AIDS Alert International: Online, "live" educational conferences teach overseas doctors about HIV treatment
AIDS Alert International
Online, "live" educational conferences teach overseas doctors about HIV treatment
A hand icon lets them ask questions
When international funds first became readily available for treating HIV-infected patients in resource-challenged economies, it was clear that many regions lacked trained clinicians for administering HIV antiretroviral treatment.
HIV clinicians and researchers at Massachusetts General Hospital in Boston, MA, decided to address this need through an online teaching conference that could be accessed by any site that had a computer and Internet capability.
Physicians and nurses in sub-Saharan Africa and in other parts of the world have an incredible need for HIV treatment education, says Rajesh Gandhi, MD, director of HIV Clinical Services and Education at Mass General. Gandhi also is an assistant professor of medicine at Harvard Medical School in Boston, MA.
"There's a lot of expansion of treatment programs, but as drugs become available, it's just as important to have training for doctors, nurses, and community educators," Gandhi says. "To use the drugs properly you need to know the side effects, whether patients have used them correctly, whether resistance has developed or co-infections, etc."
Physicians rely on conferences and medical journals to keep them up to date on practices, but in many parts of the world, there are limited opportunities for continued education, Gandhi says.
A practical and relatively simple solution is the HIV Online Provider Education (HOPE), which was developed by Gandhi and co-investigators to provide educational conferences via the Internet. Professors and HIV clinicians in the United States can provide slides and an audio lecture to dozens of doctors across the globe. The virtual attendees can even ask questions in real time, and everyone can hear the answers.
Many HIV researchers visit Africa for their studies and often provide education when they're over there. But this is more sporadic than what is needed.
"We'll give a lecture or be in a conference, but if we have to go to Africa, it's not practical," Gandhi says. "But Internet technologies allow you to link up with up to 40 different sites."
Gandhi and other lecturers can sit at their desks, speak into a microphone that costs from $10 to $20, give their lecture with the visual aides of slides, and reach physicians in Africa, India, the Caribbean, and elsewhere.
"You can show an example of a skin rash or display a diagram of a particular educational point," Gandhi says. "It's a virtual lecture, and it allows us to record these presentations, so if a physician cannot attend one day, he or she can go to the site the next day."
The only requirements for the remote sites are that they have a computer, access to the Internet, speakers, and one of the inexpensive microphones if they wish to be able to ask audible questions.
"More and more places are getting computers," Gandhi notes. "Access is increasing, and even in remote settings they can work over the telephone wires."
Interestingly, technological changes have made it easier and less expensive to provide distance lectures than when these required specialized equipment like a video camera.
"Fifteen years ago, you had to go to a certain room for a telemedicine conference, and the audience needed to be in a certain room," Gandhi says. "In South Africa, India, Rwanda, there might not be an Internet and computer in every room, but there are in most clinics."
HOPE uses Centra, an Internet-conferencing technology, to provide VoIP interactive case conferences.1
When the program first began, clinicians across the globe had very basic HIV treatment educational needs. But as time has gone on, their knowledge has become sophisticated, and so the lectures now reflect that change, Gandhi says.
"Three years ago they had very limited experience in using these drugs in these settings," he explains. "Now in three short years, they're putting thousands of patients on drugs and they're getting much more experience with the basics."
Conferences typically begin with information on a certain subject that interests clinicians in resource-limited settings, such as TB/HIV co-infection, anemia and HIV, identifying a problem with limited available diagnostic tests, etc.1
Many of the current conferences provide in depth, challenging cases, with a dialogue between the lecturers and attendees, he adds.
Some of the lectures' most informative moments are when attendees ask questions, Gandhi says.
A doctor in South Africa or the Dominican Republic can virtually raise his or her hand by pressing on the hand-up icon. The lecturer's computer screen registers the hand-up and identifies the person who has a question by location, Gandhi explains.
"Usually the lecturer will finish his train of thought and say, 'There's a question in Durban, [South Africa],'" Gandhi says.
"Because of the voice and interactivity of the site, you're responding to them in a way that mimics the classroom," he says.
The lectures typically last about an hour and are held twice a month, on the second and fourth Tuesdays of every month, Gandhi says.
"We've been doing it for over three years on every topic from drug toxicity, psychiatric issues, HIV policies, such as HIV and circumcision, HIV prevention, and TB, which is so relevant," he explains.
Investigators plan to improve and expand HOPE to have more collaboration with local experts and faculty, who help to keep the content relevant. They also will be starting a pilot project of a nursing conference for nurses in resource-limited areas, he says.
The program is open to any site that's interested in hearing or teaching the lectures, and there are a number of universities in the United States and the United Kingdom that have joined, as well, Gandhi says.
In the twice-yearly surveys, the feedback about HOPE has been very positive with more than 95 percent of respondents saying that they find the educational content useful, he notes.
"The surveys are where we identified that many nurses were listening to the program and that it would be helpful to have a parallel series for nurses," Gandhi says.
There have been some technical challenges over the past few years, including one site that had such a tight firewall that the lecturers couldn't get through. But the remaining challenges involve language and time differences, he says.
"These lectures are done in English," Gandhi explains. "And if you do a lecture at 8 a.m. in Boston, then in China it's at 8 p.m."
Reference:
- Kiviat AD, et al. HIV online provider education (HOPE): the Internet as a tool for training in HIV medicine. JID. 2007;196(Suppl 3):S512-S515.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.