||Educational Technology & Society 2(3) 1999
University of Lethbridge, Lethbridge, AB T1K 3M4
Tel: +1 403 382 7146
Fax: +1 403 329 2097
Dpt de Communication, Universite de Montreal
C.P. 6128 succ Centre-Ville, Montreal, H3C 3J7 Canada
Tel: +1 514 343 7371
Fax: +1 514 343 2298
|Medical Reference, Educational uses
McGraw-Hill Health Professions Division, 11 W. 19th Street, 2nd Floor New
York, NY 10011>. publishes both the text and online version of Harrison's
Principles of Internal Medicine. The website advertises the cooperation
of the text book's authors in creating Harrison's Online:
involvement of the Harrison's author team, Anthony S. Fauci, Eugene
Braunwald, Kurt J. Isselbacher, Dennis L. Kasper, Stephen L. Hauser, and
Dan L. Longo along with J. Larry Jameson, in Harrison's Online ensures
that the data you will find here meets the same rigorous standards that
have made the Harrison's textbook the most trusted single resource
in the medical literature. http://www.harrisonsonline.com/subscriber/aboutus_index.htm
for a linked list of the editors and their occupational qualifications.
|Harrison's Online is a very powerful database of what
is one of the medical profession's foremost text books. It is well laid
out in a concise and clear manner. Navigation is simple, aided by a stable
menu in the top frame that will take the user to three tables of contents
(TOC) -- Brief, Full and Topical -- as well as an Index, Contributors List,
Search, Forum, Sitemap, Feedback and Help. The best overall feature of
this site is its ease and speed of indexing and/or looking up references,
providing access to the industry standard medical text book. Having access
to several kinds of search options makes this site an excellent cross-referencing
tool. That this text is an evolving and continually updated resource will
be of high value to any medical practitioner. The PreTests are also very
good, offering instant feedback and reading suggestions as per user results
(please see below for more on the PreTests).
|Some of the feedback in the Forum feature of the site suggests
adding a chat function to Harrison's Online, but more importantly,
adding a highlight feature to returned search results would be the best
way to improve this site. Highlighting where in the text your search term
appears would enhance the ease and usability of the search capabilities.
There are some navigation issues--for instance there is often no way to
return to a previous screen other than using your Browser's Back button
or going back to the start of a section through the main menu links. But
as with any site of this kind, users can quickly get used to the vagaries
and nuances of getting around within this system.
|Objective of the site:
|The objectives of Harrison's Online is to provide just in time information
to medical professionals:
Harrison’s Online turns the world’s leading textbook of medicine,
Harrison’s Principles of Internal Medicine, into an updated medical database
that delivers the high-quality information synonymous with the Harrison’s
name with the immediacy that only the online environment can provide. Harrison’s
Online cuts through the glut of online medical information to give you
relevant, current, and practical information that will help you diagnose
and manage your next case. http://www.harrisonsonline.com/subscriber/aboutus_index.htm
It aims to be an open and relevant source of information that will be consulted
from a doctor's desktop while working, in order to access information quickly
and easily. Since this is a commercial venture, these objectives are entirely
appropriate. Users pay for yearly access according to the following scale
(in US dollars):
Individual user: $89
Institutional subscriptions to Harrison's Online will accommodate IP address and/or User ID/Password configurations for access.
Up to 2 concurrent users: $650
Up to 5 concurrent users: $875
Up to 10 concurrent users: $1250
Up to 20 concurrent users: $2000
More than 20 concurrent users: $2000 plus $75 per user for each concurrent user over 20
Additional users can be added to any of the Institutional Packages for $75 per additional user.
Institutional access would provide teaching hospitals an excellent resource
tool, if computer terminals are also made available. I contacted
McGraw-Hill for a list of institutions that use either the print or electronic versions of this text, and was given this response by Jack Farrell, Director of Marketing, McGraw-Hill:
While we cannot give out sales information I can tell you that
the Harrison's textbook is used in every medical center [sic] in the US
and most likely the world. It has that kind of presence. Use of Harrison's Online is growing quickly among institutional users and I'd say we are among the leading online services used in this setting.
