A Concept of eTraining Platform for Cardiology Learning based on

SOA Paradigm

Adam Piórkowski

and Jan Werewka

Department of Geoinformatics and Applied Computer Science, AGH University of Science and Technology,

al. Mickiewicza 30, 30–059 Cracow, Poland

Computer Science Laboratory, Institute of Automatics, AGH University of Science and Technology,

al. Mickiewicza 30, 30–059 Cracow, Poland

Keywords: eLearning, e-Learning, eTraining, e-Training, Computer-based Training, Internet-based Training, Web-

based Training, Interactive Learning, Cardiology, Real Time Services, SOA, EDA, Cloud Computing.

Abstract: This article discusses the problem of realization of future forms of education, like eTraining services. The

construction of such services is complex. The individual modules are created by different teams using

different technologies. Therefore, the focus was on the use of Service Oriented Architecture in this kind of

applications.

There is a reflection on an applicability of SOA in the construction of combined services in this paper. The

analysis of the demand for services is presented. The process of composition of services is discussed and

architecture of the system is proposed.

1 INTRODUCTION

The current software education system needs to

integrate different solutions coming from different

sources. The existing solutions are created based on

broad and deep knowledge in a certain domain. It is

very important to integrate the knowledge included

in different sophisticated applications in one system.

This article presents a proposal for integration

software solutions in eTraining system. The

eTraining differs from other typical eLearning

solutions by fulfilling some Real Time requirements.

The eTraining software includes simulators and

visualizations that animate the real environment.

So for the eTraining it is important to build

flexible software systems meeting the following key

parameters to the appropriate extent:

 agility – the ease of adapting to changes;

 scalability – utilising resources proportionally to

the load;

 reusable components – components may

originate from different development sources and it

is possible to select the component for the set service

type;

 efficiency – the efficient use of resources,

including working in real time (e.g. EDA);

 lightness - allowing for activities and the

functionality to be reduced to the customer's needs;

 flexibility – consists in selecting solutions

appropriate for the current needs.

The effective implementation of a software

architecture should account for the SOA paradigm

(Reference, 2009), in which the functionality of the

system is described by the service concept in a way

independent of the operating system or the

programming language. In the SOA paradigm, the

system is made up of loosely connected services

which constitute components that can be reused

many times and may occur in various compositions.

The emergence of SOA provides (Jin, 2010) a better

solutions for independent information resources,

duplication development problems and integrating

and reusing the educational resources.

2 ANALYSIS OF THE DEMAND

FOR SERVICES

Modern technologies give the opportunity to

develop skills using the virtual simulators. This also

applies to medical. A student or a doctor can

practice skills using the simulators and training

261

Piórkowski A. and Werewka J..

A Concept of eTraining Platform for Cardiology Learning based on SOA Paradigm.

DOI: 10.5220/0003973002610264

In Proceedings of the 14th International Conference on Enterprise Information Systems (ICEIS-2012), pages 261-264

ISBN: 978-989-8565-12-9

 2012 SCITEPRESS (Science and Technology Publications, Lda.)

systems. The main feature of this method is that it

does not need the presence of the patient and hence

the following advantages:

 exercises can be done at any time, at home,

outside of a hospital or clinic,

 no patient is subjected to activities that are

harmful or potentially harmful (e.g. radiation,

administration of contrast), or may be unpleasant.

The use of simulators helps in spatial orientation,

handle manipulation, and introduces the topic. It is

also possible to provide the data corresponding to

several modality and obtained by different devices,

which will facilitate student in using of various

instruments amassed by various centres.

In this article we present a proposal for a

comprehensive system of eTraining for

cardiologists. While the issue of eLearning is well

established now, eTraining systems are not popular

yet. In the cardiology, basic examinations can be

selected for virtual training, before student will start

to perform in the real world. It is possible to

compose an educational course for both students and

as a part of training for experienced users. Virtual

simulation of an examination is no substitute for real

training with real patients, but it can prepare for the

real examination and can reduce the time of

education. It should be noted that attendance at the

real examination is necessary, but learning of each

case can take a long time on waiting for an occasion.

By using a training system student can learn in less

time many cases of disease entities, which in the

clinic are rare.

3 SPECIFICATION OF SERVICES

The application of a comprehensive eLearning and

eTraining in the domain of cardiology should be

composed of several modules performing different

stages of learning and training:

 a training system for heart sounds – the aim of

this element is to introduce to the technique of

listening to the heart in two aspects:

 location of application of the chestpiece (bell

and diaphragm modes)

 determining the diagnosis, if a heart sound is

associated with pathology or normal,

 ECG training – the goal of this part is to present

sample electrocardiograms (obtained from the real

medical examinations or generated by a simulator);

in the educational part: student's task is to acquaint

with prepared by experts electrocardiogram

examples (Emergency Medicine Educator Online),

in the training part: student's task is to give the

correct diagnosis. An example of similar ECG

training module is available in the Internet

(Supraventricular Tachycardia Simulator).

 echocardiography training – it consists of two

modules:

 educational module – it provides several sets of

1D, 2D, 3D and 4D echocardiograms for normal

and pathological cases.

 training module – it enables virtual training for

echocardiography, there are two ways of perform

this examination, so training can be divided into:

• the transthoracic echocardiography

simulator ,

• the transesophageal echocardiography

simulator - an example of such kind of

simulator (web based version) is described in

(Kempny, 2010).

 angiography training – it also contains of two

modules:

 in the educational part user can acquaint with

angiography, the sets of images should be

available to study normal and pathological cases,

 the training part can help user to train in

conducting minimally invasive cardiac

procedures.

