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"All pathological changes are merely modified physiological ones, there is no essential difference between the two, and ... a knowledge of the forces controlling the one may sometimes give us a clue to the other."

Pathophysiology has been a foundational study in health care since the advent of western medicine. In fact, at one time - pathology was seen as the crux of the health care team's focus. Now, with a solid eye on health promotion and prevention, pathology has become only part of the whole picture of health and wellness. Still, it is important for nurses to understand and be able to assess common health challenges or diseases. Students can take advantage of various online and computerized pathophysiology resources to increase their understanding and cognitive retention of signs and symptoms and etiology. As technologies become more advanced, virtual reality and realistic microscopic imagery are promising to provide sophisticated visual data for both education and practice.

Pathophysiology has traditionally been a topic that utilizes verbal, textual and visual approaches to teaching. Since the beginning when didactic lectures were primarily used to teach this complex subject, visuals such as slides, specimens, and hands-on laboratory experiences were included to afford a multi-sensory learning experience. Pathophysiology is a topic that is studied by most health care professional students, including nursing, medicine and other allied health professionals. Increasingly, this study has been enriched and enhanced through the use of computer applications of various kinds.

Historically, nurses studied pathophysiology in a superficial way, through means such as lectures, some hands-on lab activity, and visual slides or photographs. Medicine has also been taught in this manner, but medical students have traditionally had access to real-life hands-on practice through the dissection and examination of human cadavers and other specimens.

Since the advent of new technologies, particularly computer programs and applications, new ways of affording rich multisensory learning experiences have become available for teaching subjects such as pathophysiology to health professionals including nursing. An important sector of nursing informatics focuses on nursing education, especially on how to use information technologies to enhance the teaching of nursing students. This includes applying various technologies to provide realistic rich visual, auditory, and interactive learning experiences to hopefully cultivate a richer understanding of pathophysiology principles, assessment, diagnosis, prognosis, and intervention skills and theory.

Increasingly, the world wide web has become a comprehensive "virtual" environment for delivering a wide variety of teaching methods including text, still graphics, animation, audio, video, film, and interactive programming. The hypertext functionality of the world wide web creates a linked or "webbed" environment instead of a linear one and permits easy and direct movement among related resources that provides substantial added value to teaching courses like pathophysiology.

Because the world wide web is a completely asynchronous environment that is easily accessible it provides a great deal of flexibility to the learner while maintaining easy central management of the learning environment. Web-based resources add a dimension to teaching pathophysiology which can help to engage learners and encourages the use of learner-centered teaching strategies. Common learning resources include web based databases, visual aids, auditory and multimedia programs, tutorials, case studies, assessment scales and other tools, Flash, simulations, and tests.

Ends in View

This learning activity is intended to give the learner the opportunity to:

1. apply pathophysiologic principles to the interpretation and treatment of symptoms and health challenge processes.

2. engage in health challenge research using a computer program and/or online resources.

3. comprehend common etiologies associated with predictable health challenges.

4. describe and discuss the epidemiology, etiology, symptomatology, and pathophysiology of specific health challenges.

In Preparation

1. EXPLORE: Medscape eMedicine Collection for integrated care guidelines for hundreds of episodic health challenges.

2. EXPLORE: Urbana Atlas of Pathology from the University of Illinois College of Medicine at Urbana-Champaign.

3. EXPLORE: the Merck Manuals - "The trusted provider of medical information since 1899."

4. EXPLORE: Virtual Healthcare Experience from Ryerson University. "This portal provides healthcare students and professionals with an experiential learning opportunity for practising client care in a safe virtual environment. Here you can access a number of simulation experiences that will engage you in clinical decision making."

5. EXPLORE: Pathology Resident Wiki - a comprehensive directory of pathology related web resources.

6. EXPLORE: Virtual Pathology at the University of Leeds - an illustrated site about physiology and challenges to proper functioning.

7. EXPLORE: HHMI BioInteractive by the Howard Hughes Medical Center which has created several Flash based, interactive pathophysiology related visual patient scenario labs for health professional students. Examples include the Cardiology Lab, the Bacterial Identification Lab, Neurophysiology lab, and Immunology Lab. They also present videos, animations, text, and lectures related to a number of physiological topics, ranging from infectious diseases to cancer.

8. EXPLORE: The Auscultation Assistant from the University of California Medical School which created this auditory and visual web based tool to help students learn to distinguish pathophysiological conditions of the heart and blood vessels. Realistic sound demonstrations replicate murmurs, venous hum, systolic, diastolic, rubs, gallops, and lung sounds including crackles and wheezes.

In Practice

1. As a group, discuss strategies for finding reliable appropriate online and computer program resources for researching health challenges and pathophysiology concepts.

2. Research a specific health challenge. Look for a minimum of three reliable resources related to your topic.

3. Make an annotated bibliography of your three chosen resources and share them with the class.

In Reflection

1. How can the internet augment the course materials to facilitate your grasp of pathophysiological concepts?

2. How can you translate pathophysiology and health challenge theory into appropriate terms for your clients?

3. Do you feel comfortable referring internet content to your clients? Why?

4. Do you see room for improvement in available resources, for visual appeal and to aid memorization?

References

Beatson, G. (1896). On the Treatment of Inoperable Cases of Carcinoma of the Mamma: Suggestions for a New Method of Treatment, with Illustrative Cases. Transactions. Medico-Chirurgical Society of Edinburgh, 15, 153–179.

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