Radiographic skills learning: procedure simulation using adaptive hypermedia.

The design and development of a simulation tool supporting learning of radiographic skills is reported. This tool has by textual, graphical and iconic resources, organized according to a building-block, adaptive hypermedia approach, which is described and supported by an image base of radiographs. It offers interactive user-controlled simulation of radiographic imaging procedures. The development is based on a commercially available environment (Toolbook 3.0, Asymetrix Corporation). The core of the system is an attributed precedence (priority) graph, which represents a task outline (concept and resources structure), which is dynamically adjusted to selected procedures. The user interface imitates a conventional radiography system, i.e. operating console, tube, table, patient and cassette. System parameters, such as patient positioning, focus-to-patient distance, magnification, field dimensions, tube voltage and mAs are under user control. Their effects on image quality are presented, by means of an image base acquired under controlled exposure conditions. Innovative use of hypermedia, computer based learning and simulation principles and technology in the development of this tool resulted in an enhanced interactive environment providing radiographic parameter control and visualization of parameter effects on image quality.