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Digital imaging is an evolving technology with significant potential for enhancing medical education and practice. Current teaching methodologies still rely on the time-honored traditions of group lectures, small group discussions, and clinical preceptorships. Educational content and value are variable. Utilization of electronic media is in its infancy but offers significant potential for enhancing if not replacing current teaching methodologies. This report details our experience with the creation of an interactive atlas on neonatal surgical conditions. The photographic atlas has been one of the classic tools of practice, reference, and especially of education in surgery. The major limitations on current atlases all stem from the fact that they are produced in book form. The limiting factors in the inclusion of large numbers of images in these volumes include the desire to limit the physical size of the book and the costs associated with high quality color reproduction of print images. The structure of the atlases usually makes them reference tools, rather than teaching tools. We have digitized a large number of clinical images dealing with the diagnosis and surgical management of all of the most common neonatal surgical conditions. The flexibility of the computer presentation environment allows the images to be organized in a number of different ways. In addition to a standard captioned atlas, the user may choose to review case histories of several of the more common conditions in neonates, complete with presenting conditions, imaging studies, surgery and pathology. Use of the computer offers the ability to choose multiple views of the images, including comparison views and transparent overlays that point out important anatomical and histopathological structures, and the ability to perform user self-tests. This atlas thus takes advantage of several aspects of data management unique to computerized digital imaging, particularly the ability to combine all aspects of medical imaging related to a single case for easy retrieval. This facet unique to digital imaging makes it the obvious choice for new methods of teaching such complex subjects as the clinical management of neonatal surgical conditions. We anticipate that many more subjects in the surgical, pathologic, and radiologic realms will eventually be presented in a similar manner.
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