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ORIGIN AND CHARACTERISTICS OF THE PROJECT.
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Origin |
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Objective |
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Description |
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Participants |
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Results |
Origin.
The systems traditionally used by physicians to update their knowledge, such as attending conferences or subscribing to medical publications in their fields, are no longer enough in a world in which there exist more than 30.000 medical publications, the best 4000 thereof publishing more than 400.000 articles each year, and where only 15% of which follow a scientific methodology which is sufficiently correct to guarantee the reliabilty of results.
Physicians understand the need to keep their knowledge up to date and they attempt to do so, but few are versed in the handling of modern computerized methods which are indispensable for handling such a volume of data. Likewise, most of them are unaware of the methods which enable a speedy screening of the information based on scientific quality, in order to select reliable articles that are worthy of study.
Lastly, health care pressure means that often the physician does not have sufficient time to review the hundreds of thousands of articles published each year, to identify those referring to his/her specialty, to evaluate the scientific quality in order to reject those whose results could be counterproductive due to having been obtained via a scientifically incorrect methodology and, finally, to study those selected in detail.
Objective.
The objective of this project is to provide health care professionals with the minimum knowledge by:
a) Having access to the scientific articles published each year in the most important medical journals in the world, and identifying those which may interest each physician and refers to his/her specialty.
b) Quickly evaluating the methodological quality of such articles, with the aim of selecting and studying only data which are reliable through scientific validation.
If it is posible to access all the information and to quickly select that which is relevant and reliable, it is then possible to update knowledge in a suitable manner with less effort and at lower cost.
Characteristics.
The Kovacs Foundation decided to organize a pilot program designed for the physicians of the Balearic Islands. It consisted of the organization of seminars aimed not at transforming the attendees into expert reseachers but at providing the minimum essential information to enable a suitable update of knowledge.
The Kovacs Foundation took the necessary steps to ensure that the seminars were attractive and useful for the physicians.
In order to render them attractive, the Foundation:
1) Selected the agenda based on the priority interests of the physicians. A questionnaire was sent to all the physicians in the Balearic Islands asking which of the following topics were of interest to them:
-Access to biomedical scientific knowledge.
-Location of Medline articles.
-Creation and handling of personal bibliographic databases via the Reference Manager.
-Internet Application on Health Sciences.
-Electronic mail and World Wide Web.
-Internet hands-on workshop.
-Basic concepts in epidemiology.
-Efficiency and effectiveness studies.
-Clinical decision making.
-Assessment of health care technology.
-Research design.
-Clinical tests and effectiveness studies on treatments.
-Critical appreciation of clinical tests.
-Evaluation of diagnostic procedures.
-Basic concepts on statistics.
-Advanced statstics: (I): Multivariate analysis. Multiple regression.
-Advanced statistics: (II): Multivariate analysis. Logistic regression.
-Advanced statistics: (III): survival analysis. Cox regression.
-Analysis of health care data via the SPSS I program.
-Analysis of health care data via the SPSS II program.
-Analysis of health care data via the SPSS III program.
-Methodology of scientific communication.
-Introduction and use of the PowerPoint presentation program.
-Teaching methodology.
-Introduction to Windows 95/98.
-Advanced use of Windows 95/98.
2) Offered physicians the opportunity to add subjects of interest that were not included in the proposed list.
3) Insisted in the practical and brief nature of the seminars. The duration of most of them has been of less than 10 hours. The idea was to transmit indispensable knowledge in a practical way and organize other more specialized and equally short seminars for whomever wished to study the subject in more depth.
4) Organized the seminars to suit the pupils; the dates and timetables of each one was set depending on the attendees' preferences, in order to facilitate attendance. Moreover, the Foundation and Sa Nostra-Caixa de Balears funded the project, so that the price to be paid by the pupil represented around 20% of the cost.
In order to ensure their usefulnes, the Foundation:
1) Hired experts as teachers who, in addition to possessing theoretical knowledge, also have to apply this on a daily basis in their professional activity.
2) Included the collaboration of clinical advisors. These, selected from among the most prestigious health care physicians in the region, identified the most current and controversial issues in their respective specialties, which were used as examples to identify studies and assess their scientific quality duing the seminars.
In order to enable the Foundation to assess their own work, all participants in each of the seminars filled out an anonymous questionnaire at the end. The organization, infrastructure used, available resources, the teaching staff, contents of the programme and practical applicability of each of the seminars was rated therein on a scale from 0 to 10. They were also asked for suggestions to improve future versions of the seminars each person had attended.
Participants in the project:
Participants in the Project, upon invitation by the Kovacs Foundation, included the Council of Health of the Balearic Government, the University, the INSALUD (National Institute for Health), the Academy of Medical Sciences and the Associations of Physicians of the Balearic Islands, and was co-funded by the Kovacs Foundation and Sa Nostra-Caixa de Balears.
Results:
The project was an overall success, both in terms of the number of pupils as in terms of the evaluation they made of the seminars. The number of registrations for the seminars was approximately equal to 15% of all member physicians of the Association of Physicians of the Balearic Islands.
In the light of the success of the first round of seminars, in 1996 the seminars were made available to other health care profesionals, as well as to physicians, such as chemists, veterinarians, psychologists, nurses and physiotherapists during 1997, 1998 and 1999.
On a scale of 0 to 10, in which 10 represents the highest possible score, the average ratings allocated to each aspect of the seminars held between September 1996 and January of the year 2000 have been the following: Organization: 8.58, Infrastructure: 8.11, Resources: 8.63, Teaching staff: 9.09, Progamme content: 8.87, applicability: 8.20.