Medical Teacher
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
The Telephone in Continuing Medical EducationThe Saskatchewan Experience Don Clarke, H. J. Spooner, O. E. Laxdal & D. I. Johnson To cite this article: Don Clarke, H. J. Spooner, O. E. Laxdal & D. I. Johnson (1979) The Telephone in Continuing Medical Education-The Saskatchewan Experience, Medical Teacher, 1:6, 298-299 To link to this article: http://dx.doi.org/10.3109/01421597909014339
Published online: 03 Jul 2009.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=imte20 Download by: [Flinders University of South Australia]
Date: 03 October 2015, At: 18:42
IN BRIEF
The Telephone in Continuing Medical Education-The Saskatchewan Experience
Downloaded by [Flinders University of South Australia] at 18:42 03 October 2015
DON CLARKE H.J. SPOONER, 0.E. LAXDAL and D. I. JOHNSON H . J . Spooner, PH.D, is Associate Professor of Medical Education, 0.E . Laxdal, MD, FRCP (C), FAAP, iS Director of Continuing Medical Education, and D. I . Johnson, R N , BSN, is Coordinator of Dial Access and Drug Information Service, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0 WO, Canada. Of all the modern communication technologies available to medical education, the telephone is probably the medium most used in medicine but also the most overlooked. The Division of Continuing Medical Education, University .of Saskatchewan, developed a unique use of the telephone through its ‘Dial Access’ programme. Modelled after a similar system at the University of Wisconsin, Dial Access was a source of prerecorded, abbreviated information to physicians on selected topics. The service was available 24 hours a day, seven days a week and was free to its users. However, after eight years of operation, Dial Access was discontinued at the end of June 1979. Dial Access: Its Use While the telephone is generally regarded as a two-way communication device, under Dial Access it was only one way. A physician dialled a central number-one for northern Saskatchewan located in Saskatoon and another for southern Saskatchewan located in Regina -requested a desired topic, listened to the recorded message (four to eight minutes) and hung up (Figure 1). There was no opportunity for interaction: the call was not a consultation and could not be regarded as a substitute for consultation. Rather, it was an updating of medical information in abbreviated form. All 1,300 Saskatchewan physicians were supplied annually with a Dial Access catalogue containing 300 titles of available tapes. The 10 most popular tapes during 1977 to 1978 were: 1 . Freshwater Drowning 2. Peptic Ulcer Disease 3. Chronic Obstructive Airways Disease 4. Sunburn and Heat Disorders 5. Sudden Infant Death Syndrome 6. Knee Injury, Management 7. Scoliosis in Children, Management
298
8. Undescended Testicles, Management 9. Diarrhoea with Vomiting in Infants: Management 10. Atopic Eczema (Infantile)
Home
The tapes were written by recognized medical authorities throughout the province, including faculty members of the College of Medicine, University of Saskatchewan, who contributed generously. Some authors were invited to submit scripts and others volunteered them. The authors updated the tapes every 18 to 24 months. Practising physicians were canvassed for topics that they felt would be of interest to them, and their suggestions were put into operation by CME. Dial Access users could request that copies of scripts be mailed to them, a service that gained popularity over the years, with approximately 2,000 scripts mailed out in the final year of operation. There were 1,100 calls to Dial Access last year, approximately 600 of which were from practising physicians (55 per cent). Of the 600, half were from city practitioners and half from practitioners in rural areas. The ratio of family physicians’ calls to specialists’ was 1 O : l . Others who made use of Dial Access included: residents, interns, medical students (21 per cent); pharmacists (15 per cent); and nurses, pharmacy students and other health science personnel (9 per cent). Dial Access: Its Demise Use of the system did not meet expectations. While the number of calls in its first year of operation was promising (over 3,000 in 1970 to 1971), over the last four years the number levelled off at approximately 1,000 per annum and, in spite of vigorous promotion to advertise availability and encourage use plus a major effort to ensure high technical quality of reproduction, the future held no promise of increased use. The system did not prove to be cost effective, particularly when long distance
Medical Teacher Vol 1 No 6 1979
Pharmaceutical Association, the College of Pharmacy, University of Saskatchewan, and the Saskatchewan Department of Health (Provincial Government).