 Computed Tomography and Magnetic

Resonance Imaging – these modalities are the basic

medical examinations, which often provide the

necessary data to make a correct diagnosis. It is

possible to share real examination results for

students, even anonymised, but it is associated with

certain inconveniences and copyright problems.

The solution to these issues is to create a Web-based

service, which has an access to the hospital PACS

system (Picture Archiving and Communications

System) and generates the appropriate 2D and 3D

visualizations for selected modality (Piórkowski,

2009).

The system can provide questionnaires for users.

Additionally, there can be allowed for user or an

anonymous person to submit own comments.

Anonymous comments, however, should be

moderated. These treatments will help in the

debugging and improving clarity of data and models

in the system. Other possible options include blogs,

as well as the ability to place advertisements.

4 SERVICE COMPOSITION

Monolithic solution, based on one selected

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technology, may require rewriting some existing

solutions to one technology in order to join them.

The SOA methodology solves this problem by the

concept of service composition, which determines

the interaction of many services that are

implemented in different environments. This feature

is a distinct advantage of the methodology and

therefore SOA is the correct way of implementing a

complex system eCardioTraining.

The system, which is composed of many services

requires a process of composition of services for

individual users. It is important to define user roles

and privileges in the system:

Anonymous user (and any other) can explore

resources, view ECG, echo, angio, CT and MR

imaging, hear the heart beat sounds and simulate

examinations.

Registered users:

 medicine students: the accounts may be set up

for all students to support education through

eLearning and eTraining. Doctor / educator

determines which cases are presented (normal and

pathological variants), and then performs a test for

students using the system,

 trainees: use the system primarily to retrain in -

need to review all options of normal and pathologic

anatomy, prepare for the examination of

specialization,

 physicians: participate in training courses, need

some variants of normal and pathological anatomy,

it is possible to test the certificate confirming skills,

 physicians – specialists: need to review all

options of normal and pathological anatomy, as

problematic or unusual situations, there is available

a consultation (or optional comments) in case of a

difficult clinical case,

 physicians – scientists and educators: prepare

new sets, use the system in the teaching process,

moderate a forum (on special)

 administrators - create accounts, grant rights to

users, moderate the forum.

4.1 The Process of Service Composition

In the case of proposed system construction service

composition process is a static process. Services are

composed precisely for each role. Combining

services can take a place for a comparison of

modalities for the same patient or the same disease

entity. Displaying ECG waveform is often

associated with echocardiogram or CT and MR

imaging. This process is illustrated in Figure 1.

In presented case (Figure 1), the user can enable

the module with ECG waveforms for all 12 lines in

the analysis of echocardiography (S3) for a given

disease entity. The standard echocardiography uses

only one ECG line. Similar activities are provided

for medical imaging, angiography, CT and MRI.

Figure 1: Complex service scenario.

The services composition need not be limited

only to one modality. Comparative analysis may

include the use of selected or all prepared

modalities. The number of possible situations is the

number of possible subsets of services and,

therefore, further considerations may be a subject of

future work.

4.2 Dynamic Service Composition

Assuming, however, a further extension of the

system modules, or create customized roles,

dynamic composition is possible. For example, a

physician educator can compose and order services

for a weekend training course. Then he should be

able to select appropriate materials, a set of services

and their place in the context of the topic of training.

The selection criterion can also be an approximate

training time (statistically obtained, based on the

experiences of users), matched to a time frame.

5 SYSTEM ARCHITECTURE

ETraining system consists of several subsystems.

Each of the subsystems may act autonomously. The

creation of such simulators takes a long time and

usually is carried out by different teams, using

different technologies. The idea behind the use of

SOA is to combine the subsystems into one system

without rewriting them into a single platform. For

this purpose, constituent services are released, which

can cooperate with each other and exchange data

even though they are developed in different

platforms. These services get data from the same

database and the same PACS system. The design of

the system is illustrated in Figure 2, according to the

model S3 (Arsanjani, 2007). The first layer (1) is the

END

service

selection

START

Echo

angio, CT,

MRI imaging

ECG

AConceptofeTrainingPlatformforCardiologyLearningbasedonSOAParadigm

263

Figure 2: S3 diagram for eCardioTraining system.

layer that provides data. There are placed specific

components that implement the processing logic in

the second layer. Third layer provides the basic

services that in the process of choreography are

combined in a service (the fourth layer) supplied to

the customer (the fifth layer).

6 CONCLUSIONS

Cloud computing together with building reusable

software components is the fastest growing part of

IT industry, offering benefits for both customers and

IT solution providers (Chang, 2010). Due the short

development cycles it is necessary to integrate parts

of legacy software into new systems (Werewka,

2011). The paper states that before starting any SOA

or cloud computing software development, it is

necessary to undertake high level decision making

and planning proposed in the paper. The described

proposals may be used as a starting point for

beginning of similar projects.

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Arsanjani, A., Zhang, L.-J., Ellis, M., Allam, A., and

Channabasavaiah, K., 2007. S3: A Service-Oriented

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Chang, V., Wills, G., De Roure, D., 2010. A Review of

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3rd Int. Conf. on Cloud Computing, IEEE Computer

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Echobasics, http://www.echobasics.de

Emergency Medicine Educator Online,

http://www.emedu.org/ecg/

Jin, Y., Wang, Y., Bian, O., 2010. An approach of Design

and Implementation on SOA –based Computer Aided

Learning Platform. The 5th Int. Conf. on Computer

Science and Education, IEEE, pp. 1568-1573

Kempny, A., and Piórkowski, A., 2010. CT2TEE - a

novel, internet-based simulator of transoesophageal

echocardiography in congenital heart disease.

Kardiologia Polska 68, 374-379.

Piórkowski A., Jajesnica L., Szostek K., 2009. Creating

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http://svtsim.com/

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