Journal Identification = IJB Article Identification = 2756 Date: July 2, 2011 Time: 3:8 am i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s 8 0 ( 2 0 1 1 ) 562–569 CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector j ournal homepage: www.ijmijournal.com Design and implementation of I2Vote –An interactive image-based voting system using windows mobile devices ∗ P.M.A. van Ooijen , A. Broekema, M. Oudkerk Dept. of Radiology, University Medical Center Groningen, University of Groningen, EB45, Hanzeplein 1, 9713 GZ Groningen, The Netherlands a r t i c l e i n f o a b s t r a c t Article history: Purpose: To develop, implement and test a novel audience response system (ARS) that allows Received 19 November 2010 image based interaction for radiology education. Received in revised form Methods: The ARS developed in this project is based on standard Personal Digital Assistants ® ® 18 May 2011 (PDAs) (HP iPAQ 114 classic handheld) running Microsoft Windows Mobile 6 Classic with a Accepted 19 May 2011 large 3.5 in. TFT touch screen (320 × 240 pixel resolution), high luminance and integrated IEEE 802.11b/g wireless. For software development Visual Studio 2008 professional (Microsoft) was used and all components were written in C#. Keywords: Tw o test sessions were conducted to test the software technically followed by two real Radiology classroom tests in a radiology class for medical students on thoracic radiology. Academic training Results: The novel ARS, called I2Vote, was successfully implemented and provided an easy Educational technics to use, stable setup. The acceptance of both students and teachers was very high and the interaction with the students improved because of the anonymous interaction possibility. Conclusion: An easy to use handheld based ARS that enables interactive, image-based, teaching is achieved. The system effectively adds an extra dimension to the use of an ARS. © 2011 Elsevier Ireland Ltd. Open access under the Elsevier OA license. ers are the most common devices nowadays and, although 1. Introduction some devices use infrared communication, most of them are using radiofrequency (RF) to communicate with the cen- The value of a standard lecture in front of a large lecture hall in tral receiver. The clickers allow entry of numerical responses terms of the capability of the attendees to grasp the key issues and the range of response possibilities are available from from that lecture as well as the level of interaction with the 10 upwards. Some clickers also allow the entry of text to students tends to be limited [1]. To enhance the participation enable open questions; however, the most common ones are of the audience during lectures, Audience Response Systems still restricted to multiple choice questions. After the ques- (ARS) can be used. tion has been posed to the audience, a limited amount of An ARS is an electronic tool that allows attendees of a time will be allowed for the voting and once the audience lecture to directly respond to questions posed by the lec- has voted, the lecturer can display the results of the vote turer using a handheld device (also known as a clicker). in, for example, percentages per answer. Research is ongo- These handheld voting devices can either be wired or wireless ing to provide a more flexible way of implementation of an and in most cases the voting is anonymous. Wireless click- ARS [2,3]. ∗ Corresponding author. Tel.: +31 503612286. E-mail address: [email protected] (P.M.A. van Ooijen). 1386-5056 © 2011 Elsevier Ireland Ltd. Open access under the Elsevier OA license. doi:10.1016/j.ijmedinf.2011.05.002 Journal Identification = IJB Article Identification = 2756 Date: July 2, 2011 Time: 3:8 am i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s 8 0 ( 2 0 1 1 ) 562–569 563 Fig. 1 – Schematic overview of the tables in the database and their relationships. The usefulness of ARS in education has already been shown answers. Using this method, results can be stored for later in multiple publications both outside and within the field of analysis. When a change occurs in a session the active ses- medicine [4–9]. sions are not changed therefore keeping the original results. However, in radiology teaching, the use of these systems is The changes will only be used when new sessions are made limited because of the limitation to multiple choice questions active. while radiology education is primarily image-based. The database model (Fig. 1) consists of multiple many to With increasing capabilities and decreasing price, Personal many and one to many connections between tables to allow Digital Assistants (PDAs) and smart phones are increasingly multiple relations between the table rows and information finding their way into different professions. Uses vary from fields. Classroom sessions are created within the table “SES- the general applications available on the device when bought SIONS” and have relations with relevant cases within the to specialised applications dedicated to a certain user group. table “CASES” through the table “SESSIONCASES” allowing Increasingly, these PDAs and smartphones are equipped with multiple cases to be used within multiple classroom ses- large, high resolution, touch screen interfaces. The aim of sions. Cases belong to a category with information within this study was therefore to use these capabilities of a current table “CATEGORIES” and have a case type definition from table device to create a novel, image based, ARS based on handheld “CASETYPES”. Cases are allowed to have multiple answers devices. and these are stored in table “ANSWERS”. When using an existing classroom session, the software creates an active 2. Methods version of the relevant session. Classroom session infor- mation will be stored in the table “ACTIVESESSIONS” with relations to the given answers from that session. When stu- The ARS developed in this project is based on standard Per- dents answer active cases the information will be stored in sonal Digital Assistants (PDAs) (HP iPAQ 114 classic handheld) ® ® table “GIVEN ANSWERS” which in turn has a relation towards running Microsoft Windows Mobile 6 Classic with a large the table CASES for the correct answers in table “ANSWERS”. 3.5 in. TFT touch screen (320 × 240 pixel resolution), high lumi- This database design allows easy access to all classroom ses- nance and integrated IEEE 802.11b/g wireless. The PDAs are sion and case information. operated using a stylus which enables accurate selection of a point on the screen. Based on these handheld devices an ARS solution was developed that allows direct audience interaction with images. 2.2. Webservice For software development Visual Studio 2008 professional (Microsoft) was used and all components were written in C#. The I2Vote webservice communicates on behalf of the PDA and Evaluation of the system was conducted in two test ses- Teacher clients with the database and, when needed, returns sions to test the software technically followed by two real information from the database. The clients communicate with classroom tests in a radiology class for medical students on the webservice using WSDL (Web Services Description Lan- thoracic radiology. guage) interfaces that enable object-oriented communication using SOAP (Simple Object Access Protocol). On joining an 2.1. Database model active classroom session with a PDA client, the client asks the webservice all relevant data consisting of questions and To allow easy access of all case and classroom session infor- images. The webservice reads the required data in realtime, mation a database model was designed that allows easy usage compresses them as one dataobject and sends the data as of available cases within multiple “active” classroom sessions bytes in a reply towards the client. (Fig. 1). To create a new classroom session first one must add Currently, two webservices are implemented, the student all cases to be used within a session. Then the session itself (or PDA) client and the teacher client. Both services require can be created with the available cases. Once the session is fin- authentication of user rights using a login. The teacher ser- ished the relations to the cases are copied within the database vice additionally introduces the roles of normal teacher and model to allow an “active” version with cases and the given administrator. Journal Identification = IJB Article Identification = 2756 Date: July 2, 2011 Time: 3:8 am 564 i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s 8 0 ( 2 0 1 1 ) 562–569 3. Results A server client system was developed that allows easy entry of cases and easy construction of courses using a selection of those cases. The I2Vote setup consists of a server running the I2Vote webservice, a PC running the I2Vote teacher client and one or more PDA’s running the I2Vote PDA Client. In the most common classroom setup, the server and teacher PC are con- nected to the client through the LAN, while the PDA clients communicate with the server via a wireless LAN access point (Fig. 2). 3.1. Teacher client The teacher software allows building questions and classroom Fig. 2 – Full I2Vote setup including all possible components.