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  • 1.
    Fyrenius, Anna
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Bergdahl, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Lectures in problem-based learning - Why, when and how? An example of interactive lecturing that stimulates meaningful learning2005In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 27, no 1, p. 61-65Article in journal (Refereed)
    Abstract [en]

    Even though opinions differ as to whether lecturing is compatible with problem-based learning (PBL) or not, lectures are still a common form of instruction in PBL curricula. This paper discusses the lecture in the framework of theories of learning in general and the medical problem-based learning tradition in particular. An example of how theories of learning can be implemented in the lecture hall is presented. Theories that underpin PBL as an educational philosophy rather than as a method of instruction are reviewed. A lecture form, organized in introductory, in depth and application lectures, that responds to important factors for stimulating deep processing of knowledge and meaningful learning is discussed. Examples of and practical points about how to renew and restructure lectures in a way that counteracts surface approaches to learning, teacher centring and student passivity are presented. We argue that, with proper awareness of possible drawbacks of the large format, lectures can be used as valuable tools for learning also in a PBL curriculum.

  • 2.
    Fyrenius, Anna
    et al.
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Silén, Charlotte
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Utgångspunkter för basgruppsarbete i PBL2003Report (Other academic)
    Abstract [sv]

    Med tiden har nya idéer om utgångspunkter utvecklats. Både lärare och studenter har upplevt att de fungerar olika bra och diskussioner har förts om vad det är som gör att utgångspunkten är mer eller mindre lyckad. Funderingar som rör innehåll och utformning av utgångspunk-ter väcker genast frågor av mer allmän karaktär avseende PBL. Vad är det som ska uppnås med utgångspunkten? Vilken inriktning i lärandet stimulerar den till och varför? Hur väljer man vilka utgångspunkter som ska användas? Hur hänger utgångspunkterna ihop genom utbild-ningen? I den här skriften har personer med erfarenhet av hur utgångs-punkter skapas och används i olika utbildningar skrivit om sina reflektioner och erfarenheter kring funktion och syfte. Inledningsvis finner du texter som teoretiskt beskriver och resonerar kring utgångspunkternas funktion i utbildningssammanhanget. Därpå följer beskrivningar från olika försök att utveckla utgångspunkter i riktning från det traditionella pappersfallet. Skriften fokuserar således inte de mest traditionella ut-gångspunkterna inom HU, utan visar på möjligheter till vidareutveck-ling och variation. Avslutningsvis finner du studentkommentarer om scenarier vid HU.

  • 3.
    Fyrenius, Anna
    et al.
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Silén, Charlotte
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Wirell, Staffan
    Linköping University, Department of Medicine and Health Sciences, Radiology . Linköping University, Faculty of Health Sciences.
    Students' conceptions of underlying principles in medical physiology: An interview study of medical students understanding in a PBL curriculum2007In: Advances in Physiology Education, ISSN 1043-4046, E-ISSN 1522-1229, Vol. 31, p. 364-369Article in journal (Refereed)
    Abstract [en]

    Medical physiology is known to be a complex area where students develop significant errors in conceptual understanding. Students’ knowledge is often bound to situational descriptions rather than underlying principles. This study explores how medical students discern and process underlying principles in physiology. Indepth interviews, where students elaborated on principles related to blood pressure and blood pressure regulation, were carried out with 16 medical students in a problem-based learning curriculum. A qualitative, phenomenographic approach was used, and interviews were audiotaped, transcribed, qualitatively analyzed, and categorized. Four categories were outlined. The underlying principles were conceived as follows: 1) general conditions for body function at a specified time point, 2) transferable phenomena between organ systems and time points, 3) conditionally transferable phenomena between organ systems and time points, and 4) cognitive constructions of limited value in medical physiology. The results offers insights into students’ thinking about underlying principles in physiology and suggest how understanding can be challenged to stimulate deep-level processing of underlying principles rather than situational descriptions of physiology. A complex conception of underlying principles includes an ability to problemize phenomena beyond long causal reasoning chains, which is often rewarded in traditional examinations and tests. Keywords for problemized processing are as follows: comparisons, differences, similarities, conditions, context, relevance, multiple sampling, connections, and dependencies.

