Out of the wilderness: flipping the classroom to advance scholarship in an internal medicine residency program.

Residents in an internal medicine residency program "flipped the classroom" in a series of learner-centered activities which included the creation of a medical student interest group, a continuing medical education symposium, and a journal supplement focused on wilderness medicine topics in Hawai'i and Asia Pacific. The project encompassed both scholarly activities (discovery, integration, application, and teaching) as well as scholarship (writing for publication). The project advanced the professional formation of residents by developing competencies and producing outcomes that are key features of the ACGME Next Accreditation System.

Takotsubo cardiomyopathy in the setting of acute alcohol withdrawal.

Takotsubo Cardiomyopathy (TCM), also known as stress-induced cardiomyopathy, is a cardiomyopathy characterized by acute reversible apical ventricular dysfunction and apical akinesis in the absence of obstructive coronary artery disease. Although the disease may be precipitated by an acute emotional or physical stressor, the pathophysiology, postulated to involve excess catecholamine release, remains unproven. In contrast, the role of catecholamine excess and hyperadrenergic physiology in acute alcohol withdrawal (AAW) is more established.

Mass-casualty triage training for international healthcare workers in the Asia-Pacific region using manikin-based simulations.

Introduction: More than half of the world's disasters occur in the Asia-Pacific region. A simulation-based exercise to teach healthcare workers prehospital triage, tagging, and treatment methods was used to link disaster management theory to practice with a student-centered, hands-on educational activity. Various strategies for teaching disaster health education have been advocated, and best-practice disaster education models continue to be sought.

Videolaryngoscopy for intubation skills training of novice military airway managers.

An estimated 10% of preventable battlefield deaths are due to Airway obstruction. Improved airway rescue strategies are needed with new tools for airway management by less experienced providers. Airway management and training are improved using video laryngoscopy (VL) compared to direct laryngoscopy (DL).

Teaching mass casualty triage skills using iterative multimanikin simulations.

Objective: Effective mass casualty triage requires rapid and accurate decision making. First responders need to be trained, but opportunities to practice triage and receive individualized feedback during traditional mass casualty (MC) exercises are uncommon. It was hypothesized that novice learners would improve in speed, accuracy, and self-efficacy after deliberate practice triaging multiple simulated casualties in a MC exercise using high-fidelity manikins.

Teaching mass casualty triage skills using immersive three-dimensional virtual reality.

Objectives: Virtual reality (VR) environments offer potential advantages over traditional paper methods, manikin simulation, and live drills for mass casualty training and assessment. The authors measured the acquisition of triage skills by novice learners after exposing them to three sequential scenarios (A, B, and C) of five simulated patients each in a fully immersed three-dimensional VR environment. The hypothesis was that learners would improve in speed, accuracy, and self-efficacy.

An international landmine telehealth symposium between Hawaii and Thailand using an Internet2 and multi-protocol videoconferencing bridge.

An international telehealth symposium was conducted between healthcare institutions in Hawaii and Thailand using a combination of Asynchronous Transfer Mode, and Internet2 connectivity. Military and civilian experts exchanged information on the acute and rehabilitative care of landmine victims in Southeast Asia. Videoconferencing can promote civil-military cooperation in healthcare fields that have multiple international stakeholders.

International medical education between Hawaii and Thailand over Internet2.

International medical education sessions have been successfully conducted by videoconferencing using Internet2. The sessions were between two tertiary care medical centres, in Honolulu and Bangkok. However, video quality was lower than for similar sessions using ISDN and audience satisfaction was less.

Interactive nursing skills training using advanced networked technology.

We have developed a Web-based e-learning tool for teaching nursing skills, using educational material from a hospital-based nursing skills 'fair'. Management software was used to track skill certification and continuing education contact hours. The content could be delivered over the Internet and through firewalls using Windows Media Player version 9.

Remote critical care consultation: telehealth projection of clinical specialty expertise.

Remote critical care consultations have been employed between the Naval Hospital in Guam and the Tripler Army Medical Center in Hawaii, a distance of 5300 km. During a 10-week study period there were physician-physician daily consultation rounds for patients in the intensive care unit at the Naval Hospital. Physiological data, video-images and sound were transmitted via a 768 kbit/s frame relay connection, albeit with a 1-3 s delay.

International distance education and the transition from ISDN to high-bandwidth Internet connectivity.

The Thailand-Hawaii Assessment of Interactive Healthcare Initiative (THAI-HI) is an international distance-education project between two teaching hospitals in Honolulu and Bangkok that uses videoconferencing over three ISDN lines. A 'morning report' format is used to discuss clinical cases primarily covering infectious disease and critical-care topics. An audience response system is used at both sites to add interactivity.

International distance education and the transition from ISDN to high-bandwidth Internet connectivity.

The Thailand Hawaii Assessment of Interactive Healthcare Initiative (THAI-HI) is an international distance-education project between two teaching hospitals in Honolulu and Bangkok that uses videoconferencing over three ISDN lines. A 'morning report' format is used to discuss clinical cases primarily covering infectious disease and critical-care topics. An audience response system is used at both sites to add interactivity.