Inconsistency as a diagnostic tool in a society of intelligent agents.

Objective: To use the detection of clinically relevant inconsistencies to support the reasoning capabilities of intelligent agents acting as physicians and tutors in the realm of clinical medicine.

Methods: We are developing a cognitive architecture, OntoAgent, that supports the creation and deployment of intelligent agents capable of simulating human-like abilities. The agents, which have a simulated mind and, if applicable, a simulated body, are intended to operate as members of multi-agent teams featuring both artificial and human agents.

Integrating cognitive simulation into the Maryland virtual patient.

This paper briefly describes four cognitively-related aspects of modeling a virtual patient: interoception, decision-making, natural language processing and learning. These phenomena are treated within the Maryland Virtual Patient simulation and training environment.

Revealing the conceptual substrate of biomedical cognitive models to the wider community.

The patient authoring interface for each disease in the Maryland Virtual Patient simulation environment reveals the conceptual substrate of the disease model. Revealing the disease model to the community both explains how the interactive simulations work and invites collaboration from the wider community.

Video technology to advance safety in the operating room and perioperative environment.

Video is a powerful medium and is underused for patient safety in several areas: education, real-time consultation, process improvement, research, and workflow coordination. We illustrate this point through an overview of uses of video in health care by the authors and others in several institutions. These uses were in the context of team work training, operating room coordination, technical skills of invasive procedures, process improvement, telementoring, and multimedia video records.

An interactive, cognitive simulation of gastroesophageal reflux disease.

The Maryland Virtual Patient (MVP) Project seeks to create realistically functioning virtual humans endowed with automatic physiological and cognitive function that can be used in the training of medical personnel. Physiologically, the state of an MVP changes in response to internal pathophysiological stimuli and external stimuli, the latter initiated by either by the patient or the trainee. Cognitively, the MVP can communicate with trainees about current symptoms, lifestyle, history, adherence to prescribed treatments, etc.

A basis for electronic cognitive simulation: the heuristic patient.

Although medical trainees are expected to become expert quickly and safely, limited electronic methods are available to rehearse medical cognition for common outpatient and non-emergent inpatient problems. We conducted a series of formal observational sessions designed to determine what interaction requirements are desirable for student rehearsal of medical management by using an electronic patient. The studies utilized both manual and electronic methods for a student to evaluate and manage patients with medical and surgical problems.

Telemedicine for the operating room of the future.

Telemedicine is becoming a subset of information science and should benefit tremendously from the geometric growth of information architecture in hospitals. The use of telemedicine to break the isolation of the operating room is a highly achievable goal. An open operating room has information on demand for the personnel, fluid communication among operating room personnel, and broad interaction with the learner community and consultants.

Looking at the forest instead of counting the trees: an alternative method for measuring faculty's clinical education efforts.

Purpose: To present an alternative approach to mission-based management (MBM) for assessing the clinical teaching efforts of the faculty in the third and fourth years of medical students' education.

Method: In fiscal years 2000 and 2001, interviews were conducted with department chairs and faculty members with major responsibilities in education at the University of Maryland School of Medicine. Using a standard worksheet, each rotation was categorized according to the amounts of time students spent in five teaching modes.

A decade of experience with renal transplantation in African-Americans.

OBJECTIVE To evaluate the strategies instituted by the authors' center to decrease the time to transplantation and increase the rate of transplantation for African-Americans, consisting of a formal education program concerning the benefits of living organ donation that is oriented to minorities; a laparoscopic living donation program; use of hepatitis C-positive donors in documented positive recipients; and encouraging vaccination for hepatitis B, allowing the use of hepatitis B core Ab-positive donors. SUMMARY BACKGROUND DATA The national shortage of suitable kidney donor organs has disproportional and adverse effects on African-Americans for several reasons. Type II diabetes mellitus and hypertension, major etiologic factors for end-stage renal disease, are more prevalent in African-Americans than in the general population.