1987 – early 1990’s
Personal computers were scarce, powerful computing machines were cumbersome, room-sized ‘mainframes,’ and the Internet was just toddling toward what would become a pervasive worldwide presence. At the same time, medical education was primarily lecture-driven didactic learning followed by clinical experience under the tutelage of practicing clinicians, with little else in between.
At Southern Illinois University School of Medicine in Carbondale, Illinois two academics — physiologist J. Hurley Myers and Dr. Kevin Dorsey – faced a cumbersome problem of their own: implementing the problem-based learning, case study model into the new medical school’s curriculum. Their premise: students learn to solve problems best by ‘doing,’ applying the knowledge they gain in the classroom to realistic medical problems and learning from their mistakes in a ‘safe’ environment. The research of Dr. Howard Barrows found an enthusiastic follower in Dr. Myers. But Myers knew there must be a better delivery method than the existing problem-based learning modules that used thick books of flip cards to supply patient history questions, physical findings, and laboratory results.
In search of some answers, Myers described the problem to artist and self-taught programmer, Eldon Benz. With a problem-solver’s mind, a vision of the potential uses for Apple’s Macintosh computers, and a knowledge of Hypercard programming, Benz’ programming skills gave shape to Myers’ vision of applying computer technology to improve medical education. Early on, they focused on two concepts: 1) bringing interactivity and computer delivery to static textbook material and 2) replacing the analog flip-book method of simulating clinical decision-making. After a successful demonstration project to produce an interactive version of a popular medical textbook on electrocardiography (released on CD as Interactive Electrocardiography), Myers secured a grant from pharmaceutical company Ciba Geigy to pursue the idea of a patient simulation program. Myers, Dorsey, and Benz teamed up to create an innovative medical education software program based on the PBL model. It was piloted at the SIU School of Medicine. To Myers, the market potential was obvious, and he began working to take the product to the private sector.
Mid to late 1990’s
Together, Dr. Myers as CEO and Benz as Vice President of Programming, piloted DxR Development Group toward new areas, developing computer programs to learning content in a more engaging way. Myers’ drive in promoting the Diagnostic Reasoning software led to key connections and eventual partnerships with pharmaceutical companies such as Ciba Geigy and Novartis. Soon, this start-up gained a reputation as a small company with a ‘get the job done’ attitude. Dr. Myers sold big-company executives on his small staff’s ability to translate their content into interactive, engaging software.The result was multimedia educational programs covering a range of medical content, including the top-selling Interactive Atlas of Human Anatomy, the Interactive Atlas of Clinical Anatomy, Irritable Bowel Syndrome, Interactive Electrocardiography, Congestive Heart Failure, and Type 2 Diabetes.
Later contracts with Sanofi Pharmaceuticals for content tutorials for their sales staff bolstered DxR’s portfolio to include employee training expertise. DxR created a new in-house product called the Clinical Competency Examination — a performance-based assessment program for evaluating the clinical and problem-solving skills of medical students.
DxR Development Group, Inc. was formed and launched the Diagnostic Reasoning product on floppy disk. Later named DxR Clinician, the program allowed medical students to interact with a ‘virtual’ patient. Students gather clinical data through interview questions, conducting a virtual physical exam, and selecting lab tests from a database and interpreting patient results, all aimed at arriving at the correct medical diagnosis, supported by the patient data. The idea was a new one that caught on quickly with medical schools that were early adopters of technology in the classroom.
DxR Clinician became a Web-delivered application in the late 90’s. As connectivity increased, the software could be used anywhere there was a reliable internet connection. Initially, that meant flexible usage for US schools, but eventually international interest increased, which meant translating Clinician into other languages… first Spanish, then Japanese (a Chinese translation came later). DxR Development Group also expanded its problem-based learning programs, with products designed for educating students in other healthcare disciplines, such as nursing, physical therapy, and chiropractic.
DxR Development expanded into online testing when it partnered with The Chauncey Group (later Educational Testing Service), the makers of the TOEIC exam. This experience would prepare the company for work with the National League for Nursing, Graduate Readiness Exam (GRE), American College of Psychiatrists, and Northwell Health System (formerly Northshore) for online testing, course development and delivery. DxR also developed its own online courseware and test delivery engine, DxR CORE, which provides the programming framework for many in-house and custom-developed products, including the Illinois Nurse Aide Testing Competency Examination.
DxR Development goes International
DxR first took its products to an international audience in the late 1990’s and early 2000’s, with foreign-language translations of DxR Clinician (Spanish, Japanese, and Chinese). Most recently, DxR Nursing SELECT and the Clinical Competency Examination have been translated into simplified Chinese. DxR partnered with Taipei-based Chun Shin Limited and DxR Asia Pacific (based in Hong Kong) to market its educational products in the Asia-Pacific region, including mainland China and the Philippines.
Reaching businesses and non-profit organizations in the 2010’s
Most recently, businesses and non-profits seeking robust solutions for a variety of needs — training, online testing, and web presence — have tapped into DxR’s expertise. Clients such as The Lincoln Academy of Illinois, Season to Buy, RevenueJump, and Wheels Through Time have come to depend on DxR for reliable, thoughtfully designed, and expertly supported software applications and Websites.
Hurley Myers and Eldon Benz say they’re amazed at where their ideas and their partnership has taken DxR Development Group. They continue to guide the company into new ventures and global markets. They, along with their staff, occasionally share their thoughts and experiences on DxR’s blog, touching on topics such as critical thinking, healthcare education, software development trends, application development, and art.
Moving forward: DxR Development Group’s staff stands ready to assist educational innovators, businesses, and non-profit groups with their educational, Web application, and technology needs. We remain committed to a thoughtful, sound, and customer-centered development process in all that we do. Let our expertise play a part in your organization’s future.