The implementation of a PACS requires training of a diagnostic imaging group’s physicians, technologists, IT personnel, and administrative staff. In addition, the practice’s referring clinician base will have to acquire new skills and learn new tools to be able to access and utilize digital radiographic images.
“Regardless of the technological way the images are transferred to the requesting physician (internal network, HIS-integration, web), there are a number of operations the physician has to perform to depict the radiological images,” wrote the authors of a recent article published online before print in the Journal of Digital Imaging. “Because in most cases these operations are new to the physician, training should be supplied.”
A group of developers from the department of radiology at Ghent University Hospital in Ghent, Belgium, created a digital learning environment accessible both from within its PACS (GE Healthcare Centricity) and from the facility’s intranet.
“Both an auditorium presentation and hands-on training sessions were considered as potential training methods,” the authors wrote. “They were deemed impractical respectively for reason of overly full physicians’ agendas or unachievable amounts of time to be spent by the PACS project team.”
The developers used cognitive load theory (CLT) as a philosophical starting point for the creation of their online PACS training tool.
CLT holds that there are three types of cognitive load: intrinsic, extraneous, and germane. Intrinsic load is connected to the complexity of the presented material; extraneous load is caused by the manner of presenting the material or extra non-significant items; and germane load is the processing of the learning material and the interpretation of the links among different information elements, according to the authors.
Applying this theory, the group selected Microsoft’s PowerPoint application to develop and present its on-line training. The slides were then exported to HTML to speed load time of the presentation and enable it to be operating system independent.
“Information contained on one slide is aimed to be self-explanatory and addresses a single (sub)topic,” the authors wrote. “Slides are set up so that all information is visible at a single glance without the need for scrolling inside the page.”
Users of the training can proceed through the presentation at their own pace, and navigate through any area of it in any order they choose. They also can access it at any time from within the PACS environment.
“Given the personal level of previous experience of the users, they can choose to either enter the e-learning system from the beginning or by selecting a specific topic about which they wish to know more from the index,” the authors reported.
Each slide is designed so that specific pieces of information are highlighted, allowing important aspects of the training to be drawn to the user’s attention.
“The dynamic presentation consists of 126 separate and dynamic slides,” the developers wrote. “All functionality, tools, and features of PACS are discussed and explained. The e-learning system is integrated into the PACS web viewer and can be accessed by clicking the question mark button.”
By adopting CLT techniques in the creation of their referring physician PACS training, the developers reported that the mental effort necessary to process the new information is minimized, which is beneficial for both patients and physicians.
“The use of a digital learning environment leads to personal advantages for the learning physician while on an organizational level providing instruction does not become a continuous effort,” they stated.