A computerized teaching program (THYROID) has been authored for thyroid diseases which utilizes a medical education driver program of the Laboratory of Computer Science at the Massachusetts General Hospital. The output of this teaching program has four components: (1) an inexhaustible generated pool of patients' protiles; (2) a glossary of permissible clinical questions, diagnoses, and therapies; (3) a teaching message for every glossary item; and (4) an evaluation of user performance. THYROID teaches problem recognition and management of 20 thyroid diseases by presenting the user with a randomly generated "patient." The program was constructed by writing question and response sets relevant to the history, physical examination, and laboratory tests of patients with various thyroid disorders. In addition to teaching messages for every glossary item, the user may request a "consultant" who guides the user stepwise through the differential diagnosis to the final correct diagnosis. THYROID can be used for medical student and house-staff education and for review of thyroid diseases by practicing physicians.
Computer technology has greatest impact in medical education when applied to reinforcement of cognitive skills (Z-5). Computer programs have been written to assist clinicians in diagnosis and management of actual patients with such endocrine and metabolic problems as acid-base disorders (6), hypercalcemia (7), and thyroid diseases (8,9). Instructional programs have been developed for patient case studies (IO), cardiopulmonary resuscitation (II, 12), and over 40 other subjects currently available nationally through a cooperative computer-assisted instruction (CAI) program network (13).'
In this paper we describe a program which teaches diseases of the thyroid gland by synthesizing patient profiles. The program was remote authored, utilizing a c1inica.l data base developed at the State University of New York at Buffalo, and a driver program was written at the Laboratory of Computer Science, Massachusetts General Hospital.