Module 1 Activities Purpose: These activities support instruction provided for COUMADIN® QuickLearn Module 1: Pathophysiology and Epidemiology of Thrombus

Module 1 Activities

Purpose: These activities support instruction provided for COUMADIN® QuickLearn Module 1: Pathophysiology and Epidemiology of Thrombus Formation

Screen prompt: Unless otherwise noted the screen prompt should be “Click Next to continue.”

Knowledge check screen prompt:: KC prompts are as indicated on storyboard; each KC prompt should be REPLACED by the standard prompt once the user has clicked Done. First / Second prompts are indicated as follows (slash between them): “Answer each question, then click Done. / Click Next to continue.”

Navigation availability:Prev/Next are always available and go to the previous or next sequential storyboard, respectively, unless otherwise noted.

Graphics: All graphics requested that come from outside published sources should be redrawn “based on” the photocopies or files provided (“stock” accelera graphics may be used as a basis for animations and building of other graphics).

Button operation:Unless otherwise indicated:– Next goes to the next screen– Prev goes to the previous screen– Done returns feedback on the student’s response. If student clicks Done before answering question (or all of question’s elements), show pop-up box: “You must answer all parts of the question before clicking Done.”– Exit closes the program (show dialog prompt with Yes/No response to question “Do you really want to exit the program?”).

Common Audio

Standard/Common Audio:

clicknext1.wav: Click Next to try the next activity.

clicknext2.wav: Click Next to continue. [NEEDED for BMS?]

Storyboard #

GRAPHICS/PROGRAMMER NOTES ON-SCREEN TEXT AND IMAGE LAYOUT

AUDIO / VIDEO

BRANCHING

Bristol-Myers Squibb

COUMADIN® QuickLearn

SCREEN PROMPTS

Module 1: Pathophysiology and Epidemiology of Thrombus Formation

Developed for BMS | by Accelera Corporation Proprietary and Confidential Page 304/18/23

C1_010

c1_010.wav: Welcome to Pathophysiology and Epidemiology of Thrombus Formation, the first module in the COUMADIN® (Warfarin Sodium) training series.

The first section of this module covers Pathophysiology, including how blood is circulated, how blood clots normally form and dissolve, and abnormal clotting, known as thrombosis. The next section provides background on the clinical implications of thrombus formation, reviewing the epidemiology, symptoms, and diagnosis of typical disorders.

Graphics: c1_010.jpg

Graphics Specs: Grab coumadin.gif from home page of http://www.coumadin.com (or coumadin_com.gif from rawgraphics folder provided. Remove “Welcome” and resize to fit right pane.

Programming Specifications:

onEnter: display c1_010.jpg and play c1_010.wav

Module Introduction (1 of 2)

Click Next to continue.

Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_020


Graphics Specs: Stock photo of Pharm Rep interacting with doctor. Altering image for each Module (e.g., female/Doctor for Module 1 and male/doctor for Module 2--different docs and nationalities).


onEnter: display graphic and play c1_020.wav

Module Introduction (2 of 2)

Stock photo of Pharm Rep (Professional) having a discussion with Doctor.


c1_020.wav: Knowledge about the processes involved in thrombus formation will help you understand the mechanism of action of COUMADIN® and the implications for its use in a variety of medical conditions and situations.

This knowledge will be valuable when discussing the advantages of using COUMADIN® with physicians and other healthcare professionals and when comparing COUMADIN® to competitive agents.

Click Next to begin reviewing the first section of this module, Pathophysiology of Thrombus Formation.

Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_030


Graphics specs: resize/use existing Accelera graphic c1_hemo.jpg showing Thrombus Formation (see raw graphics folder)


OnEnter play audio, display graphic; sync text display to audio as indicated

Section 1: Pathophysiology of Thrombus Formation


c1_030.wav: [a] In section 1, we begin with a review of the anatomy and physiology of the circulatory system, which will be helpful in understanding the process of hemostasis.

[b]Next, we’ll examine the roles of clotting factors, focusing on how the body’s release of clotting factors initiates a series of events that trigger the platelet cascade and the clotting cascade, known collectively as the “coagulation cascade.”

[c]Finally, we take a look at the how the coagulation cascade affects thrombus formation and dissolution. Let’s review our objectives.

This section covers the following topics:

• The Circulatory System

• The Coagulation Cascade

• Thrombus Formation

Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_040

c1_040.wav: After completing this section, you should be able to: [a]Describe the path of blood circulation to and from the heart·[b]Define Virchow’s Triad and discuss its significance·[c]Delineate the steps involved in hemostasis·[d]Discuss the roles of various clotting factors·[e]Describe the coagulation cascade·[f]Differentiate the roles of intrinsic and extrinsic pathways in the coagulation cascade ·[g]List the medical conditions that result in altered hemostasis·[h]Explain the process that leads to thrombosis

We’ll begin by reviewing the circulatory system.

Graphics:


onEnter play audio, display first line of text. Sync text display to audio as marked.

Learning Objectives


After completing this section, you should be able to:

• Describe the path of blood circulation to and from the heart• Define Virchow’s Triad and discuss its significance• Delineate the steps involved in hemostasis• Discuss the roles of various clotting factors• Describe the coagulation cascade• Differentiate the roles of intrinsic and extrinsic pathways in the coagulation

cascade • List the medical conditions that result in altered hemostasis• Explain the process that leads to thrombosis

Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_050

c1_050.wav: Blood circulates within the body through the circulatory system, an elaborate network of arteries, arterioles, veins, venules, and capillaries that transports nutrients throughout the body to provide nourishment to the tissues.

