Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Contribution to the Internet Congress Informedica 2002 “Paving the way to the global e-health” www.informedica.org/2002

Dr Marcelo Sosa Iudicissa European Parliament

STOAScientific and Technological Options Assessment

The e-Learning Paradigm for Health

Professionals

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Presentation, Justification 1

¿why have I been given the priviledge of making this presentation to you?

• Due to the kind invitation of Dr Nora Oliveri- who deserves all our recognition and thanks- and should be congratulated for her initiatives and projects such as Informedica 2002

• I want to express my satisfaction- for being able to contribute to such a fascinating on-line event- its format is anticipating a future that “is already here”

•

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

• ..of my professional education (what I have learned / apprehended)in medicine, public health, informatics, telecommunication

• ..of my work experiences (what I have done) family medicine, teaching, Univ of Buenos Aires, National School of Public Health, Madrid; researcher, information systems and new technologies; scientific officer, AIM-Health Telematics program, European Commission; director, National Library of Health Sciences of Spain; advisor on telemedicine, National Health Institute Carlos III, Madrid; director, electronic commerce association, consultant and entrepreneur of Internet projects; responsible, science office (STOA) of the European Parliament in Brussels

…I have the priviledge of presenting my ideas, maybe because...Presentation, Justification 2

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

As a result of all the above.. Who am I?a teacher, a researcher, an advisor, an author, an expert, a scientist?

The responsibility attached to a label is very high a toll!

I prefer to say no to all those labels!, but in fact, I think I am a random mixture of a little bit of all the above thingsThis has some advantages: a multidisciplinary vision, eclecticism, few sect fidelities, indiference of dogma, humbleness, curiosity, pleasure for learning, teaching, and sharing...

Presentation, Justification 3

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

• aesthetic context chossenThis presentation’s background is a papyrus, deserved hommage to the ancestor of paper, the medium that has made possible the collection and transmission of knowledge, now that we enter the electronic era, masterfuly summarised by professor Ron LaPorte from Pittsburgh University, in the powerfull idea:

“P-P-P, From Papyrus-To Paper-To PowerPoint”.

Presentation, Justification 4

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Educating health professionals• let’s avoid definitions- what matters: we all row in the same direction, together- a literary licence: “medicine”

embraces many disciplines

• it is sciencie and art- this has consequences and requisites

• implies personal and social power - which brings along exigencies and responsabilities

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Paradigms• Thomas Kuhn- The structure of scientific revolutions, 1970

• Pedro Laín: Greek teckhne- History of Medicine main phases: spontaneous – empiric - magic – technicalwe are at the culmen of an era of technical medicine that started in the Golden Century in ancient Greece

• Know what and know how to in medicine- Knowledge has allways developed in the context of great schools (Isle of Kos, Salerno, Montpellier, and many others)

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Traditional Paradigm• Concentration of knowledge- Isle of Kos, Ispahan, school of Salerno, etc

• Personalization of knowledge- Masters: Hippocrates - Avicena – Maimonides - Sydenham

• The aprenticeship of the art- Commitment, sacrifices, effort, priviledge • Knowledge as an scarce good- Transmission is necessarily personalized

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Educating a professional• Transmmiting knowledge- To know - Intellectual Component

• Acquire skills and habilities- To know how - Operative Component

• Acquire and develope attitudes - “Hows” and “Whys”- Emotional and Moral Component

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Labs

Industry

Universities

Hospitals

Etc

Knowledge CycleLibraries ---> Internet

Traditional printed medium: books and journals

Electronic medium: discs and on-line resources

Publications

Congresses

Committees

Shadow colleges

Etc

Generation

Universities

Hospitals

Health Centers

Special schools

EtcHistoric collection

Education

Transmission

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Data

Information Hierachy

Discrete values; must be correct and precise; required in massive amounts; of scarce value when isolated.

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

• Information

• Data

Sets of data put in relation between each other, they acquire new

meanings and operative value on reality

Information Hierachy

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

• Knowledge

• Information

• Data

Experience building up

from analysis and synthesis of information

Information Hierachy

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

• Wisdom or Intelligence

• Knowledge

• Information

• Data

Zenit

Information Hierachy

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

“In his book on the Internet, Telematics and Health, Marcelo Sosa writes ofinformation as the cornerstone of medical sciences and pays tribute tothat information giant Dr. Hector Sosa Padilla, who was a pioneer in assisting PAHO in development of information systems. Dr. Sosa Padilla is quoted thus:

Information & Knowledge

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Information Sources in Health Sciences• Primary sources example:

article in BMJ- Books- Articles- Reports- Contributions to meetings- etc.

These concepts, managed by information and documentation sciences in the last decades, are strongly affected by the new realities opened up by the Internet; however, it is advisable to bear them in mind as a scheme on sources hierarchy.

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Is there an information problem in medicine?

• Information explosion-15 million “facts” must a medical student learn-1990-91 = 50,000 articles in gastroenterology-250,000 art. Every 2 years, 342 / day, 4.2 /min.