  • 4.
    Fyrenius, Anna
    et al.
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Wirell, Staffan
    Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Silén, Charlotte
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Student approaches to achieving understanding ― Approaches to learning revisited2007In: Studies in Higher Education, ISSN 0307-5079, Vol. 32, no 2, p. 149-165Article in journal (Refereed)
    Abstract [en]

    This article presents a phenomenographic study that investigates students' approaches to achieving understanding. The results are based on interviews, addressing physiological phenomena, with 16 medical students in a problem-based curriculum. Four approaches—sifting, building, holding and moving—are outlined. The holding and moving approaches describe variations in deep-level processing. The moving approach is characterised by an intention to continuously refine understanding in an open-ended process. The student strives for a change in perspective and deliberately creates actions that are rich in variation and challenge. The holding approach is characterised by an intention to reach a final goal. This is achieved by high degrees of structure and control in the learning act. Understanding is sometimes sealed, 'held on to' and can be threatened by new input and other students' viewpoints. The study also shows how students deal with details when constructing understanding of wholes.

  • 5.
    Hård af Segerstad, Helene
    et al.
    Linköping University, Faculty of Educational Sciences. Linköping University, Department of Behavioural Sciences, Studies in Adult, Popular and Higher Education.
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Assisting learning - the tutors role in Problem-based learning1997In: International Conference on PBL,1997, 1997Conference paper (Other academic)
  • 6.
    Hård af Segerstad, Helene
    et al.
    Linköping University, Faculty of Educational Sciences. Linköping University, Department of Behavioural Sciences, Studies in Adult, Popular and Higher Education.
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Handledning av lärprocesser1999Report (Other academic)
  • 7.
    Hård af Segerstad, Helene
    et al.
    Linköping University, Faculty of Educational Sciences. Linköping University, Department of Behavioural Sciences, Studies in Adult, Popular and Higher Education.
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Hälsouniversitetets kvalitetsarbete 1993-19961996Report (Other academic)
  • 8.
    Johannesson, Eva
    et al.
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Silén, Charlotte
    Centre for Medical Education, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Hult, Håkan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Students’ experiences of learning manual clinical skills through simulation2013In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 18, no 1, p. 99-114Article in journal (Refereed)
    Abstract [en]

    Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students’ experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten thirdyear undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision™, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in threethemes: what the students learn, how the students learn, and the simulator’s contribution to the students’ learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.

  • 9. Kjellgren, K.
    et al.
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Hård af Segerstad, Helene
    Linköping University, Faculty of Educational Sciences. Linköping University, Department of Behavioural Sciences, Studies in Adult, Popular and Higher Education.
    Utveckling av ett datorbaserat utvärderingsprogram1995In: NFPF konferens,1995, 1995Conference paper (Refereed)
  • 10.
    Ljungman, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine .
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Examination involving students as peer examiners2008In: Assessment & Evaluation in Higher Education, ISSN 0260-2938, E-ISSN 1469-297X, Vol. 33, no 3, p. 289-300Article in journal (Refereed)
    Abstract [en]

    The main interest in this article is students' involvement in assessment as a part of growth towards self-directedness in learning. In order to enhance students' development of autonomy in learning, a project involving 'older' students as peer examiners for 'younger' students was designed and carried out. Students in the sixth semester in a PBL-based Master's program of Medical Biology participated, together with faculty, as examiners of fifth-semester students. The examination and the assessment situation was carefully designed based on learning theories, empirical evidence and experiences underpinning student-centred learning, especially in the form of PBL used at the faculty. The project was evaluated and analysed in order to understand students' learning processes related to the responsibility for assessing peers. The situation of the peer examiners was interpreted based on their own experiences with statements from the students assessed and faculty involved in the assessment. Evaluations from six occasions, spring and fall, 2003-2005, were included in the study. The findings suggest that involving students in assessment as equal partners with faculty makes it is possible for students to apprehend the metacognitive competences needed to be responsible and autonomous in learning. The peer examiners experience motivation to learn about learning, they acquire tacit knowledge about assessment and they learn through being involved and trusted. The student-centred educational context, which requires responsibility throughout the programme, is recognized as very important.   

  • 11.
    Silén, Charlotte
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Educational Sciences.
    Mellan kaos och kosmos: om eget ansvar och självständighet i lärande2000Doctoral thesis, monograph (Other academic)
    Abstract [en]

    In this thesis, the aim was to attain a deeper understanding according to the students meaning of learning related to their own responsibility and independence within a framework of an educa¬tional programme.

