A Program For Electronic Medical Education In Colombia, Educacion
Electronica Estructurada (E3†): A Succesful Experience
Rafael E Riveros, M.D*; Andres Isaza, M.D¥; Andres Espinosa, M.D•Ý ; Felipe Lobelo, M.D.;
Susana Pacheco, MS III; Ridda Younes, MS III.
Information Technology Dept., Mu’tah University, P. O. Box 7, Mu’tah Al-Karak, Jordan
Email: † Medical Education Research Group; School of Medicine, Universidad Colegio Mayor de Nuestra Señora del Rosario. Bogota, Colombia.
* Chairman, Department of Surgery ¥ Coordinator, Medical Education Research Group •Ý Coordinator, Medical Informatics Unit
. Coordinator, Virtual Education Project; Research Office
“We believe that ICT in medical education is not only
a tool, but a goal”
Medical education in Colombia remains, almost completely, with the
physical presence of the lecturer in the classroom. In recent years, new
alternatives in higher education have been explored, on a balanced
basis. Our faculty traditionally remains teaching with conservative
methods; therefore, strategies for incorporating informatics, virtual
education and in general, electronics are vital in our academic
environment. Our electronic medical education group, E3, is
constituted by faculty, undergraduate and graduate students.
E3 was designed to provide the urgent need to develop an appropriate
scenario for a group of faculty and students who will provide the
school with clear cut policies and strategies, to establish a permanent
and dynamic program of ICT locally, institutionally and regionally.
The project, enveloped in the objectives of E3 includes: Electronic
Academic Contents (EAC), Virtual Education Project (VEP) and
Electronic Clinical Record (ECR).
We will improve and increase, by the end of 2003, electronic medical
education at our School and radiate to the University and the academic
Key Words: E3, ICT, Electronic Academic Contents, Virtual
Education Project, Electronic Clinical Record
The increasing use of information technology (ICT) in common life
has led recent generations of students and teachers to realize that
informatics are vital in the construction of the medical doctor . In
the aim of providing politics, tools, and planning of ICT facilities in
our Medical School and profiting from the current efforts on this issue,
(EAC) led by one of the authors (AI) E3 was created.
There have been sporadic efforts  in our country to approach the use
of ICT in higher education. Unfortunately the general trend  is still
in germinal status.
To date, the most common informatics tools currently in use are virtual
libraries, general Medical websites, Medical School websites and
multimedia resources. In general, our students do not have an effective
approach to electronic facilities in situ or at home, in contrast with
most of American and European medical programs .
We believe that ICT in medical education is not only a tool, but a goal,
in order to construct a better individual, a better doctor, aware of the
current need to have access to better and more information via
Our University will be 350 years old this year. It is known at the cradle
of the Republic since at Rosario University is were independence of
the country started. Our motto, “nova et vetera” or “the new and the
old” impulses awareness of the advances in academics be them
formative or in research.
ICT embraces both universes, having always as common denominator
tutorial and mentorial education.
Currently our School has a number of informatic tools that have
progressively been used by students and teachers. Our main objective
is to boost the use of electronic tools initially in undergraduate and
then in graduate medical programs radiated to the University and then
to the academic community locally and regionally To date we have a
versatile website (www.urosario.edu.co) link to http://
medicina.urosario.edu.co which contains the Medical School’s general
Our medical library offers access to electronic journals through three
supplying companies. Access is privileged to our students, faculty and
alumni who have individual passwords.
E3 was designed to provide the urgent need to develop an appropriate
scenario for a group of faculty and students who will provide the
school with clear cut policies and strategies to establish a permanent
and dynamic program of ICT.
New projects in E3 are in progress and their objective is to develop
strategies that will help medical students and physicians to handle
current biomedical information in the benefit of patients, themselves
and the community via ICT. This project enveloped in the objectives of
• Electronic Academic Contents (EAC)
• Virtual Education Project (VEP)
• Electronic Clinical Record (ECR)
Electronic medical contents (EAC) was designed by one of the authors
(AI) in the Department of Surgery, to encourage written electronic
material from MS; it has grown as an electronic medical education
tool, amenable to permanent and sequential modification. MS will
write the narrative of academic sessions which will be then reviewed
and edited by the teacher. The document is then posted in our website,
available to privilege academic community (students, faculty and
Since MD’s have a one year obligatory rural service, Virtual Education
Project (VEP) will provide valid information via virtual lectures in two
areas in 2003: Toxicology and Forensic Sciences. It will also serve as a
permanent channel for consultation from the rural MD’s to the medical
school based and affiliated institutions.
Additionally, (VEP) will develop seminars on “Virtual Classrooms” in
current medical subjects aiming to provide continued medical
education for our general practitioners Electronic Clinical Record
(ECR) project is designed to provide medical institutions with an
interactive electronic frame to develop data to fill out the individual
clinical record. It will serve not only for academic purposes but for
financial savings in budget, planning and projection of the general
health services in affiliated and non affiliated institutions.
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E3 is consistent with the University’s Mission, Vision and planning
programs. ICT as we know it is planned on a medium term basis due to
the rapid advances in electronics. In coherence, we plan with 1 year
ahead. Our compromise is to be the number one school in electronic
medical education in Colombia.
2. PROGRAM OVERVIEW
EAC project shares five academic scenarios for
MS and teachers namely:
Step 1: Topic assignation.
All Students will be assigned individual topics in the academic
program to develop step 4.
