A257 Harnessing Web 2.0 to Improve Consultation and Communication

William E. Schreiber, MD, FASCP

Dean Giustini, MLS, MEd Michael Feldman, MD, FASCP

2010 Annual Meeting – San Francisco, CA

AMERICAN SOCIETY FOR CLINICAL PATHOLOGY 33 W. Monroe, Ste. 1600

Chicago, IL 60603

Program Content and Disclosure The primary purpose of this activity is educational and the comments, opinions, and/or recommendations expressed by the faculty or authors are their own and not those of the ASCP. There may be, on occasion, changes in faculty and program content. In order to ensure balance, independence, objectivity, and scientific rigor in all its educational activities, and in accordance with ACCME Standards, the ASCP requires all individuals in positions to influence and/or control the content of ASCP CME activities to disclose whether they do or do not have any relevant financial relationships with proprietary entities producing health care goods or services that are discussed in the CME activities, with the exemption of non-profit or government organizations and non-health care related companies. These relationships are reviewed and any identified conflicts of interest are resolved prior to the activity. Faculty are asked to use generic names in any discussion of therapeutic options, to base patient care recommendations on scientific evidence, and to base information regarding commercial products/services on scientific methods generally accepted by the medical community. All ASCP CME activities are evaluated by participants for the presence of any commercial bias and this input is utilized for subsequent CME planning decisions. The individuals below have responded that they have no relevant financial relationships with commercial interests to disclose: Course Faculty William E. Schreiber, MD, FASCP and Dean Giustini, MEd Annual Meeting/Weekend of Pathology & Educational Course Planning Committee/Commission Members and Staff:

N. Volken Adsay, MD, FASCP Carolyn Burns, MD, FASCP Francois Cady, MD, FASCP Michele L. Best, MT(ASCP), MASCP Nikolaj Lagwinski, MD Sondra Moran, MT(ASCP) Cyril Fisher, MD, DSc, FRCPath, FASCP Steven H. Kroft, MD, FASCP Stacy Kiff, MT(ASCP) Syed A. Hoda, MD, FASCP William E. Schreiber, MD, FASCP Suzanne Ziemnik, M.Ed. Monica I. Ruiz, MD Daniel D. Mais, MD, FASCP Kimberly W. Sanford, MD, FASCP Robert A. Goulart, MD, FASCP Peggy Soung Sullivan, MD, FASCP Karen A. Brown, MS, MLS(ASCP) Neil Crowson, MD, FASCP Lynnette G. Chakkaphak, MS, MT(ASCP Syed Ali, MD, FASCP Amy J. Wendel, SCT(ASCP) The individuals below have disclosed the following financial relationships with commercial interests: Course Faculty: Michael D. Feldman, MD, PhD, FASCP Aperio Technology, Inc., CRI Stock Options; Advisory Board; Consultant

Bioimagene Sponsored Research & License Patents

Planning Committee/Commission Members and Staff: Elizabeth A. Wagar, MD, FASCP Becton Dickinson Honorarium Scientific Advisory Board David J. Dabbs, MD, FASCP USLabs; Ventana Med Systems; Consultant service fees; Consulting

Dako

Dennis P. O’Malley, MD, FASCP Clarient Salary, Stock Options Employee David Grignon, MD, FASCP Integrated Lab. Automation Stock Shareholder Solutions Eric D. Hsi, MD, FASCP Allos; BD; Eli Lilly; Honorarium; Research Consultant

Facet Biotech Support Charles Lombard, MD, FASCP Broncus Tech; Asthmatx; Stock Consultant

Neomend Michael D. Feldman, MD, PhD, FASCP Aperio Technology, Inc., CRI Stock Options; Advisory Board; Consultant

Bioimagene Sponsored Research & License Patents

Peter Banks, MD, FASCP Aperio Technology, Inc. Future Stock Options; Advisory Board; Consultant

Cambridge Past Stock Options Andrew Churg, MD, FASCP Various Law Firms Regarding Consulting Fee Consultant/Expert Witness

Asbestos Disease Joel Greenson, MD, FASCP Glaxo Smith Kline; Roche/ Consulting Fee Consultant Genentech; Millennium Pharam; Genetics Squared

Copyright © 2010 by the American Society For Clinical Pathology

All Rights Reserved. Printed in the United States of America. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form

or by any means - electronic, mechanical, photocopying, recording, or otherwise – without the prior written permission of the publisher.