• “Facts” that are not factsp.e. apendicitis and pain localization

• The imprecission of medical language

F. T. de Dombal, 1993

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Principal Ideas:* Information Society* Employment, Growth, Competitiveness

Main milestones:* 1993-"Delors white book“* 1994-"Bangemann Report“* 1994-98 -Priority to ICT and Telematics R&D

Principal Iniciatives and Projects:* Action Plan* Priority in Framework Programs: IV-V-VI* Trans-European Telecom Networks* ISPO* E-Europe – e-Health Europe

www.cordis.lu

Iniciatives on telematics & health

European Union

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

- AIM (Advanced Informatics in Medicine): II Framework Program (FP) / 1989-1990, 42 projects, 22 MEcus- Healthcare Telematics: III FP / 1991-1993, 50 projects, 105 MEcus- Telematics Applications - Health: IV FP / 1994-1998, +120 projects R+D+Validation,140 MEcus- IST-Information Society Technologies - Systems and services for the citizen - Health V FP / 1999-2003 +250 MEuros- Continuation in VI FP / 2002-2005

R&D on health telematics

European Union

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

The long march of EU R&D(*)

1984 1986 1988 1990 1992 1994 1996 1998 2000

BICEPS

AIM

TELEMATICSTELEMATICSAPPLICATIONSAPPLICATIONS

II FPIII PM

IVPM

AIMEuroforum

Seville

Lisbon Conference

Barcelona Conference

V FP

Services for Citizens

Bangeman Report

INFORMATION SOCIETY

(*): R&D, research and development

TELEMATICSTELEMATICSAPPLICATIONSAPPLICATIONS

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Examples of Projects

• CHIC (Health information regional models)• HECTOR (emergencies-Telemedicine)• PROREC (Electronic Health Records)• CoCo ( Regional Networks)• IT-EDUCTRA (Health Professionals

Education and Training)• WIDENET Creation of the European Health

Records Institute EUROREC• MOBIDEV Mobile Comunications in

healthcare

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Education and Training for Health Informatics in EuropeState of the Art - Guidelines - ApplicationsEdited by: A. Hasman , A. Albert , P. Wainwright , R. Klar and M. Sosa 1995, 286 pp., hardcover ISBN: 90 5199 234 3

EductraConcerted action,started in 1992 with 12 countries of the then European Community

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

“...general guidelines for European curricula in health informatics as they were developed and elaborated by the members of the EDUCTRA Concerned Action (1992-1994). The third part of this volume entails the detailed descriptions and applications of curricula in health informatics in European states”

Eductra

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Information Society• Informatics Revolution: transistor, printed

circuits, microprocessor, PCs, Moor’s law, CD-ROM, DVD, operating systems and software

• Telecom Revolution: transmission via satellites, digitalization of basic telephony, local networks, ISDN, broadband technologies, fiber optics, mobile telephony, GSM (European success story), cable TV, videoconference, residential DSL

• Internet Revolution: open standard, data packets commutation, collaborative efforts, servers, electronic mail and WWW, platform for convergence, e-commerce

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

• Liberalization of telecommunications, universal access and tariff reductions

• From data processing to knowledge access through multimedia information

• Development of workgroup, distant learning, teleworking and telemedicine

• Massive creation of new products, services and electronic businesses of Internet-based companies

• Emergence of a new model of a digital economy

Information Society: Trends

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Electronic HealtheHealth eHealth

HealthInternet

New Paradigms

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Citizens Trends• Higher economic possibilities and

prospects of individual and family achievements

• Welfare state culture • Better levels of information and more

critical attitudes• Desire of more personal, family and

social autonomy• Higher level of exigence of public

services (infraestructures, transport, media, health care...)

“Empowerment”

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Health: Trends• Influence of the media and the Internet

• Sociological changes in the health professions

• Changes in the physician-patient relation, braking away from authoritarian and paternalistis schemes

• Changes in the relation between users and health care services, as a consequence of social changes

• Appearance of a tax-payer concience and an informed consumer attitude

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Electronic Learninge-Learning e-Learning

EducationInternet

New Paradigms

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Learners Trends• Posibilities of better vocational

achievements• Broad educational supply with great

ramifications of thematic areas• Better possibilities of geographic

mobility for all. In Europe: 1 million university students have beneffited from the Erasmus program (one year in a foreing university)

“Learning Empowerment”

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Education: Trends• Influencie of the media and the Internet

• Sociologic changes in the education professions

• Changes in the learner-teacher relations, braking away from authoritarian and paternalistic models

• Changes in the relation between users and educational establishments, as a consequence of social changes

• Emergence of a conscience of tax-payer and informed consumer

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Pioneers

Dr Francis Timothy de Dombal

England,

1937-1995

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Internet, Telematics and HealthMarcelo Sosa-Iudicissa, Nora Oliveri, Carlos Gamboa, Jean Roberts 1997, 556 pp., hardcover plus CD-ROM ISBN: 90 5199 289 0

PioneersContributions from Tim de Dombal, Ron LaPorte and other distinguished professionals totaling up to 80 authors from 22 countries.

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

PioneersF.T. De Dombal, J.R. Hartley, D.H. Sleeman:A Computer-assisted system for Learning Clinical Diagnosis.

The Lancet. Medical Education

18 January 1969

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Pioneers

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

• Massive utilization of basic information repositories. Example: Pittsburgh University Supercourse

• Use of simulation environments, virtual reality and immersion environments

• Videoconference from any where to any where, from one-to-one, from one-to-many, or from many-to-many

• Development of tools based on artificiall intelligence engines and knowledge databases

New developments

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Emerging Paradigm• Education and training along the whole life

• Without barriers of time or place

• Access to best knowledge whereever it is located

• Possibility for all to be readers and writers, students and teachers

• Utilization of all technologies available, at present or in the future, for accessing contents and learning experiences

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

The Knowledge Society

• We build it up together

• For the benefit of all

Nov 2002 – Dr Marcelo SosaNov 2002 – Dr Marcelo SosaE-Learning Paradigm for Health ProfessionalsE-Learning Paradigm for Health Professionals

Many thanks for your interest to all participants of Informedica 2002 and the Supercourse who have read this presentation. Your opinions or comments are welcomed.Dr Marcelo Sosa-IudicissaMSosa@EuroParl.EU.int