Hematology Books For Medical Students

[Manlio Chowdhury]

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A typical day and week in my practice: I usually get up very early in the morning and spend the first few hours of my day working on the computer, catching up on clinical documentation, editing or reviewing manuscripts, preparing talks, etc.

I give lots of talks and participate in a number of teaching conferences for students, residents and fellows, and for an entire month every fall, I spend several days a week teaching hematology to the first-year medical students at Yale, which is always one of the highlights of my year. I also mentor students and trainees in various research projects in benign hematology and medical education, so a lot of my time is dedicated to mentoring and advising students, residents and fellows.

The most challenging and rewarding aspects of hematology: Hematology is a very interesting and complex field that crosses all disciplines. A lot of patients come to see a hematologist either because they have an unusual constellation of symptoms without a diagnosis and are seeking answers, or because they have a rare disease that is unfamiliar to other providers.

Because of the nature of the diseases that I see, I end up forming wonderful lifelong relationships both with patients and with other providers. Also, since I work in a university-based hospital setting, I am constantly interacting with lots of medical students and trainees, so teaching and mentoring is a large part of the core of my profession.

During clinic visits, I therefore spend time getting to know my patients, understanding their life stories, what makes them tick outside of the exam room, etc., so each clinic visit becomes not only a medical encounter but also a chance to break bread with another person through a shared humanity.

Another key to achieving a good work-life balance as a hematologist has been recognition that life experiences and humanistic endeavors make all of us better people and better physicians. Because of this, I embrace my life outside of work as much as I embrace my work itself.

Keith Wailoo, PhD, Drawing Blood: Technology and Disease Identity in Twentieth-Century America. This narrative describes some of the major developments in the history of hematology and links scientific discoveries in the field with social perspectives from the time. The author, a medical historian and chair of the history department at Princeton, was the recipient of the Arthur J. Viseltear Prize from the American Public Health Association for his work on this book.

The online resource students interested in hematology should follow: The American Society of Hematology (ASH) is the major professional organization for hematologists in the U.S. and across the globe. ASH has a fantastic Twitter account containing the latest updates in hematology. Also, the ASH website contains great educational resources as well as information about research and funding opportunities for students, trainees and young hematologists.

Quick insights I would give students who are considering hematology: Hematology has always had a special role at the epicenter of medicine, and the field right now has become incredibly exciting thanks to all the molecular advances that are rapidly changing our understanding of disease. Inherited diseases like sickle cell anemia, thalassemia and hemophilia, long-viewed as chronic, life-altering conditions, are becoming curable with the promise of gene editing.

Rare diseases like porphyrias, histiocytic disorders, and thrombotic microangiopathies are being given new treatment modalities aimed at specific molecular targets. At the same time, classical paradigms of thrombosis, hemostasis, inflammation, and complement are finding new, shared relationships with infinite therapeutic possibilities.

Fifty-one interns from three Taiwan medical schools training by a single teacher in the pediatric hematology department of Kaohsiung Chang Gung Memorial Hospital, Taiwan, participated in this study. 25 interns were allocated for training with a traditional PowerPoint atlas and 26 interns for training with an interactive multimedia eBook atlas. Learning outcomes were examined by pre-test and post-test using the CellQuiz of CellAtlas App. Attitudes and perceptions were collected by survey questions regarding interest, motivation and effectiveness.

Using traditional teaching methods to teach interns hematology, one issue with students was that the materials used did not effectively train students to differentiate blood cells, when they started to study in the pediatric hematology department, because the knowledge delivered was limited. Also, many students find the PPT materials a little dry, and we hoped to create more engaging materials for students. The creation of an interactive eBooks has the potential to transform learning away from basic acquisition of facts (i.e. printed materials, didactic lectures, PPT) to actively acquiring and applying knowledge and skills as it can include multimedia and interactive learning.

