Obstetrics & Gynecology

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5 Νοε 2013 (πριν από 3 χρόνια και 8 μήνες)

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Obstetrics & Gynecology
Resources on the Internet

Krishna B. Singh, MD

Department of Obstetrics & Gynecology

LSU Health Sciences Center

Shreveport, LA

Learning Objectives

After viewing this slide show, you
should be able to...

-

understand

Web
-
based applications and Internet

-

name two
advantages

of online learning

-

list

two
disadvantages

of the above

-

browse the website

of the department

The contents of these slides are provided for educational purposes only. Trademarks for the
companies, products and services listed here are held by their respective trademark owners.
Conflict of interest by the author: None.


Internet: Literature Review


1969 ARPANET: the Department of Defense


1970’s Networking tools: Telnet, Usenet, FTP


1980’s TCP/IP standardized; PC’s & Macintoshes


1990’s Web technology; Smart browsers


The Year of the Internet (1998)


Academic world evaluating potentials


Technology takes a tremendous leap!

ARPA means Advanced Research Projects Agency; Became DARPA in the mid ‘70s. The Web
went online in 1992: > 200 servers (1993), > 6.5 millions servers (1995). Hundred+ millions world
-
wide. In the last
four years

in the United States alone, the Internet has grown by 31,000 percent.


Growth of the Internet


The world’s largest computer network, “network of
networks” or “cyberspace”


Millions of all types of computers are connected


Highly disorganized, unstructured, widely distributed


Information may not be up to date or accurate


Different tools for accessing different types of
information

The Internet: What Is It?

In 1994, about 3 million people worldwide used the Internet.

In 1997, ~16 million people in
USA (43% of 40 million Internet users) used the Internet for
obtaining medical information
,
mostly (~80%) got information from the medical centers. In 2002, more than 160 million
people in USA had Internet access;
more than 100 thousand health sites were available!

What Internet Tools to Use?


Internet tools you can use are listed below:


E
-
mail and mailing lists: the most common tools


The World Wide Web: the multimedia version of the Internet


File Transfer Protocol (FTP): transfers files between computers


Listservs are discussion groups via E
-
mail


Newsgroups is a network of discussion forums (Usenet)


Internet Relay Chat (IRC) is a virtual meeting place


Gopher is a menu system to find Internet resources


Telnet allows you to connect to remote computers

What Is the World Wide Web?

Key points to Remember


A new tool to provide and access information on the Internet


Based on Hypertext Markup Language (HTML) and HTTP
(Hypertext Transfer Protocol); DHTTP (D=Dynamic)*


Non
-
linear, flexible, and easy to use


The multimedia version of the Internet


Platform independent;
browser dependent
. Our Web site has
been
optimized

for Netscape© version 4.0 or later

*The recent trend in Web authoring is toward using DHTTP and scripting to increase
interactivity. In future, Extensible Markup Language (XML) would be widely used for this
purpose.

How the Web Works?



The Web presents information as a series of "documents" often referred to as
Web pages, that are prepared using the Hypertext Markup Language (HTML).



Using HTML, the author can specially code sections of the document to "point"
to other information resources. These specially coded sections are referred to as
hypertext links
.



Users viewing the Web page can select the hypertext link and retrieve or
connect to the information resource that the link provides.

What Is the Web Language?

The Web is the universe of information available via hypertext transfer protocol
(HTTP) of the Internet.


The HTML (language, to write the page) and HTTP (protocol, to transfer the info)
together will allow to:




create "links" from one piece of information to another



incorporate references to graphics, sounds, and movies



"understand" other Internet protocols, such as FTP


What Are Web Links?

Using
smart browsers
, hypertext
"links" can lead you to other
linked text documents, images,
graphics, animations, audio and
video files and databases (like
library catalogs). You don’t type
URLs anymore, everything
happens in the background!


This sample Web page is from the Smithsonian Institute.

How the Web Uses Links?

The Web links can incorporate graphics and "understand" other Internet protocols; it
can provide an easy
-
to
-
use interface for resources available via these protocols.

Web page

link

link

link

Gopher site
with images,
sounds, text

Library Catalogs

(Telnet)

Software Repository

(ftp)

What Is Surfing the Web?

The Web is
non
-
linear
, which means you do not have to follow a hierarchical path to
information resources. Simple
steps for browsing

and searching the Web are:



Go directly to the Uniform Resource Locator (URL) box, and type the address:

http://obg.lsumc.edu/obg/index.html



You can then jump from one link (resource) to another:

External link

Internal link

What Is Multimedia Web?

Because the Web is not
hierarchical and can handle
graphics, it offers a great
deal of flexibility in the way
information resources can
be organized, presented,
and described to you!

Site maps are down and dirty tools for navigation on the Web.
For a more efficient navigation, you’ll use the navigation bar.


What Technology Provides?


Web Tools & Techniques


Dynamic Text: uses cascading style sheets


Graphics/Images (GIF, JPEG)


3D Animation (Vector graphics)


Streaming Audio & Video


Virtual Reality Mode: learn laparoscopy


Interactive Applications (CAI, CAL, CAT)


Decision Support & Expert Systems


Hybrid Technology:

CD
-
ROM+ Internet


Harrison’s Principles of Internal Medicine. From our
Web site, go to the library, and click on
Harrison’s
Online
. Simply click on the link to save time

Web
-
based Education Online


Teaching Medicine On the Net/Web


Curriculum administration & content


Electronic Medical Records & teaching files


Electronic publications & online libraries


Lectures on demand (virtual university)


Best of the Net
-

Women’s Health Care


Women’s Health Care: Yahoo! WebMD.com


AMA, ACOG
-

committee opinions;
bulletins; guidelines for women’s health
care


Government: CDC; Healthfinder provides
topic
-
specific site


Medical Centers provide useful information

What Key Advantages?


