Web-based academic discussions could well be the way forward for cost-effective and tailored continuing education for health professionals. China’s interactive Orthochina.org wiki project for orthopaedic surgeons is an example of the potential of such internet training for continuing medical education. Zhen-Sheng Ma of the Fourth Military Medical University in Xi’an, China, and his colleagues thoroughly evaluated this online tool and will publish their results¹ in the October issue of Springer’s journal Clinical Orthopaedics and Related Research.
Until recently, the primary vehicle for continuing medical education has been the more traditional conferences and training courses. However, the content of these sorts of courses is not necessarily tailored to meet the individual or immediate needs of professionals and their cost-effectiveness has yet to be established. Created in 1998, Orthochina.org uses an interactive case-based format and is structured using the wiki concept, where the content of the website is created collaboratively by users through an Internet browser. Information in Chinese and English is posted, edited, deleted and updated by carefully screened participants and is academically monitored by its orthopaedic users. Ten years on, the site boasts nearly 34,000 users and counts over 6,000 visits and over 2,000 posts every month.
Real patient cases are submitted for discussion by orthopaedic surgeons. They include the patient’s complaint, findings from physical examinations and relevant images. Professional discussions between participants take place anywhere, anytime, giving suggestions for diagnosis and treatment. Multiple opinions can help the surgeon who has posted his complex case, and is seeking advice on how to treat it, to make an informed decision about his treatment plan.
The authors firmly believe that “surgeon-to-surgeon communication is the most important, the easiest, most closely related to clinical practice, and cost-effective method of patient-problem-orientated continuing medical education.” By using the Internet, orthopaedic surgeons from different backgrounds and geographic locations can work together to enhance their quality of care, something workshops and meetings cannot provide in such a tailored and timely manner.
As a profession that is hampered by practice variation and difficulty adapting (changing) to more evidence based treatemt, I feel physical therapy could really fourish with a similar approach. While we do have great sites to share ideas (EIM, Rehabedge, SomaSimple), often time the forum type format can be disonjointed and hard to follow or return to in the future.
Jason L. Harris