A257 Harnessing Web 2.0 to Improve Consultation and Communication – NEW Get an overview of the power of Web 2.0 to link laboratory practitioners across the globe. Discussions will include a big-picture view of how the internet is changing communication among professionals, how digital pathology can facilitate consultations, and much more. Interactive lectures will offer you an opportunity to connect with select web sites and participate in a Q&A session. You will leave with the ability to: • Establish communication networks with colleagues around the world. • Understand how digital image capture/sharing will transform practice in the next decade. • Access web sites that offer specialized content in pathology and laboratory medicine. Director: William E. Schreiber, MD, FASCP University of British Columbia Faculty: Dean Giustini, MLS, MEd University of British Columbia Michael Feldman, MD, FASCP University of Pennsylvania 2.0 CME Credits MGMT/SPEC MOC: PBL, ICS

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Harnessing Web 2.0to Improve Consultation and Communication

William E. Schreiber, MDDean Giustini, MLS, MEdMichael Feldman, MD, PhD

Faculty disclosure & CME

Dr. Michael Feldman

• Aperio - Scientific Advisory Board

• Cambridge Research Instrumentation - Scientific Advisory Board

• BioImagene - Licensed Image processing patents with Sponsored Research Award for developing automated recognition and grading Research Award for developing automated recognition and grading of prostate cancer

• Siemens Corporation - Sponsored Research Award - Integrated diagnostic signature for aggressive prostate cancer

Number of credits: 2.0

MOC Competencies: Practice-based Learning and Improvement,

Interpersonal and Communication Skills

Workshop objectives

• Learn what web 2.0 is and what it can do

• Identify useful websites in medicine and pathology that use web 2.0 technologiesp gy g

• Find out how to get connected with colleagues from around the world

• Recognize the potential for digital image capture and sharing to change practice

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Web 2.0 – the Basics

William E. Schreiber, MDDept. of Pathology & Laboratory MedicineThe University of British Columbia

What is Web 2.0?

The term “Web 2.0” is commonly associated with web applications that facilitate interactive information sharing, interoperability, user-centered design, and collaboration on the World Wide Web. A Web 2.0 site gives its users the free choice to interact or collaborate with each other in a social media dialog e as c eato s (p os me ) of sesocial media dialogue as creators (prosumer) of user-generated content in a virtual community, in contrast to websites where users (consumer) are limited to the passive viewing of content that was created for them. Examples of Web 2.0 include social-networking sites, blogs, wikis, video-sharing sites, hosted services, web applications, mashups and folksonomies.

Web 2.0 definition, Wikipedia, August 26th, 2010

Features of Web 2.0

• Two-way interaction – the hallmark of web 2.0: interactivity

• Social networking – users post and share personal opinions, artistic creations, and connect with others having similar interests

• Decentralized content production – a combination of experts and interested users generate a website’s content by uploading files, using online word processors and sharing online documents

McGee JB, Begg M. Medical Teacher 2008;30:164-169

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Features of Web 2.0

• Syndication – the ability to subscribe to content which automatically comes to the user based on his or her interests

• Software that gets better the more people use it –users contribute original content, others review and organize it, and as the user base grows, so does the quantity and quality of the content

McGee JB, Begg M. Medical Teacher 2008;30:164-169

Web 2.0 Vocabulary

• Blog – an individual’s informal online journal space, typically (but not necessarily) written by an expert who solicits comments from readers

• Mash-up – combining data and content from two or more separate websites to create a unique view, interpretation or service (e.g., Google maps)

McGee JB, Begg M. Medical Teacher 2008;30:164-169

Web 2.0 Vocabulary

• Podcast – an audio or video file which resides on a website and can be easily downloaded to a mobile device (eg, iPod) or desktop computer

• Wiki – a type of collaborative writing tool that allows multiple authors and editors to contribute simultaneously and on an ongoing basis to a document

McGee JB, Begg M. Medical Teacher 2008;30:164-169

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Web 2.0 Vocabulary

• Social bookmarking – a method for Internet users to organize, store, manage and search for bookmarks of resources online. Descriptions may be added to these bookmarks, so that users understand the content of the resource without first needing to download it for themselves. An example would be ‘tagging’ websites using your own words.

• Folksonomy – a system of classification derived from the practice of collaboratively creating and managing tags to annotate and categorize content. It is a combination of the words folk and taxonomy.