Examples of Web
-
based Curricula/Sites


Distance learning: Virtual Hospital @ University of Utah


Dynamic interactive learning: CD
-
ROM+ Internet


Interactive communication: Utah, Iowa, CA, NC, TX


Organizations: AMA, ACOG, AMIA, AAMC


Instant access resources: ClinWeb, MedWorld


Collaborative materials among teaching centers


Future Challenges for the Academic World


Technical issues: bandwidth, standardization


Attitude problems
-

faculty, students, admin


About 75% K
-
12 schools are wired for the Internet, but only 15% of the teachers would use
the Net in the class room. Study shows
83% medical schools

provide computer training to
students (AAMC 1998).


The Internet On Steroids

Summary So Far…

The World Wide Web is a system, based on hypertext and HTTP, for
providing, organizing, and accessing a wide variety of resources (text,
images, sound, video) that are available via the Internet. The Web is a
multimedia version of the Internet.


The
advantages

of the Web
-
based learning are its flexibility in organizing
and presenting information, its non
-
hierarchical easy
-
to
-
navigate
structure, its ability to handle and "understand" many different file formats
and Internet protocols, and its overall ease of use. There are only a few
disadvantages

related to logistics but
not related to technology

and tools!

USA Physicians Online


Physicians Online Computing


E
-
mail: used for research, communication


The World Wide Web: to search databases


Newsgroups; Listserve for specific information


File Transfer Protocol (FTP) for huge files


Internet Relay Chat (IRC), Forums


Others
-

Videoconferencing; NetMeeting.


Computers In Medicine JAMA
280
; 1289: 1998


Attitudes and practices of physicians


Quality of information on the Internet


Guidelines for creating a Web site




Internet use in USA is growing rapidly: enormous quantity, but variable quality (JAMA 1997).
Guidelines for electronic publishing and E
-
mail for patient care published (1998).

Surveys About MD Online

American Healthcare Survey (1997)


About 300 physicians interviewed nationwide


Only 43% had used the Internet (25
-
30%)


About half believed online information was of high quality


But only 39% believed information was useful


Some 75% physicians thought highly of forums


Other recent surveys: AMA, Harris poll, Boston Group

Why aren’t more
physicians

going online?
Answer:

lack of time, lack of PC skills and
knowledge (KAP studies of students, residents, physicians).

Web Portals And Gateways

WebMD/medscape

-

http://www.webmd.com/

UpToDate
-

http://www.uptodate.com

The Web is a jungle, you will need
a road map. Surfing is easy, but
finding specific information on the
Internet is another story. Learn
some tricks for surfing and
navigation

by visiting our Web
site!

Gateways and portals provide “everything” that you need on a given topic: Medical
news, medline, new items, journals, CME, consultations, assistance and answers to
Frequently Asked Questions (FAQs).

Advantages of eLearning


Linked resources on different academic sites


Efficient way for delivering course materials


3A letter words: Any time, Any where, Anything!


Student centered learning vs. teacher focused


Supporting and complementary to traditional


Distant global audience, the intranet or VPN


Interactive synchronous or asynchronous

Power of PowerPoint

Thirty million lectures created daily; 250 million posted on the Web.
Click here
.

Limitations of eLearning


Access to computers, internet service providers


Multimedia websites with audio, video, simulations


Asynchronous learning experience can be frustrating


Infrastructure of website design, website applications


Information quality, content and timely postings @ websites


Students need basic computer skills, support and guidance


Awareness of the value of distance learning among faculty!


The Future Challenges


Higher bandwidth and throughput


DSL; T1 and T3; cable; satellite;
remote wireless access


Greater user friendly and smart technology, “push technology” such as
PointCast®


Security and copyright issues: signatures, validation, cash transactions
for billings and collections (HIPPA compliant)


Graphic Interface and Virtual Reality Domains (SUN, Silicon Graphics)


Virtual university, hospitals, clinics, and doctor’s offices


Hospital Information System (HIS) with integrated EMR


Web integration with TV and DVD/VCR for edutainment


Faster, smarter, and more user friendly computers/browsers

Departmental Website Design


The following items were selected for postings


Obstetrics & Gynecology Databases


Women’s Health Care Websites


Reproductive Medicine Websites


Gynecologic Oncology Websites


Maternal Fetal Medicine Websites


Medical Informatics Websites


Organizations & Institutions


Events & Announcements


Interactive Learning Modules

Methods and Materials:

Online academic resources provided basic materials for building the
infrastructure of our Web site at:
http://obg.lsumc.edu/obg/index.html
.

Website Growth 1998
-
2002

0
10,000
20,000
30,000
40,000
50,000
60,000
Jan 01/01/1998
Dec 12/03/1998
Nov 11/04/1999
Oct 10/05/2000
Sep 09/06/2001
Aug 08/08/2002
Jul 07/10/2003
Jun 06/10/2004
May 05/12/2005
Apr 04/13/2006
Visits
Visits
Visits
Jan 01/01/1998 - Dec 12/31/2002 (10 Year Scale)
This was our Home page in 1997.
Please browse the current edition, and enjoy!

Internet/Web Summary



Content is the king, not the technology


Tons of resources on the Internet/Web*


Many ways of accessing information


Accuracy (?) but guidelines available


May be outdated (?) so look carefully


Remember the real world situations :
-
(


Future potentials are looking great!

*T
he purpose for designing our site is to support learning resources for MS III, residents and
practicing physicians, according to established guidelines (see the
Disclaimer

page).