RASHI Tutorial  -- for Human Biology Cases

Version:  2/24/04, tm

This document takes you through a quick use of the main components of the RASHI system.  In real use you will spend more time investigating with each component, and you will use them in any order you want to.  The RASHI home page is at:

http://ccbit.cs.umass.edu/rashihome/.

Notes:

- RASHI will only work on these operating systems and internet browsers:  Most modern Windows operating systems,  Mac OS 9, Mac OS 10.

- You need to be connected to the internet while you use RASHI. 

- With dial-up modems you can expect  a long delay when you first load a case.

- Additional RASHI help can be obtained at :

http://portal.cs.umass.edu/rashi/rashi2eb/latest/rashiHelp/rashiHelp.html

1) Install the RASHI software by copying  the RASHI folder (it may have a name like “rashi022304” indicating the version date)  to anywhere on your hard drive.  You can do this by copying it from a CDROM or downloading it from this web site: http://portal.cs.umass.edu/rashi/rashi2eb/latest/rashiHelp/rashiHelp.html.

2) Launch the RASHI application by double-clicking on rashiWin.exe  (for PCs) or rashiMacOSX, rashiMacOX9 for the appropriate operating system (the program  name may be slightly different).

3) Login: Type your name at the login screen.  Choose a subject matter type (biology, in this case).  Press the Login button.  Then choose the case “Tutorial Case” from the list of cases.  Wait as the case loads, then press the Start button.  For you name  you can enter whatever you want but  it is best to type first initial and last name (more if someone else in the class has the same name).  Remember your user name so your saved work can be reloaded each time you use the system.

4) Statement of Case.  Read the statement of case.  Type in one thing that you think is important about the situation .  Press Save To Notebook. You may next see a dialog box asking you about your entry—just follow the instructions.   To come back to the statement of case click the Statement of Case icon (orange folder at lower left).

5) Click on the Examination icon (picture of a body).  You will see the outline of a body. Click on one of the feet to see a zoomed-in picture of the body.  Pass the mouse over the left foot and click when you see “left foot” text.  In the list of things you can examine to the left, click “examine Achilles tendon”.   Read the exam results and click Save.  Click around on the body and find a couple of other exam results to Save.

6) Click the Patient Interview icon (microphone).   Type “what is your like diet lately?” and click the ASK button.  You will see a list of the question/answer items  that are in the RASHI data base that match your question.  Click “Describe diet”  You should see a video or picture of the patient.  (If it’s a video,  make sure the sound on your computer is turned on.)  You will also see a textual version of the patients answer.   Click the “Save in my notebook” button.  Ask the patient a couple more questions and save them in your notebook.

7)  Click on the Laboratory icon (microscope).   You will see a scrolling list of lab tests that you can “order”.  Click on “Blood count; Red Blood Cell”.  You will be asked to type a justification of why you think this information is relevant (which is asked because lab tests can be expensive and you should only order tests that you think will clearly impact the diagnosis).   Type any text in the middle text box (for this tutorial it does no matter what you type).  Click Save.  (In some versions of the software you may have to then click another Save button.)   Save a couple more lab tests to your notebook.

8) Click the Notebook icon (upper left).  You will see a table listing the information you have gathered so far from the RASHI tools (we sometimes call them “widgets”).  Click on “describe diet” to select that row.  Click Edit to see details on that notebook item.   Select a “Type”:  Observation.   (At this point you could edit the short description, long description, or Explanation text boxes if you wanted to.)  Click “Save Changes.”   Do something similar for a couple other notebook items.  

9) Click on the Sources icon (hat) to be able to enter descriptions of external information sources .  (You may first have to close or hide the Notebook window.)   For Short Description type “Smiths Medical Reference.”  For the Long Description type “This is my favorite book.   1998,  Prentice Hall publishing. “  For Type select “book”.  (Note the other  source categories you can create.)   Press Add Source and you will see it appear in the source list.  

10) Click the NoteBook icon again.  This time we will enter something that  came from a text book rather than from one of the RASHI widgets.  Click the New button.  In the Short Description type “Patient has ice cream related  fever. “  For Type choose “inference”.   For source choose “Smiths Medical Reference.”  For Page type  “120-122”.  Type anything you want in the long Description and Explanation boxes.  Click Save Changes then click Close Notebook.

11) Click on the Hypothesis Editor (Mr. Rashi).  Click New Hypothesis.   For the hypothesis name type “Whooping cough”.  For the rating choose “possible”.  Click Save.  Repeat this to create three (or more) additional hypotheses.    Rate one as “top” and another as “ruled out”.  You will see your hypotheses listed in the Hypothesis Editor.  Note how  the icons are different for Top, Possible, and Ruled out.  You can always go back and change these ratings, and add or remove hypotheses in your ongoing investigation.

12) Creating Arguments.  Next we will create arguments to support or refute hypotheses  by linking them with items from the NoteBook.  Of course, for our Tutorial  Case the arguments will not be sound medical reasons.   In the Hypothesis Editor click on “Patient has ice cream related  fever”.  It will change color to indicate that it is the “selected hypothesis. “  Now bring up the Notebook.  In the middle you will see some text to tell you what that currently selected hypothesis is.   Click on Describe Diet to select that notebook item.  Then click “add notebook selection” to add the notebook selection as evidence to the selected hypothesis.   Now go back to the Hypothesis Editor.  You will see a visual indicator to the left of the Ice Cream hypothesis that it has some evidence underneath it.   You can click on this indicator to expand or contract the attached  notebook items.  Click to expand this hypothesis and you will see “describe diet”.  Double click on “describe diet” (or select it and press the Edit button).  For Relationship choose “Strongly Supports”.  In principle you would  type why you think the patients diet information strong supports this hypothesis.   Click OK button.  Note that the color next to the Diet item has changed to green.   Add more arguments to other hypotheses in the same way.  You will note that a “refutes” type of relationship creates a red icon.   You can have your arguments  go several levels deep if you want.  If you select an evidence item rather than a hypothesis, you can add arguments supporting or refuting this.  In this way you can create an argument where X supports Y which supports A which supports B, in a chain of reasoning. 

13) Click the Final Report icon (white stack of paper).   When you do this RASHI automatically generates some text which summarizes your current arguments and investigation process (each time you click the icon it will change to reflect your current work).   You can cut and paste this text into a word processing document to help you write a final or interim report on your investigation.   The text is brief and cryptic,  so its just a starting place that you will have to edit and expand.

14)  Click the To Do List icon (yellow stickies).  This is a place to keep notes to yourself (these notes, and everything else you do, are saved from one session to another—remember your login name!, and remember to occasionally click Save Notebook in the notebook tool).   As you diagnose a real Case,   you will be looking at medical reference books and other sources, and be accumulating both lists of possible hypotheses and lists of lab or exam tests that you want to do to help support or refute your hypotheses; and perhaps things you want to remember to ask your teacher, or external sources you want to look into.  You can only do one thing at a time so in the early stages of your work your list of things to do will explode faster than you can do them.  Use the To Do List to keep track of all of this.

15) Help icon.  The Help icon (a question mark) will take you to your machines internet browser with a RASHI help page.

16) Coach icon.  In the hypothesis editor and the Notebook you will see an icon of a graduation hat—this is the Coach.   You can click on the coach to get some advice.  (The coaching part is still being refined, so don’t be surprised if the help is not particularly relevant at this time.)