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On-line version ISSN 1806-4841
An. Bras. Dermatol. vol.85 no.3 Rio de Janeiro June 2010
Cybertutor: a teaching tool in Dermatology*
Mariana SoirefmannI; Juliana Catucci BozaII; Cristiane ComparinIII; Tania Ferreira CestariIV; Chao Lung WenV
IMaster Degree of Medical Science
from the Federal University of Rio Grande do Sul (UFRGS), Dermatologist - Porto
Alegre (RS), Brazil
IIIntern, Dermatology service, University Hospital of Porto Alegre (HCPA) - Porto Alegre (RS), Brazil
IIIMedical doctor graduated from the Federal University of Rio Grande do Sul, (UFRGS) - Porto Alegre (RS), Brazil
IVDoctorate degree (Dermatology) from the Federal University of Rio de Janeiro, (UFRJ), Associate Professor of the Department of Internal Medicine/Dermatology of the Federal University of Rio Grande do Sul (UFRGS), Researcher responsible for the Laboratory of Photomedicine and Teledermatology of the Research Center of the University Hospital of Porto Alegre (HCPA) - Porto Alegre (RS), Brazil
VFull professor of the Medical School of the University of São Paulo (USP), Head of the Discipline Telemedicine - São Paulo (SP), Brazil
It was developed a teaching tool in Dermatology for undergraduate medical students, using an interactive website, the Cybertutor. Clinical cases, lectures and updated bibliography were selected. Photographies of dermatological lesions were taken from ambulatory patients. The topics of the lectures were based on the current curriculum of the Federal University of Rio Grande do Sul. The Cybertutor is a dynamic and modern teaching tool, allowing constant innovation.
Keywords: Dermatology; Education, medical; Telemedicine; Education, distance
Telemedicine is defined as the use of telecommunications technology applied to the medical practice. 1 In especial, to Teledermatology, an area of Telemedicine that studies the application of telecommunications technology and information technology to dermatological practice. Teledermatology has been presenting an important increase all over the world.2-4 One of the most promising and versatile applications of Teledermatology is the development of distance learning projects, training and even tutorials and assessment of learning. This occurs because it is possible to integrate texts, images (still or dynamic), virtual reality models or sounds in distance learning programs about health with pedagogic structures and communication strategies.1
Besides that, some articles show that e-learning has been lately considered an important part of medical education.5 E-learning can be understood as the use of Internet technologies to increase the knowldge and performance as it allows students to have more control about content, timing, sequencing and rithm of learning.6
The current teaching model for medical students based on traditional theoretical lectures7 is being discussed as the retention of knowledge and the level of interest of students seem to be decreasing. Studies show that multimedia programs have many advantages in relation to traditional teaching. 8
So, it was developed an object for medical teaching in Dermatology, using the educational platform named Cybertutor. This study was carried out in the dermatological service of the University Hospital of Porto Alegre (HCPA) and in the Laboratory of Applied Photomedicine and Telemedicine of the Research Center of HCPA and also with the technical support of the discipline "Telemedicine" of the University of São Paulo (USP).
The discipline "Telemedicine" of the University of São Paulo (USP) developed the Cybertutor (eletronic tutor) which is a computational system based on the WEB.9 To carry out the Cybertutor project with emphasis on Dermatology students of the discipline "Introduction to Science" of the Faculty of Medicine of the Federal University of Rio Grande do Sul (UFRGS), interns of the dermatologic service of the University Hospital of Porto Alegre (HCPA) and post-graduation students of the Federal University of Porto Alegre (UFRGS) selected some of the most frequent clinical cases of dermatosis. The patients selected were informed about the interest of the staff in photographing their lesions and they signed an agreement consent allowing the use of the images of their lesions to illustrate topics which were part of the syllabus of the program of medical education.
Subsequently to the photographies clinical cases refering to the selected diseases were elaborated containing a brief description of the clinical history and dematologic exam and also including images of the lesion followed by multiple choice questions about the diagnosis, clinical symptoms and treatment of the condition presented. To each possible answer to the questions it was added a hypertext explaining the reasons why an answer was considered correct or wrong and that information could only be accessed by the student after he/she had answered the question. Lists with updated bibliography that could be easily accessed for each course content were added in the end of the clinical case. As aditional help for students there were also included slides presentations.
