The pressures of a changing health care system are making inroads on the commitment and effort that both basic science and clinical faculty can give to medical education. A tool that has the potential to compensate for decreased faculty time and thereby to improve medical education is multimedia computer instruction that is applicable at all levels of medical education, developed according to instructional design principles, and supported by evidence of effectiveness. The authors describe the experiences of six medical schools in implementing a comprehensive computer-based four-year curriculum in bedside cardiology developed by a consortium of university cardiologists and educational professionals. The curriculum consisted of ten interactive, patient-centered, case-based modules focused on the history, physical examination, laboratory data, diagnosis, and treatment. While an optimal implementation plan was recommended, each institution determined its own strategy. Major goals of the project, which took place from July 1996 to June 1997, were to identify and solve problems of implementation and to assess learners' and instructors' acceptance of the system and their views of its value. A total of 1,586 students used individual modules of the curriculum 6,131 times. Over 80% of students rated all aspects of the system highly, especially its clarity and educational value compared with traditional lectures. The authors discuss the aspects of the curriculum that worked, problems that occurred (such as difficulties in scheduling use of the modules in the third year), barriers to change and ways to overcome them (such as the type of team needed to win acceptance for and oversee implementation of this type of curriculum), and the need in succeeding years to formally assess the educational effectiveness of this and similar kinds of computer-based curricula.

The Lord Howe Island Biodiversity Management Plan targeted significant species for the Lord Howe Island Group and formed the recovery plan for 30 threatened species and one endangered ecological community. The plan addressed threats and management actions relevant to the Lord Howe Island Group's overall biodiversity, with a particular focus on rare and significant species and communities. The Biodiversity Management Plan approach enabled holistic and cost-effective planning for the management of biodiversity on Lord Howe Island. We describe the approach, as applied to Lord Howe Island, including the utilization of expert and community knowledge, species research data and GIS innovations.

This article discusses Joint Commission on Accreditation of Healthcare Organizations (JCAHO) preparedness. A literature search reveals articles discussing varying tactics for addressing JCAHO preparedness (e.g., mock surveys, crossword puzzles, e-mail and paper updates, games, and pocket resource cards). However, no articles address the use of monthly pretests and posttests. This article focuses on the use of pretests and posttests as well as other interventions to prepare staff for the JCAHO tracer methodology.