Step 2: e-guides
Pre-session (e-guides) in which the teacher will
provide the following information:
3- Questions to be answered by the student
5- Teacher’s e-mail and name.
6- Review Date.
The e-guide is then posted, on the website in the
specific academic electronic contents link of each
department for the students to prepare for the
Step 3. The academic session
The lecture will then be an interactive participative and conclusive
experience based on auto-education from the MS part and guidance of
the session by the teacher. The assigned student to write the “narrative”
will take notes during class.
Step 4. The “narrative”
The assigned student will write the narrative based on three sources;
first, information derived for the search objectives and bibliography
suggested in the e-guide, second the development of evidence-based
information and valid remarks, and third, a second systematic
bibliographical search, derived from the academic session.
“Narrative” structure in clinical sciences is:
Signs and symptoms
Diagnostic Confirmation (Imagenology and Labs)
Current therapeutic approaches
Step 5. Review, editing and definitive posting.
The teacher will review the material contained in the “narrative” and
will validate it with biographical and self-experience information to
produce the definitive document that will be posted in the website.
This narrative will serve as the basic tool to be reviewed by the
assigned student in the next semester.
VEP will work on two scenarios:
1. Virtual education aimed at rural doctors during 2003 on two
B- Forensic Sciences.
These two topics will be developed in three
• Pre-chat session: one month prior to the information the
participant will receive pertinent literature on the topic to be
• Chat session: The coordinating teacher will moderate a 2
hour chat- session in an introduction, Questions and answers
• Post-chat session: two weeks after the chat session a
definitive document will be distributed to the participants
with an evaluation form. And electronic certificate will be
2. “Virtual Classrooms”. The medical school will work
collaboratively with ILADIBA (Instituto Latinoamericano de
Investigaciones Biologicas) in various medical topics to be
formally reviewed up to the state-of-the-art. The first one to be
launched electronically in a seminar format will be will be on
Epilepsy. Aimed to general practitioners (GP’s), the seminars will
be subdivided in modules and planned to last 3 months. Pertinent
academic material will provided in advance to be reviewed by the
GP’s. Two weeks later, lectures will be given via live
videoconference. Review modules will be then evaluated using
electronic formats. Graduation certificates will be provides for a
ECR is designed to provide third year MS with a disciplined module of
structured electronic clinical record that will be radiated all through
clinical semesters for continuous evaluation and peerage in clinical and
surgical departments to design a final product that will have practical
application in affiliated and non-affiliated institutions. It will be
developed in the following steps:
• Structured proposal (E3)
• Socialization to three teachers in each of the clinical and
surgical departments who will make remarks on the
document and return it for E3
• Final evaluation of the model by the Epidemiology
Department which will be returned to E3
• ECR will be reviewed and directives in the different
affiliated hospitals who will work with it on a 1-year trial
• A final evaluation will be carried out by E3, the
Epidemiology Department and one delegate of each of the
• Qualification of the document
• Commercialization to non-affiliated institutions and
3. PROGRAM RESULTS
So far the only evaluable data comes from EAC.
In January 2002, 4th year (8
semester) medical students started to
create and use the “narratives” as a part of a new educational program.
Narratives were only partial due to the fact that it was an initial pilot
program in the surgery and specialties semester. In the next two
semesters it became an official pilot program in the department of
surgery with the following results:
40 (76%) “narratives” had been made out of 78 academic subjects in
the General Surgery area.
By specialties figures are shown in table 1.
All the students (100% ) developed their assigned “narrative”.
Satisfaction level reported by students was 75%.
The use of “narratives” as a research and study tool was observed by a
raise (62,5%) in the number of visits of this particular link in the
School’s website. Monthly we found an average of 1364 visits during a
5 month period, compared with 853 visits six months earlier.
Although it implies extra work for teachers and MS, reading, editing
and posting of “narratives” has been done promptly. Level of
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acceptance among teachers from Surgical Department has reached
Average grades given to students for their “narrative” was 4.3 on a
maximum 5.0 scale.
E3 group at Universidad del Rosario School of Medicine is a novel
experience in Colombian medical education. Its creation was the result
of an urgent academic need in the
School. It was presented as a project to school and University
authorities who promptly approved it and provided academic and
financial disposition for its development. The group is constituted by
the Chairman of the Department of Surgery (RER), two members of
the Research Office (AI and FL) the coordinator of the Medical
Informatics Unit (AE) and two third semester MS (SP and RY).
Total Narratives Posted In 2002
Department directors and faculty in general had shown intermediate
enthusiasm to cooperate with the project. No strategic maneuvers are
been designed by the group to attract attention and enthusiasm to E3.
Socialization of the program in the undergraduate and graduate
population is underway.
As we can see, of the three subprojects, valid data of EAC are quite
positive so far. Cooperative meetings with Chair persons of the
Clinical and Surgical Departments are in progress with positive results.
The other two subprojects (VEP and ECR) have been embraced
positively by School authorities and a new paper will show preliminary
E3 has been a happy and successful experience.
Faculty and MS enrollment in teamwork, in search of generalization of
the use of ICT in our medical School, is a challenging scenario in the
germinal state but initial results are demanding, and propose
formidable work to be carried out by the group and conditional to
directive compromise in the persons of Universities and Medical
School’s authorities, chair persons and administrative personnel.
Follow up papers will be published to share this experience with the
informatics and academic communities.
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