KidsCareEverywhere-Vietnam study findings: SAEM 2012 meeting

I recently had the pleasure of presenting our KidsCareEverywhere-Vietnam team's study findings at the national SAEM meeting in Chicago.

Bottom line: 
Despite knowing English as a second language, Vietnamese physicians were able to easily navigate an English-based, clinical decision support software (PEMSoft) after only a brief 80-minute training session, conducted by non-physicians. Their post-test exam scores improved by 84%!

Work in progress: iShowU HD software

Have you ever needed to create a video that required screen-capture recording? As an educator, I have managed to do this using Quicktime Player's "New Screen Recording" option. This allows you to record everything on your screen. Unfortunately, this includes recording the area of interest (good!), plus your messy folders and an embarrassing background photo on your desktop (bad).

There are a few free video-capture tools out there, but I find that the resolution is poor, especially if you want to zoom up on particular aspects of the screen.

Recently, I discovered a relatively affordable software called iShowU. Although I am not intentionally a Macintosh-snob, this software is only for Macs. There are three tiers of functionality: iShowU ($20) , iShowU HD ($30) , and iShowU HD Pro ($60). I bought the middle one. Demo versions are available for free, but they have a subtle watermark on them.

What do I love about iShowU HD?

1. You can select what part of the screen you want to video-capture.

2. If you have watched training videos before, the mouse and mouse-clicks can be difficult to appreciate and follow. This software automatically creates a "click" noise and animates the click with an expanding green circle halo. These audio and video cues are critical to keep the viewer's eyes focused on your teaching point. Go to the 00:45 mark in Training Module #1 below to see the mouse-click feature in action!

3. When you type anything on the keyboard, the software automatically displays these letters/numbers simultaneously at the bottom of the screen for emphasis.

4. The resolution of the videos are amazing.

I am in the process of creating English-language and Vietnamese-language training videos on using a medical decision software PEMSoft. In case you were curious, here's how they were made:

• Video captured using iShowU HD
• Audio captured using Quicktime Player ("New Audio Recording" feature) - Each sentence is a separate audio AIFF file.
• Matched video with audio on iMovie
• Exported video without audio into Flash CS4 - to create simple animations and overlay text
• Re-imported Flash-edited video back into iMovie where it was re-matched with the audio
• Uploaded into Youtube from iMovie

These updated videos are up at our KidsCareEverywhere website and the PEMSoft website as well.

Training Module:

An Introduction

Training Module #1:

Basic Navigation and Utilization of PEMSoft

Training Module #2:

Phoenix Resuscitation Calculator

Disclaimer: I do not have any financial ties with this software company. Just a fan.

Work in progress: KidsCareEverywhere website redesign

One of the great things in medical academia is that I get opportunities to participate in lots of amazing projects. I am currently a Member of the Board for a budding non-profit organization KidsCareEverywhere. Because of my interest in social media, web design, and branding, I am also the de facto webmaster.

Our prior website, designed by a professional graphic designer who donated his time, created a beautiful design layout which we used for a year. Unfortunately, it was a relatively static website -- primarily because I am a novice in manipulating HTML and CSS coding. It didn't reflect all of the great initiatives and projects that we have going on.

I just redesigned the KCE website using Google Sites to continually boost our visibility and legitimacy. This application allows novice web designers to create a professional looking website. There are multiple templates available to get you started. The key advantage in using this platform is that now I can give guest access to other members of our organization. They can now post in blog-like sections ("Hot off the press" and "Intern Blog") so that we have a dynamically changing and rich media content website.

www.KidsCareEverywhere.org

What I really love is that the Google Sites platform significantly improves inclusivity by allowing the least tech-saavy member to actively participate in web content development. You know who you are...

What next will Google come up with?! Needless to say, I'm a fan.

Work in progress: Global health conference poster

Every once in a while I have to pinch myself, because I never envisioned myself working in the area of Global Health. It's amazing/crazy what opportunities come to you, if you just hang out with creative, collaborative, passionate, and hard-working people.


This past year, I went on a KidsCareEverywhere trip to Vietnam where we hosted an educational conference in Hanoi, teaching Vietnamese pediatricians how use a medical software (PEMSoft) to improve their care of kids (prior blog post). We embedded a pre-test/post-test research study question. How well do pediatricians improve their clinical knowledge after spending 3 hours learning an English-based medical decision support software?