    An empirical study with an ethnographic approach was carried out during one term of a nursing programme that uses the PBL-approach. Based on observations, conversations, inter¬views and documents, three narratives were formulated. One describes the phases students experience in the planned curricula. Periods characterised of chaos, uncertainty and a heavy workload, alternate with periods of ‘cosmos’, optimism, curiosity and satisfaction. The second narrative is about students' learning objectives while realising that they have to make choices and decisions on their own to succeed. A dialectic driving force emerging from frustration and stimulation, chaos and cosmos, results in questions about what to learn and how to act. The third narrative describes how students handle these questions.

    The narratives reveal two dimensions. One concerns how the students form attitudes about the relevance of learning objectives and how they go about learning a knowledge base necessary for their future profession. The other dimension takes as its starting point the fact that students try to manage their learning situation taking into consideration the framework of the educa¬tional programme. These dimensions were further analysed using theoretical references. The first dimension was analysed from the perspective of teacher/learner control and a didactic analysis of the meaning of an educational setting. The second dimension was analysed on the basis of phenomenographic learning theory.

    As regards responsibility and independence there seems to be a point in abandoning the concept of self-directed learning. Instead of emphasising self, the interaction between people, the individual and the educational framework and the interaction with content, are found to be fundamental. This interaction includes communication, dialogue and active participation in all the parts of a learning situation. Based on the results of this study, I claim that the driving force in student-centred learning is the dialectic relation between frustration and stimulation, chaos and cosmos. This stimulates the students to engage in the teachers' traditional didactic ques¬tions concerning an educational programme: what are we going to study, how and why, and what are the objectives? The students' conduct as regards independence, vis à vis dependence, are related to a dialectic relationship between the prerequisites provided by the educational frame¬work and the students' interpretation and ability to use them. Expressions of responsibility and independence emerge as choices and decisions concerning the didactic questions, initiative, activity, search for opportunities to reflect and co-operate and self-confidence. The opposite, dependence, is characterised by strategies for “survival”. The students plan their learning situa¬tion so that the examinations and assignments can be successfully tackled, and the learning situation takes on features of a surface approach. I believe that further insights into learning in student-centred education can be found in the two dialectic relationships described above.

  • 12.
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Physiology .
    The tutor's approach in base groups (PBL)2006In: Higher Education, ISSN 0018-1560, E-ISSN 1573-174X, Vol. 51, no 3, p. 373-385Article, review/survey (Refereed)
    Abstract [en]

    In this article, the concept of approach related to tutor functioning in problem-based learning (PBL) is explored and the significance of a phenomenological perspective of the body in relation to learning and tutoring is investigated. The aim has been to understand the concept of approach in a context where the individual, thoughts, emotions and body are regarded as a whole in a learning process - a non-dualistic entity. The analysis is primarily based on Merleau-Ponty (Phenomenologie de la Perception. Editions Gallimard, Kroppens fenomenologi. Oslo: Pax) and Leder (1990). The outcome of the analysis is related to the pedagogical view that characterises PBL and tutoring in base groups. An earlier study (Silén Licentiate thesis n 3/1996. Linköping University) about tutor functioning in PBL was the starting-point for the exploration. On the basis of the phenomenological analysis, I assign approach the following meaning: - the total message expressed by 'the lived body' in interaction with its life world. The analysis indicates that the tutor's approach influences group work in different ways. One of phenomenology's most important messages implies that the tutor's approach should be characterised by 'presence', attention on the students and what is happening in the group, and not on the tutor's own actions and thoughts. The ability to be 'present' is possible when the knowing is rooted in the lived body. This conclusion brings to the fore the necessity of the tutor's own understanding of the ideas of PBL and the underlying theories, and also highlights the importance of regarding tutor training as an ongoing learning process. The focus of the exploration has been on the tutor in PBL. In principle, I would argue that a corresponding line of reasoning is applicable to tutoring and learning in general. © Springer 2006.

  • 13.
    Silén, Charlotte
    et al.
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Hård af Segerstad, Helene
    Linköping University, Department of Behavioural Sciences, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.
    Texter om PBL: texter, praktik, reflektioner2001Report (Other academic)
    Abstract [sv]

    Upprinnelsen till den rapport som du nu har i din hand är att det under några år har hållits en intern universitetspedagogisk konferens vid Linköpings universitet. Syftet med konferenserna har varit att stimulera universitetets lärare att skriva om sina pedagogiska erfarenheter och tankar. Ett antal utbildningar inom universitetet använder PBL och flera bidrag som diskuterar och belyser PBL har presenterats. Dessa har kommit att bli viktiga i den fortsatta utvecklingen av PBL. Nu har vissa av de tidigare rapporterna tagit slut och det har uppstått behov av att trycka dessa igen och då gärna i en samlad rapport.