Social bookmarking and folksonomy definitions, Wikipedia, August 26th, 2010

Web 2.0 Vocabulary

Really simple syndication (RSS) – a family of web feed formats used to publish frequently updated works – such as blog entries, news headlines, audio, and video – in a standardized format. An RSS document (which is called a "feed", "web feed“ or "channel") includes full or s mma i ed te t pl s metadata s ch as p blishing dates summarized text, plus metadata such as publishing dates and authorship. Web feeds...benefit readers who want to subscribe to timely updates from favored websites or to aggregate feeds from many sites into one place.

Watch a YouTube video that explains RSS: http://www.youtube.com/watch?v=0klgLsSxGsU

RSS definition, Wikipedia, August 26th, 2010

Popular Web 2.0 Sites

• Facebook (social networking) http://facebook.com

• Wikipedia (encyclopedia) http://wikipedia.org

• YouTube (video sharing) http://youtube.com( g) p //y

• Twitter (microblogging) http://twitter.com

• LinkedIn (professional networking) http://linkedin.com

• Delicious (bookmarking) http://delicious.com

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Medical Sites Using Web 2.0 Tools

Medical encyclopedia

• AskDrWiki http://askdr.wiki.com/• Ganfyd http://www.ganfyd.org

M di l d tiMedical education

• HEAL http://www.healcentral.org• Meducation http://www.meducation.net

Communities of practice

• Sermo http://www.sermo.com/• TRIPAnswers http://www.tripanswers.org/

Web 1.0 – Lab Tests Online

“A public resource on clinical lab

t ti f th l b ttesting from the laboratory

professionals who do the testing”

www.labtestsonline.org

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Web 2.0 - Medpedia

“An open platform connecting

people and information to

advance medicine”

www.medpedia.com

Harnessing Web 2.0 (Part II)

Dean Giustini, MLS, MEdUBC biomedical branch librariandean.giustini@ubc.ca

All links in this presentation are available on my wiki:

http://bit.ly/bzSL9r

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“Web 2.0” Part II

• Why am I here?• I’m a biomed librarian at UBC, blogger, ‘early adopter’• I teach physicians how to find information• My aim: engage, interact with & hear from you ~ 45 mins

• Share my experience with Web 2.0 and what it can doti l t l i• stimulate your learning

• time to discuss pros & cons-downside of Web 2.0 tools

• Illustrate some innovative uses of web 2.0

• Exchange ideas for a more collaborative pathology & lab medicine

“…the truth is that Web 2.0 is a difficult term to define …phrases like web as platform and architecture of participationare used to describe Web 2.0… [but] rather than the platform it's the spirit of open sharing and collaboration that is important …the more we use, share, and exchange information on the web in a continual loop of analysis and refinement, the

d ti th l tf b h th

How Web 2.0 is Changing Medicine (2006)

more open and creative the platform becomes; hence, the more useful it is in our work.”

Reference: Giustini D. How web 2.0 is changing medicine: is a medical wikipedia the next step? BMJ 2006;333: 1283-84.

Described as having these main features:Described as having these main features:

1.1. Social NetworkingSocial Networking

2.2. ParticipationParticipation

3.3. CollaborationCollaboration

Medicine 2.0: is it for you? (2008)

4.4. Apomediation Apomediation ((‘stand‘stand--by’ wisdom of crowdsby’ wisdom of crowds))

5.5. OpennessOpenness

Reference: Eysenbach G. Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness. J Med Internet Res 2008;10(3):e22.

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Medicine 2.0: is it for you? (2008)

Schreiber Schreiber –– Giustini article looks at pathology from web 1.0 to 2.0Giustini article looks at pathology from web 1.0 to 2.0

“… Web 2.0 applications have been available for some time. [but] there are legitimate concerns about how these information technologies will be used and whether they will

Pathology in an era of web 2.0 (2009)

benefit the pathology community. …how might Web 2.0 technology be used to enhance practice within our field? ”

Reference: Schreiber W, Giustini D. Pathology in an era of web 2.0. American Journal of Clinical Pathology. December 2009; 132: 824-829.