Blood also carries wastes away from the tissues for excretion.

Graphics: c1_050.swf

Graphic Specs: Figure 1-1 (animation: arrows moving in directions indicated and blood moving through--style to match other module graphics [see c1_hemo.jpg]): Blood Flow through the Arterial and Venous Systems1 [based on Goldhaber, continuous flow of blood through heart, through arteries to body, through veins back to heart] [1/Goldhaber, p. 1437]


onEnter, play audio, play animation (blood flow in continuous motion) continuously

The Circulatory System

Figure 1-1 (animation): Blood Flow through the Arterial and Venous Systems1 [based on Goldhaber, continuous flow of blood through heart, through arteries to body, through veins back to heart] [1/Goldhaber, p. 1437]


Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_060

c1_060.wav: The circulatory system has three major pathways:[a] In systemic circulation, arteries carry oxygenated blood and nutrients from the left side of the heart to the body tissues, and the veins carry deoxygenated blood and carbon dioxide (CO2)

back to the right side of the heart. [b] In pulmonary circulation, deoxygenated blood and CO2 are

carried from the right side of the heart to the lungs, where blood is oxygenated and CO2 expelled, then oxygenated blood is returned to the left side of the heart.[c]Coronary circulation carries blood through the arteries of the heart, supplying heart muscle with oxygen and nutrients while carriying deoxygenated blood and wastes back to the right side of the heart.


Graphic Specs: see raw graphics folder for c1_060.jpg, resize


onEnter, play audio, display graphic. Sync display of a “highlight” of the title of each section with audio as marked (highlight = yellow “glow” behind bold head? Pick something to use throughout modules)

Sync points =

[a] Systemic circulation

[b] Pulmonary circulation

[c] Coronary Circulation

Major Pathways


Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_070

c1_070.wav:Let’s review.

For each of the following statements about the circulatory process, click the button before left or right to indicate the correct direction of blood flow.

Answer each question, then click Done.

Graphics:

Graphic Specs:


onEnter, play audio.

Program radio buttons for left vs. right choices; both unselected by default.

Display “answer all” dialog: “You must answer all parts of the question before clicking Done.” if user clicks done before choosing answers for each.

Feedback (Display on click of Done):

Correct = That's correct.

Incorrect = Incorrect. The correct answers are (1) left, (2) right, (3) right, (4) left, and (5) right.

Please review Major Pathways, then try again.

Knowledge Check

Answer each question, then click Done. / Click Next to continue.

1. In systemic circulation, which side of the heart are oxygenated blood and nutrients carried from? left right [answer = left]

2. Systemic circulation returns deoxygenated blood and carbon dioxide (CO2) back to the which side of the heart? left right [answer = right]

3. In pulmonary circulation, which side of the heart are deoxygenated blood and CO2 carried from? left right [answer = right]

4. Pulmonary circulation returns oxygenated blood to the which side of the heart? left right [answer = left]

5. Coronary circulation supplies heart muscle with oxygen and nutrients and carries deoxygenated blood and wastes back to which side of the heart? left right [answer = right]

DONE

Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_080

cl_080.wav: In a normal, healthy individual, the process of blood coagulation is delicately balanced. Blood remains fluid as it flows through the vessels, but clots rapidly when the vessels are injured.

When an injury causes a break in a blood vessel wall, it triggers hemostasis, the process of clot formation and dissolution.

Graphics: c1_080.swf, c1_080.jpg

Graphic Specs: c1_080.jpg = Play Animation button

c1_080.swf = Take file c1_hemo.jpg from raw graphics folder; see also c1_hemo2.jpg. Crop to use TOP of graphic and animate (1) to show blood cells flowing through the artery (no clump at bottom), (2) small break in vessel, (3) white and red cells start to clump at the break (others keep flying by), (4) yellow fibrin appears/threaded through clump to hold it together, (5) dissolve clump piece by piece and fill in break in vessel wall, (6) end with blood flowing freely [as in Step 1].

Programming Specifications: onEnter, play audio, play animation once then stop.

onClick of Play Animation: replay c1_080.swf

Hemostasis (1 of 2)


Play Animation

Storyboard #


AUDIO / VIDEO

BRANCHING



SCREEN PROMPTS



C1_090

cl_090.wav: Hemostasis involves a series of four major events that occur in a particular order: · [a] Vascular constriction · [b] Platelet adhesion, activation, and aggregation· [c] Formation of a clot, or thrombus, and· [d] Dissolution of the clot.

Each event is described in greater detail in the next topic, The Coagulation Cascade.2 [2/King,/p. 1]

Graphics:

Graphic Specs:

Programming Specifications: onEnter, play audio; display first line of text. Sync display of numbered items to audio as marked.

Hemostasis (2 of 2)


Hemostasis involves a series of four major events that occur in order:

1. Vascular constriction

2. Platelet adhesion, activation, and aggregation

3. Formation of a clot, or thrombus

4. Dissolution of the clot

Documents

Module 1 Activities Purpose: These activities support instruction provided for COUMADIN® QuickLearn Module 1: Pathophysiology and Epidemiology of Thrombus