A concurrent license for 20 users could feasibly accommodate a large institution, since it is not a synchronous learning tool/environment.
|The site's target audience could be anyone in
the medical profession, but there is an emphasis on attracting those doctors
still in training: "Perfect for board prep or as a clinical refresher"
advertises the PreTests. Further:
Harrison's Principles of Internal Medicine: PreTest Self-Assessment
and Review has been designed to provide physicians with a comprehensive,
relevant, and convenient instrument for self-evaluation and review within
the broad area of internal medicine. Although it should be particularly
helpful for residents preparing for the American Board of Internal Medicine
(ABIM) certification examination and for board-certified internists preparing
for recertification, it should also be useful for internists, family practitioners,
and other practising physicans who are simply interested in maintaining
a high level of competence in internal medicine. Study of this self-assessment
and review section of Harrison's Online should help to (1) identify areas
of relative weakness; (2) confirm areas of expertise; (3) assess knowledge
of the sciences fundamental to internal medicine; (4) assess clinical judgment
and problem-solving skills; and (5) introduce recent developments in general
internal medicine. http://www.harrisonsonline.com/server-java/Arknoid/harrisons/1096-7133/Pretests
The idea is very sound: use of the testing function will help those medical
professionals who desire exam preparation or routine knowledge testing.
Quick and easy access to what amounts to a medical encyclopedia--and an
evolving one at that--will allow medical practitioners to keep abreast
of the latest research and treatments.
|Domain Related Aspects:
|It is more of a reference book than a learning
environment, though very well done. It presents an impressive sum of information
in medicine that you may search using different navigation tools: TOC,
map, index, search. Though I may not judge for the interest of the content,
it appears to be very complete to cover different aspects of the knowledge
in medicine: Dx, Clinical studies, pharmacology, approach to patient, etc.
As for the interface outside from the regular functions of the Internet
(cache), there are no traces of what you have seen (even though a cookie
is set) or possibility to takes notes. This makes a more systematic consultation
difficult. It is not organized for teaching but to give access to information
"just in time", using features of the Internet to make it much easier than
a book (search, multiple hierarchies).
This site has good educational value. It presents an enormous amount
of medical information specifically geared to its target audience of medical
professionals. Most educationally valuable is the PreTest section of Harrison's
Online. These multiple choice questions provide excellent feedback. When
an incorrect response is given, the user has the option of choosing either
a link to the relevant chapter or the correct response with a detailed
explanation. This reinforces the process of learning and the reasoning
behind the right answers, a very important feature given the kind of education
this service provides.
The Forum on Harrison's Online is a threaded discussion environment, a useful pedagogical
device for rapid dissemination of new research and clinical data.
Also, the Clinical Trials section, which is also slated for regular updates,
will provide medical professionals with timely and up to date information
on the latest developments in their field.
|Connectivity and Interface Related Aspects:
|The site is designed well. It loads quickly even over my 28.8
modem. On my T1 line it is of course very fast. The framesets keep all
information in view (no scrolling) and it has a uniform look and feel throughout.
The main page (start) is Search Harrison's Online, presumably to offer
quick and efficient information searching for those physicians logging
on in need of just in time data. The search is standard with an advanced
The maximum number of results that you will get for each part
of the search (chapters/updates and figures/tables) is 75. While there
may be more results available, we have limited the number returned to you
in order to decrease the loading time and to provide you with the closest
This proviso indicates that some editorial work has been done to truncate
the results. Valuing their users' bandwidth is a good consideration, but
it may be better to additionally offer an open search string (like a standard search
engine) in order to get a thorough search of all of their resources. Some
nice search features are built in:
To refine your search, you may restrict it to Parts of Harrison's Online,
chapter/update titles, contributors, or words in the text. The Search will
include all of the chapters in the selected Part(s) of Harrison's and all
of the Updates, Clinical Trials, New References, and Editorials associated
with the chapters in the selected Parts.
This is a handy feature that will help those familiar with Harrison's
Online and medicine in general find information fast. Harrison's
Online is a medical encyclopedia that can be used like an electronic
dictionary. It also has a Subject index that cross references subject
All graphics are optimized for speedy downloads, and I could locate
no use of multimedia.
|As a resource database this site is excellent, for the most part because
its search capabilities are very robust. This service is user friendly,
and the feedback in their Forum has so far been very positive. There were
several annoying things about my guest account--mostly that I kept getting
sent out of the Harrison's Online environment and asked to log in.
When I did so, I was sent an error message saying that I was already logged
on: "Maximum connections for this account reached." Presumably this
will not be the case for a regular subscriber. I did contact their help
desk and received quick and effective responses to my queries about this
issue. In fact, this issue was resolved so that I was able to get full
access for the two week trial period. There is also a biweekly email newsletter
that informs subscribers of the latest additions to Harrison's Online.
Overall, Harrison's Online is a very effective learning and resource
tool. I should think that any medical professional would find this
a valuable resource.