1. Asklepios - http://www.cma.ca/asklepios

2. CardioExchange - http://cardioexchange.org/

3. Doc2Doc - http://doc2doc.bmj.com/

4. DoctorsHangout - http://doctorshangout.com/

5. Meducation - http://www.meducation.net/

Social Networking I

5. Meducation http://www.meducation.net/

6. Ozmosis - http://www.ozmosis.com/

7. Phyzoom - http://phyzoom.com/

8. Webicina.com - http://www.webicina.com/

9. Within3 - http://within3.com/

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Social Networking II (Lab Science)(Lab Science)

PathXchange PathXchange http://www.pathxchange.org/

Social Networking III

….is a vendor-neutral, not-for-profit professional networking portal for the global pathology community, promoting digital pathology and telepathology. Px brings the field of pathology into the digital age with Web 2.0 features designed to promote exchange of pathological cases, ideas, knowledge, information, products, and services. Cases and information can originate from anywhere, from any platform, and shared with the sub-groups of your choice.

PathXchange.org (Px) = Pathology 2.0 with Web 2.0 features

Social Networking IV(Lab Science)(Lab Science)

1. BioCrowd - http://www.biocrowd.com/

2. BioMedExperts -http://www.biomedexperts.com/

3. Epernicus - http://www.epernicus.com/

4 LabAction http://www labaction com/4. LabAction - http://www.labaction.com/

5. LabMeeting - http://www.labmeeting.com

6. Laboratree - http://www.laboratree.org/

7. LabRoots - http://www.labroots.com/

8. LabSpaces - http://www.labspaces.net/

9. Medsphere - http://medsphere.org/

10. ResearchGATE - https://www.researchgate.net/

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Participation I (Webicina (Webicina –– Pathology)Pathology)

Participation II (pubmed.gov)(pubmed.gov)

• Save your PubMed searches for periodic updates

• Keep up with today’s literature using RSS feeds

• Receive literature updates in your e-mail

• Scan updates on iGoogle or other ‘RSS reader’

Participation III (Medscape.com (Medscape.com ––

Pathology & Lab Medicine)Pathology & Lab Medicine)

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Participation IV(Facebook)(Facebook)

Participation IV(Facebook)(Facebook)

Participation

Feldman, Giustini & Schreiber – American Society of Clinical Pathology (ASCP) 2010 Conference, San Francisco

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Collaboration I (Group blogging)(Group blogging)

Keith Kaplan

Kenneth Youens

Collaboration II(Twitter)(Twitter)

Google is not just a search engine in 2010Google is a “web 2.0” companyFollows your online activities Use a pseudonym or anonymizer

Google creates many Web 2.0 tools

Collaboration III(Google 2.0)(Google 2.0)

blogs, wikis, calendars, media, writing tools,YouTube, iGoogle, even more …

Google Books & Google Scholar Search pathology and lab medicine literaturee.g., pathology AND web 2.0

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Apomediation I

A few examples of removing “medical intermediary”

• HelloHealth http://hellohealth.com/physicians

• MyDigitalHealth http://www.mydigitalhealth.com

Apomediation II(Twitter Q& A)(Twitter Q& A)

@giustini Send a tweet to ask a question

Openness I(Online Doctoring)(Online Doctoring)

Salter, C. “The Doctor of the Future” Fast Company 2009

Jay Parkinson MD MPH

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Openness II(Surgical Tweets)(Surgical Tweets)

@HenryFordNews

Openness I(Surgical Tweets)

Openness III(Ethics, professionalism)(Ethics, professionalism)

Does tweeting ‘live’ not contravene HIPAA regulations?Does tweeting ‘live’ not contravene HIPAA regulations?

There are 18 identifiers that must not be present about a case

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‘Harnessing Web 2.0’

Use Web 2.0 tools to connect / network globally with experts

Many medical and pathology sites now use web 2.0 tools for social engagement, education & collaborationfor social engagement, education & collaboration

Web 2.0 + Pathology & Lab Medicine = Pathology 2.0

Mobiles, virtual & ‘immersive’ reality take us to web 3.0

Harnessing Web 2.0 to Improve Consultation and Communication:Digital imaging

Michael Feldman, MD, PhDAssociate Prof Pathology & Lab MedicineUniversity of Pennsylvaniafeldmanm@mail.med.upenn.edu

Outline

Web 1.0, 2.0 or 3.0 – what’s it aboutDigital imaging basicsWeb 2.0 applications

PathXchange

Web 3.0 applicationsSlide Tutor

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Web 1.0Static contentContent managementTop down design, not easy for end userMinimal interactionLower bandwidthNo ontology or semanticgy

Terry Lew, in his 3rd Edition of New Media described what he believed to characterize the differences between Web 1.0 and Web 2.0:

"move from personal websites to blogs and blog site aggregation, from publishing to participation, from web content as the outcome of large up-front investment to an ongoing and interactive process, and from content management systems to links based on tagging (folksonomy)".

