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Bright future ahead for teaching tool
Physicians at Memorial Sloan-Kettering Cancer Center in New York City routinely offer their patients a computer CD-ROM that covers the type of cancer they have — whether colorectal, ovarian, breast, soft-tissue sarcoma, or lung. Nurses also ask patients to review portions of the CD-ROMs during their office visit while they wait for the physician. The CD-ROMs cost about $2 each, not much more than a pamphlet, but they are encyclopedic.
Therefore, each CD-ROM has information on basic cell biology and how cancer starts, on the staging and grading systems of cancers, treatment options, resources patients can access, and on survivorship. In that way, if patients want the information, they can access it. "Even if 5% of patients want to look at a topic, we can put it into a CD-ROM, whereas we could never put it into a booklet," says Patricia Agre, EdD, RN, director of patient and family education at Memorial Sloan-Kettering.
Agre found that patients want lots of information about their cancer if it is given to them in a way that they can understand. To determine what topics to include, she surveyed lung cancer survivors and found that they were even interested in learning about cell biology.
The ability to provide detailed information is only one benefit of using a CD-ROM. "Patients now come in with 150 pages downloaded from the Internet. My problem with that is a lot of it is garbage. Our CD-ROM, I trust," says Agre.
Deciding when and how to make the CD-ROMs available to patients has been difficult. At first, patients were invited to review them while waiting for their scheduled appointment, and computers were placed in every waiting room. However, patients would not access the information at that time either because they were anxious, distracted, in a hurry, or in pain. The health care facility even had someone go to the waiting rooms and try to interest the patients in viewing the CD-ROM. That’s when the institution began giving the CD-ROM to patients when they came for their first medical visit with a physician.
Learning how to distribute
Just as Agre conducted research to determine what information to include in the CD-ROM and had patients evaluate them once they were completed, she plans to apply for grants to research the timing for distribution. "We have asked patients when they would like to receive a CD-ROM, and they say as soon as they are diagnosed; but often, they come to us after they have seen lots of other doctors," says Agre.
To help people access the information more quickly, all the CD-ROMs produced by Memorial Sloan-Kettering are being put on the Internet. In addition to specific cancers, they cover treatment options such as chemotherapy, and symptom management, such as pain, nausea, and vomiting. The only problem with the transfer is that multimedia sometimes is slow to load. "We may take out the media and just put the content in using text and maybe some still illustrations. We are trying both," says Agre.
Most institutions can create CD-ROMs as educational tools. "You need money and most pharmaceutical companies will give you money. You create what you can create given the amount of money you are given," says Agre. An outside agency must be brought into the process for computer programming.
It is an option that should be tried, and Agre sees a bright future for the teaching tool. CD-ROMs can greatly enhance education, says Agre. A nurse or physician can give them to a patient, asking that he or she review certain sections so upon the return visit, the discussion is on a more sophisticated level. If the patient reviews the information on the CD-ROM, health care providers don’t have to cover the basics. "They can cover what the patient didn’t understand or what is different or peculiar to that patient. I think CD-ROMs can change the dynamics of the patient-physician interaction," says Agre.
(Editor’s Note: All the CD-ROMS produced at Memorial Sloan-Kettering Cancer Center are available for purchase for $8.95. They are not institution-specific. There is an order form on the health care facility’s web site: www.mskcc.org. Patient education managers interested in purchasing the CD-ROMS in bulk can contact Pat Agre.) n
For more information on using CD-ROMS as a patient education tool, contact:
• Pat Agre, EdD, RN, Director of Patient and Family Education, Memorial Sloan-Kettering Cancer Center, Box 179, 1275 York Ave., New York, NY 10021. Telephone: (212) 434-5114. E-mail: email@example.com.