Introduction

Within Information Technology (I.T.), multimediality has become one of the most sophisticated technologies now available and a rapidly growing tool to develop new educational and training systems for medicine.
COMPUTER AIDED LEARNING (C.A.L.) is a specific area of application and research of Medical Informatics and is based on the integration of three major factors: TECHNOLOGY, CLINICAL KNOWLEDGE REPRESENTATION, and COGNITIVE and SENSE PERCEPTION.
It is evident that the availability and the combined use of multistation sites, cd.rom disks, digital data, three dimensional imagine, hypertexts, together with the progressively decreasing costs of hardware, create the right combination for researchers and medical doctors to explore this field.
The representation and visualization of medical knowledge is still a major task, mostly because of the obvious empirical content of medicine and of the well-known individuality of doctors. However the need to design real-time systems that make the information available, and permit the construction of models that integrate and visualize clinical knowledge, which has to be transferred from the “experts” to the “non-experts” is continually increasing.
The major features of this multimedia system area data integration, user computer inter-activity, user perspective adaptability, and the linking of different semantic units. These features allow the user to follow an educational program according to his knowledge and his learning needs, thus enabling the user to activate a self-directed learning methodology.
Digital technology, hypertexts and three dimensional imagine have been used and integrated on the same support to represent all the information related to the “Progress  in pediatric liver transplantation” surgical procedure. In particular N. 163 hypertexts, No 114 tooltip and captions, N. 492 bibliographic notes, N. 113 digital images, N. 27 digital films, N. 11 virtual images are embedded within this cd-rom.
The contents, which are oriented toward the transferring of a conceptual model derived from the expertise of the Authors, is organized according to different knowledge units that can be linked and integrated by the user at different levels.
The three dimensional structure represented here has set up the media vertically and the expanding level of investigation is horizontal. The third dimension shows the possibility of integration and linking of information according to the learning process chosen by the user.
The same principles were adopted to develop another multimedia system entitled “Paduan Ileal Bladder” by W.Artibani, F.Pagano, C.Romano, 1999, to teach the ortotopic ileal bladder procedure. But we believe that the impact and the teaching capabilities of this model will be greatly enhanced because of the introduction of the virtual imaging technology, which we have introduced for the first time.

CARLO ROMANO

MultimediaTechnology and Education $