The Internet contains a plethora of potential technology applications that create opportunities for faculty to create engaging learning experiences for students in the classroom. During a primarily lecture-based course with digitally literate learners, I integrated a virtual surgery into an interactive lecture format. This strategy also provided an orthopedic observational operating room experience for some students who were unable to gain this experience in the clinical setting.

The strategy involved hyperlinking animated images of orthopedic, joint replacement surgical procedures into a PowerPoint presentation associated with a discussion of the surgical management of osteoarthritis. The PowerPoint presentation with the hyperlinked Web site was then placed on the Blackboard Course Management System so that students could access again at future times for reinforcement of learning as they desired. To access these animations, a Smart Classroom (technology-enhanced classroom) is required with Internet access and appropriate software such as Shockwave Player from Macromedia Inc.

Before viewing the animated orthopedic surgeries, students and faculty discussed care of the patient with osteoarthritis. The pathophysiology, risk factors, and medical and nursing management were addressed. When the time came to discuss the surgical procedures of joint replacement, the students were "taken" to the Web site of the Arthritis Foundation1 to view the animated steps of the virtual surgery of a joint hip replacement and a knee replacement. As the steps were advanced, the associated brief text that describes the actions was read to the students. During the progression of the "surgical steps," I answered questions from students seeking clarification.

In the hip replacement surgery, using a reaming device, students viewed the removal of damaged cartilage and bone, insertion of the metal shell into the pelvic bone socket, placement of the plastic liner on the metal shell, hollowing out of the end of the femur, and filling with bone cement. Then, a metal implant was positioned into the femur, and the metal ball component was connected to the stem of the femur. The same type of procedure was observed for the knee replacement.

Student reaction was favorable. They felt that the actual viewing of the surgery helped them more effectively understand these procedures. Some selected student comments included the following:

Did a good job of showing exactly what happens, very helpful?

It will be good to review later when studying.

I was taking care of a patient with a total hip and it was helpful for me to explain why she couldn't move her hip one way and why her positioning is so important.

I loved to see the surgery procedures in class.

Conclusion

The visual representations of these procedures engaged the students and enlivened the text-based nature of content classroom dissemination. Students gained an elementary understanding of the steps involved in these surgeries, why the patient experiences pain in the postoperative period, and key points to guide patient education. These digitally literate students are not dazzled by technology. Rather, they are interested in discovering technology's function for them.2,3 Our challenge as educators is to guide our students in merging the recreational use of technology with the academic digital world to support lifelong learning.

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