    Den rapport som nu kommit till består alltså till stor del av tidigare presenterade bidrag. Rapporten har kompletterats med ett nyskrivet bidrag av Charlotte Silén och två bidrag som Charlotte skrivit i samband med forskarutbildningskurser. I rapporten finns också ett bidrag som  presenterats av Karin von Shilling på en PBL konferens 1995.

    Med denna design hoppas vi att rapporten ska kunna bli intressant både för den som vill skaffa sig en introduktion och för den som har erfarenheter av PBL och som vill skaffa sig idéer och perspektiv.

  • 14.
    Silén, Charlotte
    et al.
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Wirell, Staffan
    Linköping University, Department of Medical and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Nylander, Eva
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Fyrénius, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Clinical Physiology.
    Smedby, Örjan
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Advanced 3D visualization in student-centred medical education2008In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 30, no 5, p. e115-e124Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Healthcare students have difficulties achieving a conceptual understanding of 3D anatomy and misconceptions about physiological phenomena are persistent and hard to address. 3D visualization has improved the possibilities of facilitating understanding of complex phenomena. A project was carried out in which high quality 3D visualizations using high-resolution CT and MR images from clinical research were developed for educational use. Instead of standard stacks of slices (original or multiplanar reformatted) volume-rendering images in the quicktime VR format that enables students to interact intuitively were included. Based on learning theories underpinning problem based learning, 3D visualizations were implemented in the existing curricula of the medical and physiotherapy programs. The images/films were used in lectures, demonstrations and tutorial sessions. Self-study material was also developed. AIMS: To support learning efficacy by developing and using 3D datasets in regular health care curricula and enhancing the knowledge about possible educational value of 3D visualizations in learning anatomy and physiology. METHOD: Questionnaires were used to investigate the medical and physiotherapy students' opinions about the different formats of visualizations and their learning experiences. RESULTS: The 3D images/films stimulated the students will to understand more and helped them to get insights about biological variations and different organs size, space extent and relation to each other. The virtual dissections gave a clearer picture than ordinary dissections and the possibility to turn structures around was instructive. CONCLUSIONS: 3D visualizations based on authentic, viable material point out a new dimension of learning material in anatomy, physiology and probably also pathophysiology. It was successful to implement 3D images in already existing themes in the educational programs. The results show that deeper knowledge is required about students' interpretation of images/films in relation to learning outcomes. There is also a need for preparations and facilitation principles connected to the use of 3D visualizations.

  • 15.
    Siwe, Karin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Silén, Charlotte
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Performing the First Pelvic Examination: Female Medical Students’ Transition to Examiners2007In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 69, no 1-3, p. 55-62Article in journal (Refereed)
    Abstract [en]

    Objective: To gain a deeper understanding of how female medical students perceive and experience performing their first pelvic examination (PE).

    Methods: A qualitative study. In-depth interviews after the students’ involvement in a learning session about the PE, with professional patients (PPs) as instructors and a gynaecologist as supervisor. The interviews were analysed according to the constant comparative method to acquire a deeper understanding of the students’ experiences and the ongoing social processes.

    Results: “Transcending unspoken boundaries and taboos, a prerequisite for learning” was the essence of the entire material and was identified from two categories: “A didactic design facilitates the transition to examiner” and “Interactive support enables creative learning of interpersonal and palpation skills”.

    Conclusion: Through interactive guidance from the PPs, the students overcame affective obstacles and achieved the aim of becoming an examiner. The favourable learning experience heightened their awareness of their own bodies and promoted a deeper interest in PEs, both as examiners and as patients.

    Practice implications: Engaging voluntary, healthy and knowledgeable women as instructors in the PE situation creates a safe learning environment and promotes interaction with students. Immediate feedback teaches students to integrate communicative and behavioural skills in a professional manner and to palpate the uterus.

  • 16.
    Smedby, Örjan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Medical Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Wirell, Staffan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Medical Radiology.
    Kvist, Joanna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Physiotherapy.
    Silén, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Göran, Pettersson
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, CSELAB - Cognitive Systems Engineering Laboratory.
    Fyrenius, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Interactive volume rendering 3D images for anatomy learning on low-end computers2007In: ECR - European Congress of Radiology,2007, 2007Conference paper (Other academic)
    Abstract [en]

      

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