1. Dudley-Brown, Sharon PhD, RN-CS, FNP

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Case Studies in Gastroenterology, 2nd edition. Silver Platter Education. Roberts, I. (1998).


Case Studies in Gastroenterology is an interactive CD-ROM that allows providers to review and fortify their interpretive abilities in reading radiology, histology, and pathology tests used as diagnostic approaches in the diagnosis and management of gastrointestinal disorders. This CD-ROM was created to serve as a review for the GI board certification exam for physicians.


This particular CD-ROM contains 25 different case studies. The table of contents simply lists the 25 cases with the chief complaint, such as "37-year old female with epigastric pain." The information in the case studies is read to the viewer; simultaneously, the major highlights are presented in individual slides. Once you click on a case, it opens with the history. After the history, pertinent findings on the physical exam are then presented. Clinical course is next, followed by laboratory tests. In this section, you can click on and choose between blood and urine tests, radiology, CT, MRI, biopsy, and histology findings. For the radiology section, you can view the images up close and are able to access "hints," which essentially describes the image you are viewing.


The next section is diagnosis, in which you choose the correct diagnosis from four choices. If you choose the wrong answer, you can try again. Following a brief description on why that choice is the correct diagnosis (based on the history, physical, and lab findings), there is a series of six separate questions on the topic. Again, for these questions, if you answer incorrectly, you can retry until you make the correct choice. Brief feedback is once again given on the correct answers. This aspect of the CD-ROM greatly facilitates learning of the material presented from these cases.


These case studies seem to cover somewhat less common problems in GI, for example: IMHN, aortoesophageal fistula, Menetrier's disease, wandering spleen, GAVE, and Boerhaaven syndrome. In totality, it takes about 1 1/2 to 2 hours to complete all the cases, but you can exit the program and return to the cases at another time. Since no CEUs are available for completion of the cases, there is no tracking of your results on the questions. The release date of May, 1998 is not prohibitive as it seemed that the material presented was still up-to-date.


The slides are uniform in their content and design. The material is well presented overall, and the format is easy to follow. Due to their uniformity, the presentation becomes a bit boring after a few cases. This inhibits reviewing all 25 of the cases in one sitting. The reader can, however, complete the material at his or her own pace, completing just one case at a sitting if desired. The section on diagnostic tests is probably the highlight of this CD-ROM, as the actual images are presented. This tends to be an area of weakness for most nurses, so viewing the actual films with an explanation is helpful. Some other nice features of this CD-ROM are that you can download particular slides for future use for teaching, and you have the capability to pause, fast forward, reverse, and actually mark the slides if desired.


This material, while touted to be aimed at physicians for board review, would certainly be appropriate for all nurses working in GI. It can be used as a review for seasoned nurses, or as part of an educational program for nurses new to the GI field. It does, however, neglect some of the more common GI problems, so it should not be used as a sole educational resource. In addition, the focus on diagnosis of a complaint may be more appropriate for nurse practitioners and physician assistants than registered nurses in GI. Cost, while unknown at the time of the review, also may be prohibitive for one's own library. Overall, I can see its usefulness for nurses and physicians in both GI specialty practice and in primary care.