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MEDIA REVIEWS

MOSBY’S ECGS ONLINE

St. Louis, MO: MosbyJems, 2003,

$36.95

Mosby’s ECGs Online is a very goodonline educational media productthat can be used as either a coursesupplement or as a self-directedlearning activity. The course isBlackboard-based and most suc-cessfully completed using a high-speed cable modem connection,because some of the graphics andaudio files are a bit large for timelydownloading with a dial-up mo-dem. The course can be accessedusing either Microsoft InternetExplorer version 5.0 or higher ormost versions of Netscape 4.5 andhigher. Elsevier’s use of the Black-board platform for its Evolve prod-ucts is a definite advantage, becauseit allows fairly intuitive coursenavigation. Evolve is Elsevier’sversion of the Internet-accessibleelectronic courseware now perva-sive in many disciplines. Evolve istechnologically contemporary andoffers a variety of on-line courseswith characteristics that allow forinstructor administration of thecourse. Such features include mes-sage boards and electronic gradebooks, which make it easy forinstructors to integrate the productas a program supplement. The 14-page course resource booklet thataccompanies the course purchaseoffers step-by-step instructions forselecting the appropriate screenresolution, as well as for enablingcookies and JavaScript, both neces-sary for using the course. Althoughthe course resource bookletwas a bitinaccurate in terms of instructionsfor course enrollment, the enroll-

ment process itself was relativelyeasy.ECGs Online offers a variety of

educationally sound features, mak-ing it a worthwhile purchase foranyone who is either learning orwho needs to review basic electro-physiology and electrocardiography(emergency medical technicians:intermediates, paramedics, nurses,cardiovascular techs, etc.). Thecourse is logically organized thecontents and scope are appropriateto entry-level electrocardiography(ECG) students; it offers a variety ofinteractive features; it has well-worded educational objectives; ithas accurate, well-delivered infor-mation; and it is an opportunity forstudents to check their learningand receive feedback on wronganswers.The course organization flows

well for the most part. It consistsof 11 modules, each with an in-troduction, a variable number oflessons, a summary, review exer-cises, and a post-quiz. Themodules include anatomy andphysiology, basic electrophysiology,sinus mechanisms, atrial rhythms,junctional rhythms, ventricularrhythms, atrioventricular blocks,pacemaker rhythms, introductionto 12-lead ECGs, a comprehensivereview, and a 100-item posttest.‘‘Chunking’’ of material is a soundeducational strategy that allows foreasier assimilation of material, andthis is done well in the programwith the exception of the secondmodule. The second module, ‘‘BasicElectrophysiology,’’ is divided intotoo many ultrashort lessons,thereby fragmenting, rather thanstructuring, the material. Thismodule would be better learned

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by most if it were thought of as twomodules: basic electrophysiologyand basic electrocardiography.The course offers a variety of

interactive features to enhancelearning, including audio files thatprovide the correct pronunciationof terminology, although a fewterms that I would have expectedto be available for pronunciationwere not linked to audio files (i.e.,sulcus/sulci and chordae tendo-nae). Other features include videoclips, an interactive ECG ruler, in-teractive graphs and diagrams, andreferences available at the clickof a mouse. One of the best featuresis the ‘‘On the Job’’ icon which,when clicked, offers practical, real-life information about the applica-tion of ECG knowledge in patientcare.The review exercises, quizzes,

and posttest are generally welldone, offering an opportunity forimmediate application of materialand feedback on items missed.However, the matching exercisesdo not necessarily test learning,but are rather an exercise in iconicmemory of the placement ofmatching game tiles. The multiple-choice and true–false items areremarkably well written and arebased solidly on the course ob-jectives. The authors are to becommended for their skill in writ-ing both educational objectives andtest items.Although the advantages of ECGs

Online far outweigh the dis-advantages, there are a few itemsof which instructors should beaware to avoid potential problems.As part of a structured course, theinstructor will want to set time-lines for students to keep them

Q&A COLOR REVIEW

OF PEDIATRIC EMERGENCY

MEDICINE

BY STEPHEN LUDWIG,

PATRICIA O. BRENNAN, AND

JANET G. YASSA.