In this study, SimMAGIC eBooK editing software ( com.tw/Products/eBook/functions.aspx) was employed to create an interactive multimedia eBook of blood cell morphology. This eBook software uses a simple and clear editing layout and includes customized editing tools and various content editing functions enabling editors to make creative content for eBooks and publications quickly. In addition, it emphasizes interactive quiz creation and easy design by integrating and importing various multimedia, such as PPT, PDF or video to make a simulative and operational eBook. Students interact with the operational eBook very well. In addition, eBook includes many different operation simulations, allowing students to not only enjoy reading but also interact with the book and take simulated tests. Customize right/wrong answer pop-up message windows, simulative interactive functions such as input, click and drag, screen clicking and selection, also include links to related documents providing additional support. Students could get feedback immediately and learn effectively.

This randomized controlled trial was conducted from Jan, 2013 to Dec, 2013 in the pediatric hematology department at Kaohsiung Chang Gung Memorial Hospital, Taiwan. The curriculum was composed of a 2-week course for learning pediatric hematology. Fifty-one interns participating in the study during their rotation at the Department of Pediatric Hematology were eligible for inclusion in the study. Interns that rotated to the pediatrics hematology department who were interns were selected for this study. At the beginning of each week of training, the students were told that they would participate in an educational study and that their participation would have no effect on their final grades and scores.

All interns were allocated a traditional PowerPoint atlas or an interactive multimedia eBook atlas, as their study material. Purely self-directed learning was requested. Students in the traditional PowerPoint group (TPP) learned the topic of blood cell morphology in a conventional PPT approach, while the students in the interactive multimedia eBook group (IME) learned the topic with an eBook. For the TPP approach, the students were provided with power point slides containing all the material to acquire knowledge on the learning objectives. The TPP includes an introductory part on the blood cell formation, normal cell morphology of blood and bone marrow. In the following section, the TPP scripts abnormal cells. Finally, it explains diseases in which the blood cells represent. For the IME group, the learning content was almost identical to TPP except interactive tests, the contents including five chapters. Chapter 1: Introduction to Blood Cell Formation, Chapter 2: Peripheral Blood Cells, Chapter 3: Bone Marrow Cells, Chapter 4: Recognizing Abnormal Cells, Chapter 5: Interactive Game-based Tests. IME include four types of interactive game-based practice: correctly identifying cell types, identifying abnormal cell types, clinical case examination and challenges. The student interactive learning included picture matching, multiple choice, clinical diagnosis simulations, picture labelling and drag and drop e-learning modules. Students can see their rank and progress.

The eBook includes functionality for automated marking, allowing the system to indicate to the user if their chosen annotated answer was correct or incorrect. The reasoning behind the answer was also provided to the user, regardless of the answer outcome, therefore students could further understand the content, especially when incorrect answers were given. The student answers and data was sent to a server to centralize the data for the teacher, and by analyzing the class progress and results, the teacher could adjust his classes accordingly, responding to problem areas revealed by the captured in the server data.

This study compares two learning methods used to teach blood and bone marrow cell morphology, one being a more traditional way of learning using PowerPoint and the other method using eBooks. There was no instruction given to students. Both groups were asked to review the course material given. In the TPP group, students viewed the power point slide materials, while the eBook group view the eBook materials provided. The two groups had similar pre-test scores. However, it was found that a significantly better outcome was achieved by participants in the eBook group in the post-test scores. The learning content in IME group was almost identical to TPP group, except IME included interactive game-based tests. This could be due to the fact that the eBook provided interactive tests for participants to use, compared to none for the PowerPoint group. With our randomized controlled trial, this might explain the different test outcomes between the two groups and the results could also mean that learning with interactive multimedia eBooks is not only more effective, but also more attractive to students than learning through traditional methods. Furthermore, it is important to note that students were interested in learning blood cell morphology even though it meant investing more time in practicing tests, and this also demonstrates the high acceptance of eBook in this study.

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