Web 2.0

Web is not static, more than source dataNot screenfulls of text and graphics (W b 1 0) b t t t (Web 1.0) but a transport mechanism to facilitate interactivity. It will [...] appear on your computer screen, TV set, car dashboard, smart phone, hand-held and tablet devices, maybe even your home appliances.

Web 1.0 vs Web 2.0

http://www.sizlopedia.com/2007/08/18/web‐10‐vs‐web‐20‐the‐visual‐difference/

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Web 1.0 vs Web 2.0

http://blog.vovici.com/blog/bid/18085/Web‐1‐0‐vs‐Web‐2‐0

Web 3.0(Semantic Web)

Methods and technologies to allow machines to understand the meaning - or "semantics" –Encodes relationships of words into Encodes relationships of words into machine readable metadata

Metadata - concepts that describe knowledgeSemantic connects

Synonymy – use synonyms to tag wordsHyponymy/Hypernymy – “is a” relationships. “Car” is a hyponym of “vehicle”

http://www.theappgap.com/beyond‐web‐20.html

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Web 3.0 layers

Outline

Web 1.0, 2.0 or 3.0 – what’s it aboutDigital imaging basicsWeb 2.0 applications

PathXchange

Web 3.0 applicationsSlide Tutor

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Digital imaging basicsDigital Camera

Good old days, largely gone

Whole Slide imager

Multispectral

File formats

The image produced by camera is stored as a file, of which there are many different file types.Loss less formats:

RAW – pure binary data from the camera sensor, proprietary and largeTIFF – old standard.

Lossy FormatsJPEG – (Joint Photographic Experts Group ) Again, an older standard which uses a mathematical algorithm to reduce the image size (throws out some data).

Variable amount of compression can be used from very little to a whole lot, 10-20:1 compression produces so little change that it is imperceptible

JPEG2000 – newer version of jpeg uses wavelet compression. More compression with less degradation of image quality. Not widely adopted yet but could be interesting in future. Also does lossless compression

Virtual SlidesPyramidal files format, each vendor is unique, no standard (svs, jp2, tiff…).DICOM WG26 just adopted a standard

MultispectralProprietary, data cubes with position and wavelength encoded information

Virtual Slide Creation

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Virtual Slide formats

Demo virtual slide

User Interface

Thin clientsJava based (Pathexchange)Flash based (Digital slide box)

Thi k li tThick clientsApplication installed on local PC (Imagescope)Proprietary, often read multiple formats

Why use Digital Pathology?

Sinard et al, Human Pathology 2002

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Digital Pathology Use cases

Web 2.0 Interactivity– PathXchangeWeb 3.0, Intelligent Systems SlideTutor from UPMCMultiheaded microscope –ConferencingQuantitation beyond 0-3+Prognostics & Integration with other digital formats (Can be web enabled in future)

Digital slide Conferencing

These two yellows are identical…

Quantitation beyond 0-3+, MSI Primer - Strictly speaking, light has no color—color is a “pigment” of our imagination

…but their spectra are distinct

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Spectra

Spectral Data Acquisition

1. Take images at different wavelengths with a CCD

5 Quantum dot vials

2. Assemble the data into a “cube” in memory

Intensities at each wavelength = a spectrum at every pixel

650 nm

625 nm

600 nm

575 nm

550 nm

x

y

z

Multispectral imaging for quantitation beyond 0-3+

teach computer thespectral profile ofchromogen/fluorophoreA, B, C

“extract” spectra of individual stains

A B C

Multispectral imaging for quantitation beyond 0-3+

Nucleus and cytoplasm segson top of tumor

Machine Learning Cytometric Segmentation

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FACS like list mode data

Per-cell multi-parameter IHC Core (2,11)Core (10,3)

Core (12,6)Core (7,7)

Core (12,6) Core (7,7) Core (12,6) Core (7,7)

Multispectral imaging for quantitation beyond 0-3+

01000

20003000

40005000

6000

0

1000

2000

3000

4000

5000

0

2000

4000

6000

PRER

Her

2

0 1000 2000 3000 4000 50000

1000

2000

3000

4000

5000

6000Per-cell multi-parameter IHC

ER

Her

2

0 1000 2000 3000 4000 5000 60000

1000

2000

3000

4000

5000

6000Per-cell multi-parameter IHC

PR

Her

2

Core (2,11) Core (10,3) Core (2,11) Core (10,3)

