Continuing Education in Cardiology through the Internet

Pacher A; Alonso E; Bustamante J; Casco V; Esandi D; Eskenazi S; Flichtentrei D; Garófalo D; Heñin M; Lombardo R; Luque A.; Nanfara S; Ortiz Baeza O; Peiró A; Quiroga A; Sanagua J; Schapachnik E; Valente J.

Argentine Federation of Cardiology - PCVC Group

 

ABSTRACT
Objectives: Our objectives were to develop post-degree distance Continuing Education in Cardiology (CEE) using the different services of the Internet (I).
Methodology: The I is used with our own servers (Web, e-mail [E], mailing lists [ML], FTPMail and Chat). A system was designed based mainly, on E and secondarily on the Web. There were 20 thematic ML configured and kept working on subspecialties; all of them moderated, and 8 of them devoted to work (W).
Results: Using these methods, since October 1999, two international congresses of cardiology (VC) were held, and a third one is being prepared (registrations/countries: VC 1: 7573/95; VC 2: 11700/107; VC 3: 12449/119), two international symposia, lectures, courses, athenaeums, discussion of cases, brief communications with peer review, and recertification activities. A total 14,564 messages (M) were exchanged in the thematic ML (mean 9.9 M/day: Arrhythmias 2404, Informatics 1976, Chagas Disease 1879, Epidemiology 1336, Pediatric Cardiology 980, Transdisciplinary Cardiology 837, Clinical Cardiology 834, Coronary Heart Disease, 777, Sports Cardiology 760, Nursing 719, Echocardiography 572, HBP 509, Images 481, Stroke 443, Interventional Cardiology 373, Pharmacology 361, Heart Failure 341, Surgery 109, Basic Sciences 61, History 35) and 10299 in ML of W (mean 8.8 M/day). Outside the VC, the thematic ML have 8445 subscribers (422/ML).
Conclusions: We could develop and keep a structure and continuing activities of CEE through the Internet.

INTRODUCTION
Among other tools that enable the realization of distance education activities, the different services of the Internet have optimized communications and lowered costs, making use easier.

OBJECTIVES
Our objectives were to employ the different services of the Internet to develop distance continuing education activities on Cardiology (CEE).

MATERIAL AND METHODS
Through a preliminary plan presented in 1986 to the Argentine Federation of Cardiology - FAC (scientific organization founded in 1965, constituted by 34 Societies of Cardiology and 11 Regional Offices, distributed along the whole national territory), in year 1994 the Center of Teleinformatics of FAC - CETIFAC- was created, with its headquarters in the Engineering - Bioengineering School of the National University of Entre Rios, Parana.[1] CETIFAC had as its main goal, to develop the Medical Informatics area in the FAC. By the end of 1994, we began with the activities through the ARPAC network, using as platform Windows NT; in 1995 we moved to the Internet, using a server of the CERIDE (CONICET, National Council of Scientific and Technical Research, Santa Fe, Argentina). In 1998 we configured our own server (with GNU/Linux systems - free or open source software, listed in Chart 1).

Chart 1
Software configured in the server

Apache
Mailman
FreeBSD
Majordomo
FTPMail
Perl
Ht://Dig
PHP
IRCD-Hybrid
PostgreSQL
Sendmail

 

Regarding distance Continuing Education in Cardiology (CEE) through the Internet, in 1998 several clinical athenaeums were held, and a work group was established, which had as its objectives:

a.- to carry out a congress of Cardiology to be held completely on the Internet, and
b.- to have an environment established for continuing education on Cardiology through the Internet.

We called the initial work group to join up through the Internet, and the same means, and mailing lists and chat sessions were used to organize the activities.

RESULTS [3-22]
A congress on Cardiology was completely held on the Internet (1st Virtual Congress of Cardiology - FVCC) from October 1st, 1999 to March 31st, 2000. It gathered 7,573 participants, from 95 countries; we received and published in the Web 173 lectures and 419 Brief Communications (accepted from the 517 abstracts received and subjected to peer review). The opinions, input, questions and replies were sent through e-mail, through the bilingual mailing lists. There were discussions in real time, through scheduled Chats, and activities were configured for self-evaluation and recertification (REFACIN - REcertification of FAC through the INternet). In the FVCC the bilingual mailing lists (two of them below ListServ from RedIRIS, Spain) worked through an original circuit, which is displayed in Fig. 1.

Fig. 1: original circuit, configured for bilingual mailing lists. The lists are moderated: the messages, sent whether to the respective address or directly from the windows in the lectures and brief communications, are received by the Moderator. When the content is in agreement with the objectives of the Forum, or those messages received after forwarding them to the lecturers, authors or experts, they are sent to the translators, who finally forward them to the lists. The messages received in Spanish are distributed in Spanish and English, those received in Portuguese are forwarded in Portuguese and English, and those that are written in English are submitted in English and Spanish.

After the FVCC, in a similar way to what happens in a city that has been the site for the Olympic games (where after its fulfillment there is an infrastructure created for the event that remains as an added value), the human and technical resources created for its development were put to work in what was called the Forum of Continuing Education on Cardiology - FECC. Continuing activities were programmed through the permanent Forums (Chart 2; currently there are 20 thematic forums working, directed by Moderators and Coordinators and 8 work forums), and it was decided that a congress would be carried out on the Internet every two years.

Chart 2
Permanent thematic forums of the FECC
Arrhythmias (RedIRIS)
Heart Failure
Basic Sciences
History of Cardiology
Cardiovascular Interventionism
Hypertension
Cardiovascular Nursing
Ischemic Heart Disease
Cardiovascular Pharmacology
Medical Informatics
Cardiovascular Surgery
Nuclear Cardiology
Chagas Disease
Pediatric Cardiology
Clinical Cardiology (RedIRIS)
Sports Cardiology
Echocardiography
Stroke
Epidemiology and Cardiovascular Prevention
Transdisciplinary Cardiology

Between September and November 2001, the 2nd Virtual Congress of Cardiology - SVCC was held, which gathered 11,700 participants from 107 countries, and there were 257 lectures and 193 brief communications published. At the time this paper is being sent (May 2003), we already had for the 3rd Virtual Congress of Cardiology - TVCC (Sept 1st - Nov 30th, 2003), 12,449 registrations from 119 countries (Fig. 2).

Fig. 2:Registrations to the congresses of cardiology carried out on the Internet (figures on the top) and countries of origin (figures on the bottom). Note: the figures of the TVCC are from May 2003.

In the intermediate periods between congresses, two international symposia (SICH 1 - SICH 2), lectures, courses (presential and distance mixed), athenaeums and discussion of cases were developed; besides interconsultations, bibliographical guides and thematic updatings.

There are 14,564 messages exchanged in the thematic mailing lists, with an average of 9.9 daily messages (Fig. 3). In the work lists, there were 10,299 messages, with an average of 8.8 messages per day.

Fig. 3: Distribution of messages in the thematic mailing lists.

During the congresses, besides the thematic lists, there is one enabled for general information (INFO-PCVC), where all the participants are subscribers. Outside the congresses, the forums have 8,445 subscribers (an average of 422 per mailing list).

The permanent work group ("PCVC Group") is multinationally constituted, with members from Argentina, Brazil, Colombia, Cuba, Spain, France, Mexico, Peru, USA and Venezuela.

CONCLUSIONS
We were able to develop and keep, between 1998 and today, a structure and ongoing activities of post-degree distance continuing education through the Internet.

BIBLIOGRAPHY

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Updating: 12/02/2003