DIAL ACCESS
Downloaded by [Flinders University of South Australia] at 18:42 03 October 2015
DRUG INFORMATION SERVICE
a telephone information service for Saskatchewan physicians and pharmacists 1978
T h e Telephone in CME:Its Future Although Dial Access has ceased operation, its demise does not call into question the use of the telephone as a teaching tool so much as it questions whether the telephone was appropriate for delivery of this kind of message (prerecorded medical information in abbreviated form) to this audience (physicians). Inherent shortcomings in any recorded message include its fixed pace, its non-specific information and one-way communication. That is, a physician called Dial Access with a specific problem in mind but had to listen to the whole four to eight minute message to get a one-sentence answer. Even then, he might not get the information he desired and he could not ask the tape to provide it. Dr 0. E. Laxdal, Director of CME, and D. I. Johnson, the Coordinator of Dial Access, consider that physicians who use audio methods of learning prefer to listen to audio cassettes of 30 to 60 minutes duration, where information can be presented in detail and users can listen at their convenience, e.g. on the way to the office in their car. This opinion is being tested by CME which has circulated a sample cassette on treatment of heart conditions and has asked for feedback on its usefulness. While slightly disillusioned by its experience with Dial Access for physicians, CME continues its romance with the telephone in three other ways, one involving a physician clientele, one with a combined pharmacistphysician audience, and the third with the public.
Telephone Conferences
Figure 1. The Dial Access Drug Information Semce f o r Physicians and Pharmacists. charges were considered. At the time the decision was made to discontinue the programme, its annual operating cost exceeded $20,000. Agencies which contributed to the support of Dial Access over the years were Medical Services Incorporated of Saskatchewan, Group Medical Services of Regina, the Saskatchewan Medical Association, the Saskatchewan
Medical Teacher Vol 1 No 6 1979
The physician programme offers the most potential to CME for using the telephone as an educational instrument, namely to hold telephone conferences. Because of the size of Saskatchewan and its predominantly rural nature, travel by medical specialists to outlying areas to teach is always time consuming and sometimes hazar dous, especially in winter. An alternative to on-site visits is the use of the phone in a conference setting. Four conferences have been held to date and results are encouraging. The four conferences involved 38 physicians in five communities more than 100 miles from CME headquarters in Saskatoon. Each conference was on a different topic using different consultants; examples of topics were emergency room care for the accident victim, tuberculosis, dislocation of the hip, and paediatrics. Topics were selected by the participating physicians, actual case problems were pre-submitted by them to consultants and the problems formed the focus of discussion. The length of each conference was 30 to 45 minutes and participants were surprised how quickly the time went by. The physicians were sufficiently impressed by teleconferencing that they would be willing to try further conferences. Features of the teleconferences that the physicians particularly appreciated were the openness and informality, the frankness and practicality, the 299
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
The Telephone in Continuing Medical EducationThe Saskatchewan Experience Don Clarke, H. J. Spooner, O. E. Laxdal & D. I. Johnson To cite this article: Don Clarke, H. J. Spooner, O. E. Laxdal & D. I. Johnson (1979) The Telephone in Continuing Medical Education-The Saskatchewan Experience, Medical Teacher, 1:6, 298-299 To link to this article: http://dx.doi.org/10.3109/01421597909014339
Published online: 03 Jul 2009.
Submit your article to this journal
Article views: 7
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=imte20 Download by: [Flinders University of South Australia]
Date: 03 October 2015, At: 18:42
IN BRIEF
The Telephone in Continuing Medical Education-The Saskatchewan Experience
Downloaded by [Flinders University of South Australia] at 18:42 03 October 2015
DON CLARKE H.J. SPOONER, 0.E. LAXDAL and D. I. JOHNSON H . J . Spooner, PH.D, is Associate Professor of Medical Education, 0.E . Laxdal, MD, FRCP (C), FAAP, iS Director of Continuing Medical Education, and D. I . Johnson, R N , BSN, is Coordinator of Dial Access and Drug Information Service, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0 WO, Canada. Of all the modern communication technologies available to medical education, the telephone is probably the medium most used in medicine but also the most overlooked. The Division of Continuing Medical Education, University .of Saskatchewan, developed a unique use of the telephone through its ‘Dial Access’ programme. Modelled after a similar system at the University of Wisconsin, Dial Access was a source of prerecorded, abbreviated information to physicians on selected topics. The service was available 24 hours a day, seven days a week and was free to its users. However, after eight years of operation, Dial Access was discontinued at the end of June 1979. Dial Access: Its Use While the telephone is generally regarded as a two-way communication device, under Dial Access it was only one way. A physician dialled a central number-one for northern Saskatchewan located in Saskatoon and another for southern Saskatchewan located in Regina -requested a desired topic, listened to the recorded message (four to eight minutes) and hung up (Figure 1). There was no opportunity for interaction: the call was not a consultation and could not be regarded as a substitute for consultation. Rather, it was an updating of medical information in abbreviated form. All 1,300 Saskatchewan physicians were supplied annually with a Dial Access catalogue containing 300 titles of available tapes. The 10 most popular tapes during 1977 to 1978 were: 1 . Freshwater Drowning 2. Peptic Ulcer Disease 3. Chronic Obstructive Airways Disease 4. Sunburn and Heat Disorders 5. Sudden Infant Death Syndrome 6. Knee Injury, Management 7. Scoliosis in Children, Management