The development of the Cybertutor in Dermatology was based on the elaboration of didactic clinical cases complemented with relevant theoric information and updated bibliography. Thirty clinical cases were elaborated about the following dermatosis: mycoses (onychomycosis, pityriasis versicolor, tinea pedis, tinea capitis), sexually transmitted diseases (syphilis, cancrum, lymphogranuloma venereum), eczema (atopic dermatitis, contact eczema, seborrheic dermatitis), cutaneous neoplasias (melanoma, basal cell carcinoma, epidermoid carcinoma), viroses (molluscum, contagiosum, varicella, herpes zoster), zoodermatosis (scabies, pediculosis, myiasis, larva migrans), nail diseases (paronychial), infections (erysipelas/cellulitis, folliculitis), acne, psoriasis and vitiligo.
The topics of the theoric lectures were based on the current curriculum of Dermatology of this university. Updated bibliography of each clinical case and theoric lectures were found through research in MEDLINE indexed magazines between 1997 and 20007, according to the topic of each clinical case, and also through research in text books recommended as supplementary reading material for this discipline.
This new technology combines traditional teaching methods with innovative opportunities. Besides that, it is a dynamic, modern and updated method which enables constant updating of medical knowledge in its platform, ensuring updated information about the most varied themes. The Cybertutor allows professors to save time as lectures and video materials broadcasted can be previously recorded and, simultaneously it encourages students to actively manage their role as student.
Further studies will be necessary to assess the performance of students undergoing this new teaching method and, especially, the effectiveness of such a tool and the impact of its use to teach Dermatology to undergraduate medical students in the Federal University of Rio Grande do Sul (UFRGS).
1. Miot HA, Paixão MP, Wen CL. Teledermatologia Passado, presente e futuro. An Bras Dermatol. 2005;80:523-32. [ Links ]
2. Eedy DJ, Wootton R. Teledermatology: a review. Br J Dermatol. 2001;144:696-707. [ Links ]
3. High WA, Houston MS, Calobrisi SD, Drage LA, McEvoy MT. Assessment of the accuracy of low-cost store-andforward teledermatology consultation. J Am Acad Dermatol. 2000;42:776-83. [ Links ]
4. Chao LW, Silveira PS, Böhm GM. Telemedicine and education in Brazil. J Telemed Telecare. 1999;5:137-8. [ Links ]
5. Ellaway R, Masters K. AMEE Guide 32: e-Learning in medical education Part 1: Learning, teaching and assessment. Med Teach. 2008;30:455-73. [ Links ]
6. Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med. 2006;81:207-12. [ Links ]
7. Clark D. Psychological myths in e-learning. Med Teach. 2002;24:598-604. [ Links ]
8. Hong CH, McLean D, Shapiro J, Lui H. Using the internet to assess and teach medical students in dermatology.J Cutan Med Surg. 2002;6:315-9. [ Links ]
9. Veronezi MC, Sgavioli CAPP, Böhm GM, Wen LW. Cybertutor: educação mediada por tecnologia na odontologia. Revista da ABENO (Associação Brasileira de Ensino Odontológico), Belo Horizonte. 2004_4:88. [ Links ]
Mailing Address: Received on 28.10.2008. * Study carried
out in the Faculty of Medicine of the Federal University of Rio Grande do Sul
(UFRGS) and Laboratory of Telemedicine and Applied Photobiology Research Center
of the University Hospital of Porto Alegre (HCPA)1; Discipline "Telemedicine"
of the University of São Paulo(USP)- São Paulo (SP), Brazil.
Juliana Catucci Boza
Rua Santo Antônio, 792 - Ap. 403 - Bairro Bom Fim
90220 010 Porto Alegre, RS
Tel./fax: 51 3273-3210 9652 1887
Approved by the Advisory Board and accepted for publication on 31.07.09.
Conflict of interest: None
Financial funding: Programm "Instituto do Milênio" from the Ministry of Science and Technology / National Council of Scientific and Technological Development (CNPq), Fund for Incentive to Research (FIPE) University Hospital of Porto Alegre (HCPA) - Porto Alegre (RS), Brazil
Received on 28.10.2008.
* Study carried out in the Faculty of Medicine of the Federal University of Rio Grande do Sul (UFRGS) and Laboratory of Telemedicine and Applied Photobiology Research Center of the University Hospital of Porto Alegre (HCPA)1; Discipline "Telemedicine" of the University of São Paulo(USP)- São Paulo (SP), Brazil.