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Medical Meeting Reports

American College of Surgery Clinical Congress

October 10-15, 1999

font=>By Karen Sandrick

W. William Haines of MD Consult, St. Louis, Missouri, provided an overview of online surgical education sites from established CME publishers.

Few Sites Devoted to Surgery

Compared with other specialty CME on the Internet, there are few sites devoted to surgery, and many sites have limited information. Most sites are highly focused, and most are free. The quality of information the sites provide is mixed, however, and the credibility of the information is not always readily apparent. Increasing numbers of sites are using videos of surgical procedures. Videos are not exceptionally sharp, however, because of the low bandwidth of modem connections.

Specific Surgical Sites

The Online Atlas of Surgery from Wake Forest University (bgsm.edu) is still in development; at the present time, only five laparoscopic procedures are online. The format for each of the procedures includes illustrations as well as text, and all follow a similar format -- introduction, a set-up diagram, illustrations, and narrative.

Virtual OR (thevirtualor.com) also presents surgical procedures. The site offers only a few cardiac procedures at this time, complete with videos.

Virtual Hospital (vh.org) is a pioneering site created by the University of Iowa. Virtual Hospital provides information across several specialties. For surgery, the site includes five multimedia textbooks on surgical topics with photos and narrative.

Healthstream (healthstreamuniversity.com) is a major provider of CME content. It has just opened a surgery center within the site that has one online program. Healthstream charges $10 for every CME hour, which is the going rate for online CME.

Medscape (medscape.com) is a broad-based site that offers information across a wide spectrum of specialties. It has news about surgical topics, links to practice guidelines and surgical journals, some of which are not on the Index Medicus. Medscape also has summaries of clinical conferences as well as a CME testing capability. Surgeons may take a multiple-choice CME test after reviewing the material from a clinical conference and receive feedback on their performance.

Virtual Symposia from Physicians Homepage is a website from the Silverplatter CME publishing company (cme.silverplatter.com). It recaps clinical conferences and includes actual audio and slides. Surgeons may gain CME credit at a cost of $12 per hour. Virtual Symposia has only a few conferences on surgically related topics.

Vesalius (vesalius.com) provides short educational narratives on surgical anatomy and procedures. It has more than 1,000 photos and radiographs in its archives, and these illustrations can be annotated through the site's drag and drop feature. Narratives provide anatomical context for surgical procedures, and images of anatomy are constructed so the surgeon can proceed layer by layer through the body.

Index-Related Sites

Emory University has MedWeb (medweb.emory.edu) which contains a variety of links to other online sites and a search engine so surgeons can explore each of those sites.

Medical Matrix (medmatrix.org) categorizes sites across a broad spectrum of clinical specialties, including surgery. The site provides an abstract or synopsis of what is available on each of the sites as well as a ranking. Information on the site is not always up-to-date, however. Medical Matrix lists about 130 sites related to surgery.

Other Sites

Pubmed (ncbi.nhm.nih.gov) of the National Library of Medicine, which provides access to Medline, is testing a new feature that will link journal citations from the Medline database to CME publishers' sites so surgeons can get full text copies of specific articles. MDConsult (mdconsult.com) focuses on primary care but also includes some information about surgery, including a textbook on surgery, articles from surgical journals, and clinical practice guidelines from a number of surgical societies.

CME Publishers' Perspectives

Haines stated that, from the point of view of CME publishers, the interest in online CME is more expressed than real for three principal reasons: physicians have a wide variety of offline opportunities to gain CME credit; they do not have access to clear video formats; and they are not willing to pay for online CME. Haines believes, however, that CME publishers will be less willing to offer full text articles for free in the future. Journal publishers will be requiring subscription access and payment by the byte for content, he said, so they can protect the economic models of their print publications.

Ortho Biotech

Funded through an unrestricted educational grant by Ortho Biotech.

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