Digital Pathology & Prognostics

Embedding Component 1

GE on Graph Features

Embedding Component 2

Em

bedd

ing

Com

pone

nt 3

FNF

GE on Mass Spec

Image features

Embedding Component 1Embedding Component 2

Em

bedd

ing

Com

pone

nt 3

FNF

Embedding Component 1

SSGEAL on Fused Data

Embedding Component 2

Em

bedd

ing

Com

pone

nt 3

FNF

Proteomics from FFPE

Fused data signature for Prostate cancer recurrence afterradical resection

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IMAGE BASED SURVIVAL PREDICTION –CORRELATING WITH MOLECULAR ASSAY (Oncotype Dx) Breast cancer

Grade based discrimination

Oncotype Dx

Outline

Web 1.0, 2.0 or 3.0 – what’s it aboutDigital imaging basicsWeb 2.0 applications

Pathexchange

Web 3.0 applicationsSlideTutor

A professional networking, collaborating and learning portal promoting digital pathology

Web 2 0 features: YouTube and

What is PathXchange

Web 2.0 features: YouTube and Facebook for pathology! Centers around content by the users and for the usersNot –for-profit and vendor-neutral

PathXchange.org = Pathology 2.0

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Why PathXchangeDisseminate pathological advances

E-learning for pathology students and residentsCME for pathologistsAggregate pathology-related news

Provide a virtual community to pathologistsConnect pathologists working in silos, from different countries and institutionsAccess to an expert network for questions and second opinions

Remove barriers to adoption of digital pathologyFree slide scanning for up to five cases per monthWorks across all platforms and browsers24 x 7 accessibility, no IT maintenance, and no installation necessaryExtremely large storage; global infrastructure

What can you do on PathXchange

Browse

Create

ShareShare

Search

Learn

Ask

Who’s on PathXchange

Explosive growth since launch8500+ users2000+ cases, thousands of images

Users from 160 countries, 1000 institutionsWord-of-mouth adoption T t iWord-of-mouth adoption

6

Top countries: USA IndiaCanadaBrazilUK,SwitzerlandFrance RussiaChina

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How is How is PathXchangePathXchange being usedbeing used

Virtual tumor board

Virtual tumor board

Slide sharing

club

Slide sharing

clubE-learningE-learning

Research studies

Research studies

Case conference

s

Case conference

s

Collabora-tive slide viewing

Collabora-tive slide viewing

Peer-second opinion

facilitation

Peer-second opinion

facilitation

PathXchange

PathXchange Groups

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Browse Similar Cases

Create a Case

Scan Slides and Upload Images

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Search for Cases, Users, and Comments

PathSearch – Search Pathology Related Websites

Professional Networking

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Pathology Blog Feed

Browse Courses

Take An Online Course

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Create Your Own Course

Fully Annotated Digital Slide Box

Self-Assessments

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Outline

Web 1.0, 2.0 or 3.0 – what’s it aboutDigital imaging basicsWeb 2.0 applications

Pathexchange

Web 3.0 applicationsSlideTutor

Slide Tutor

Under the hood

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Knowledge base (Web 3.0 Ontology)

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Slide Tutor Results

Supports learningShort (days) and long term recall (months)

PUBLICATIONSSaadawi GM, Tseytin E, Legowski E, Jukic D, Castine M, and Crowley RS. A natural language intelligent tutoring system for training pathologists: implementation and evaluation. Adv Health SciEduc Theory Pract. 2007 Oct 13; [Epub ahead of print] Crowley RS, Legowski E, Medvedeva, OM, Tseytlin E, Roh E and Jukic D. Evaluation of an Intelligent Tutoring System in Pathology: Effects of External Representation on Performance Gains, Metacognition, and Acceptance. JAMIA 2007 14(2):182-190; Yudelson MV, Medvedeva OP, and Crowley RS. Stepwise Multifactor Approach to Student Model Evaluation in a Complex Cognitive Domain, Accepted by User Modeling and User Adapted Interaction, December 2007 Yudelson MV, Medvedeva O, Legowski E, Castine M, Jukic D, and Crowley RS. Mining student learning data to develop high lever pedagogic strategy in a medical ITS. Educ Data Mining Workshop Proc AAAI 2006 Educational Data Mining 21st Natl Conf Artificial Intell. Boston, MA. Technical Report WS-06-05. AAAI press:82-90.

References

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Harnessing Web 2.0 to Improve Consultation and Communication

Harnessing Web 2.0 to Improve Consultation and Communication

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