We recently got the abstract of our study accepted into the 12th Annual Bay Area International Health Interest Group Conference, hosted by UCSF Global Health Sciences on March 7, 2010. It is at Cole Hall on the UCSF campus. We are working on the poster layout this week.

Effect of Decision Support Software on the Clinical Performance of Vietnamese Physicians
Dieckmann MG, Sharp J, Lin M, Dieckmann R

Introduction
Vietnamese physicians have limited access to current medical references and “decision support” tools. Lack of availability of current information contributes to preventable morbidity and mortality. While most Vietnamese hospitals have computer systems, no previous study has evaluated the impact of computer-based medical decision support on Vietnamese physician performance. A nonprofit organization, “KidsCareEverywhere”, donates computerized decision support software to public hospitals in the developing world. In September 2009, KidsCareEverywhere, sponsored by the “UCSF Vietnam Working Group”, installed such software in Vietnam’s National Hospital of Pediatrics. The team trained the physicians in using the software, then evaluated the effect of the software on physicians’ clinical decision making skills.

Methodology
All training materials were translated into Vietnamese to attain clarity, although the medical software content remained in English. Before the training, half of the study group received one set of cases on common pediatric emergencies, and the other half received a similar but distinctly different set of alternative cases. Subjects were asked to use any familiar references on pediatric emergencies to answer the pre-test questions. After the training, the physicians used the computer software to answer the post-test questions. Each cohort was given the alternative set of cases for the post-test. The primary outcome measure was the change in test scores.

Results
This prospective, randomized crossover study of 54 physicians demonstrated a 61% improvement on test scores, assessing common pediatric emergencies (p < 0.0001).

Discussion
Computer-based, English language decision support software offers an effective tool for Vietnamese physicians. Vietnam is a fertile site for this form of information support, due to extraordinary need, dramatic increases in computer availability, and the familiarity of physicians with English medical terminology.

Acknowledgements
We would like to acknowledge the invaluable assistance provided by UCSF Vietnam Working Group and the KidsCareEverywhere Board of Directors.

Hot off the press: Tarascon Medical Translation Pocketbook

Go to Amazon link.

At my residency alma mater Harbor-UCLA, my friend Dr. Tim Horeczko (pediatric EM fellow) co-wrote a medical translation pocketbook guide with Dr. Ross Donaldson. I wish I had thought of the idea. This guidebook is so convenient, because doing a 3-way translation through a telephone service every time you have a basic question is a pain. What if you just wanted to ask "Are you having pain right now?" It makes sense that we should have a basic list of commonly-used questions/phrases in various languages.

In this reference, common words, questions, and phrases are translated into 17 languages including: Arabic, Farsi, French, German, Hindi, Italian, Japanese, Korean, Mandarin, Polish, Portuguese, Russian, Spanish, Tagalog, Thai, Ukrainian, and Vietnamese. Check it out!

Just as an example, I took some quick snapshots of the phrase "Do you have pain?" in French, Hindi, and Mandarin. It's hard not to chuckle at yourself when you pronounce these words aloud using the phonetic guide.

French

Hindi

Chinese Mandarin

Teaching opportunity for emergency physicians in Bhutan

I think I've caught the bug -- the "global health bug". To be perfectly honest, I never quite got it... until now. I've always known that it is important and tons of physicians dedicate their careers to it. Only after I got back from a KidsCareEverywhere trip to Vietnam did I understand how life-changing, perspective-altering, and fulfilling an experience it can be.

How does this work with my academic niche of medical education? Interestingly, I find global health a natural extension of my niche. Global health, in a way, is all about education. If you have an interest in education and even if you haven't thought about doing international work in underserved countries, I encourage you to at least explore it. It takes so little effort and few resources to make a tremendous impact in local health care systems.

I was just informed of a new international opportunity from an orthopedist friend at UCSF and San Francisco General Hospital, Dr. Rick Coughlin, who has been extremely involved with global health. UCSF sends orthopedic residents to various countries including Uganda and Bhutan.

Map of Bhutan

For the first time, Bhutan is looking to build a medical school and is interested in specifically recruiting board-certified emergency physicians to volunteer their time to teach local physicians about EM. Assignments are for 4 weeks. The sponsoring non-profit organization coordinating these efforts is Health Volunteers Overseas (HVO). Check it out!

http://www.hvousa.org/whereWeWork/special.html