and occasionally jerky. In some of the video clips it was hard to identify anything.
While these CDs undoubtedly represent a conceptual advance in the teaching of operative surgery, they disappoint in their current form because of their failure to realise the full potential of multimedia. Most of the information provided can be found in any good textbook of operative surgery at a fraction of the price, and with a greater ease of use. In the end, the senior reviewer resorted to the tried and tested method of apprenticeship by learning the Lichtenstein repair at the operating table under the supervision of the junior reviewer.
In the future, the teaching of operative surgery will almost certainly involve computer based learning packages such as these. With better attention to the quality of illustrations and video footage and less ambitious claims about hardware compatibility, these CDs will undoubtedly be useful as part of a teaching resource. At present, they are limited in scope and expensive, and most trainees are unlikely to find them more useful than the traditional combination of a textbook of operative surgery and a period of supervised training in the operating theatre.
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