298
8. Undescended Testicles, Management 9. Diarrhoea with Vomiting in Infants: Management 10. Atopic Eczema (Infantile)
Home
The tapes were written by recognized medical authorities throughout the province, including faculty members of the College of Medicine, University of Saskatchewan, who contributed generously. Some authors were invited to submit scripts and others volunteered them. The authors updated the tapes every 18 to 24 months. Practising physicians were canvassed for topics that they felt would be of interest to them, and their suggestions were put into operation by CME. Dial Access users could request that copies of scripts be mailed to them, a service that gained popularity over the years, with approximately 2,000 scripts mailed out in the final year of operation. There were 1,100 calls to Dial Access last year, approximately 600 of which were from practising physicians (55 per cent). Of the 600, half were from city practitioners and half from practitioners in rural areas. The ratio of family physicians’ calls to specialists’ was 1 O : l . Others who made use of Dial Access included: residents, interns, medical students (21 per cent); pharmacists (15 per cent); and nurses, pharmacy students and other health science personnel (9 per cent). Dial Access: Its Demise Use of the system did not meet expectations. While the number of calls in its first year of operation was promising (over 3,000 in 1970 to 1971), over the last four years the number levelled off at approximately 1,000 per annum and, in spite of vigorous promotion to advertise availability and encourage use plus a major effort to ensure high technical quality of reproduction, the future held no promise of increased use. The system did not prove to be cost effective, particularly when long distance
Medical Teacher Vol 1 No 6 1979
Pharmaceutical Association, the College of Pharmacy, University of Saskatchewan, and the Saskatchewan Department of Health (Provincial Government).
DIAL ACCESS
Downloaded by [Flinders University of South Australia] at 18:42 03 October 2015
DRUG INFORMATION SERVICE
a telephone information service for Saskatchewan physicians and pharmacists 1978
T h e Telephone in CME:Its Future Although Dial Access has ceased operation, its demise does not call into question the use of the telephone as a teaching tool so much as it questions whether the telephone was appropriate for delivery of this kind of message (prerecorded medical information in abbreviated form) to this audience (physicians). Inherent shortcomings in any recorded message include its fixed pace, its non-specific information and one-way communication. That is, a physician called Dial Access with a specific problem in mind but had to listen to the whole four to eight minute message to get a one-sentence answer. Even then, he might not get the information he desired and he could not ask the tape to provide it. Dr 0. E. Laxdal, Director of CME, and D. I. Johnson, the Coordinator of Dial Access, consider that physicians who use audio methods of learning prefer to listen to audio cassettes of 30 to 60 minutes duration, where information can be presented in detail and users can listen at their convenience, e.g. on the way to the office in their car. This opinion is being tested by CME which has circulated a sample cassette on treatment of heart conditions and has asked for feedback on its usefulness. While slightly disillusioned by its experience with Dial Access for physicians, CME continues its romance with the telephone in three other ways, one involving a physician clientele, one with a combined pharmacistphysician audience, and the third with the public.
Telephone Conferences
Figure 1. The Dial Access Drug Information Semce f o r Physicians and Pharmacists. charges were considered. At the time the decision was made to discontinue the programme, its annual operating cost exceeded $20,000. Agencies which contributed to the support of Dial Access over the years were Medical Services Incorporated of Saskatchewan, Group Medical Services of Regina, the Saskatchewan Medical Association, the Saskatchewan
Medical Teacher Vol 1 No 6 1979
The physician programme offers the most potential to CME for using the telephone as an educational instrument, namely to hold telephone conferences. Because of the size of Saskatchewan and its predominantly rural nature, travel by medical specialists to outlying areas to teach is always time consuming and sometimes hazar dous, especially in winter. An alternative to on-site visits is the use of the phone in a conference setting. Four conferences have been held to date and results are encouraging. The four conferences involved 38 physicians in five communities more than 100 miles from CME headquarters in Saskatoon. Each conference was on a different topic using different consultants; examples of topics were emergency room care for the accident victim, tuberculosis, dislocation of the hip, and paediatrics. Topics were selected by the participating physicians, actual case problems were pre-submitted by them to consultants and the problems formed the focus of discussion. The length of each conference was 30 to 45 minutes and participants were surprised how quickly the time went by. The physicians were sufficiently impressed by teleconferencing that they would be willing to try further conferences. Features of the teleconferences that the physicians particularly appreciated were the openness and informality, the frankness and practicality, the 299