New York: Thieme, 2003,

192 pages, $34.95 (softcover)

Q&A Color Review of PediatricEmergency Medicine by StephenLudwig, Patricia O. Brennan, andJanet G. Yassa is a 2003 192-pagesoftcover text on pediatrics. The textcontent is appropriate for multipledisciplines whose objective is toevaluate and/or expand theirknowledge in pediatric emergencymedicine. This would include thespecialty services in training witha focus of pediatrics related tonursing, medicine, primary care,surgery, orthopedics, emergencyand prehospital care.A multitude of diseases specific

to pediatric medicine are presentedin a question-and-answer format.The answer(s), which immediatelyfollow, include specific manifesta-tions of the case, differential diag-nosis, and management includingcomplications, which may occur.Pediatrics is the focus on identifica-tion of diseases and pertinent in-formation, which emphasizes adultand pediatric medicine as separatespecialties. Twenty plus expert au-thors from around the world havecontributed to this text. The textis extremely organized in its con-tent of 207 question and answers,which address common and not-so-common conditions in children.Questions are based on clinical

cases, which are addressed in theiracute stage and are accompaniedby high-quality graphic pictorials,illustrations, and/or x-rays. Theseillustrations and graphics will en-hance the reader’s comprehensionof both knowledge and physicalpresentation of specific man-ifestations of a disease(s). A discus-sion accompanies the answer(s) toeach of the questions presented. The

discussion (answers) focus on thekey as well as differentiating factorsof each individual case questionpresented. Discussion is not limited.Answers addressed in discussionidentify the acute onset and mani-festation of symptoms, etiology,current treatment modalities, po-tential complications, differentialdiagnosis, and further evaluationand management. The thorough-ness and clarity of the discussionaccompanying each question can-not be overemphasized. This en-hances the reader in determiningappropriate diagnosis and manage-ment, including complications thatmay manifest themselves. All ofthis information is organized tofollow each individual questionand/or case. Frequent page-turningfor references and explanations isconsolidated versus partial refer-ence throughout the text.The classification of cases is

extensive. High-quality graphicphotographs accompany commonchildhood illnesses and injuriessuch as bites, scratches, non-accidental injuries, dermatology,and viral disorders. Complex casesinvolving cardiac, respiratory, gas-trointestinal, renal, oncology, andneurologic etiologies are accompa-nied by their manifestations specificto pediatrics. As stated previously,the high-quality color visuals andradiographic findings are excep-tional and enhance the reader whohas not had clinical experience inthese areas.Two hundred nine questions are

presented. A broad classification ofcases and list of abbreviations arelocated at the beginning of the text.A comprehensive index located inthe back of the text identifies thecase topic and identifies all refer-ences to the questions and answersas identified by the case number. Asan educator and advanced practicenurse, I find this one of the mostsimplified, extensive but con-densed, up-to-date pediatric refer-ence texts. The size of the text and

74 PREHOSPITAL EMERGENCY CARE JANUARY / MARCH 2004 VOLUME 8 / NUMBER 1

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synchronized with classroom con-tent. (The publisher may want toconsider including a sample plan ofstudy to assist self-directed learnersin staying on track.) The speed atwhich some of the supplementalfeature files are downloaded (14minutes for the video from module1, lesson 2 with a 56-Kmodem) maytempt some students to skip them.Instructors should impress onstudents the tremendous learningbenefits of taking advantage ofthese features. This is a potentialdownfall for those without access tocable modem service. Finally, theinstructor should caution studentsabout the simplicity of the pretestfor module 1. It is overly simple andmay tempt the student into as-suming greater mastery of themodule than he or she has, andsubsequently underestimate theimportance of thoroughly engagingin the module materials and activ-ities.Overall, Mosby’s ECGs Online is

an excellent, comprehensive educa-tional package. It is sound withregard to educational principles aswell as accuracy and thoroughnessof content. It offers advantages bothas a classroom supplement and asa self-directed learning project. Itallows the student flexible optionsfor studying the material and offersthe opportunity for repeated ex-posure to more complex concepts.It is more than just a textbook for-matted for on-line delivery; it is astimulating, interactive educationalexperience.

MELISSA ALEXANDER, MS,

NREMTP

Department of Emergency

Medicine

George Washington University

Washington, DC

d