Patient-assisted teledermatology practice: What is it: When, where, and how it is applied.

Recent teledermatology practice has been focused on different models made possible by robust advances in information technology leading to consistent interaction between the patient and health care professionals. Patient-assisted teledermatology practice also called patient-enabled teledermatology or home based teledermatology is one such novel model. There is a lack of scientifi c literature and substantive reviews on patient-assisted teledermatology practice. The present article reviews several studies and surveys on patientassisted teledermatology practice and outlines its advantages and barriers to clinical utility and analyses the potentiality of this concept. Incorporating patient-assisted teledermatology practice as a novel model in the revised classifi cation of teledermatology practice is proposed. In patient-assisted teledermatology, the patient can upload his/her clinical images as a fi rst contact with the dermatologist or an initial face-to-face examination can be followed by teledermatology consultations. The latter method is well suited to chronic diseases such as psoriasis, vitiligo, and leg ulcers, which may need frequent follow-up entailing signifi cant costs and time, particularly in the elderly. Teledermatology may also be used by the treating dermatologist to seek expert opinion for diffi cult cases. Studies have demonstrated the importance and usability of the concept of patient-assisted teledermatology practice. Various teledermatology care models are available and the appropriate model should be chosen depending on whether the clinical situation is that of easily diagnosed cases (“spotters”), chronic cases or doubtful cases and difficult-to-manage cases.

Atendimento ao trauma de face por telemedicina: validação de modelo de videoconferência com uso de smartphone e análise da concorância com atendimento presencial / Facial trauma assessment through telemedicine: validation of a videoconference via smartphones model and analysis of agreement between telemedicine and face-to-face attending

As dimensões continentais de alguns países e a distribuição heterogênea da rede hospitalar dificultam o acesso ao atendimento inicial adequado ao trauma de face principalmente aos pacientes residentes em regiões mais remotas. Um modelo de atendimento por telemedicina pode ser uma opção ao atendimento especializado presencial. Os objetivos deste trabalho são apresentar um modelo de atendimento por especialistas à distância, por meio de videoconferência utilizando-se smartphone, e analisar a concordância deste atendimento por telemedicina com o atendimento presencial, considerado padrão ouro. Cinquenta pacientes com trauma de face e suspeita de fratura de face (n=50) foram atendidos, por duas equipes independentes, uma presencialmente e outra por telemedicina. A equipe presencial, que era formada pela equipe de plantão de cirurgia plástica na unidade de emergência, prestou o atendimento à beira do leito (história, exame físico e análise de imagens por tomografia computadorizada). A equipe telemedicina, composta por um médico generalista atendendo à beira do leito, prestou atendimento em conjunto com um cirurgião plástico à distância através de videoconferência com um smartphone. Após cada atendimento as duas equipes responderam a um questionário, com informações sobre dados epidemiológicos, dados do exame físico, sobre indicações de tomografia computadorizada, achados radiológicos da tomografia e conduta. Os dados foram analisados e comparados quanto à concordância das respostas através da análise estatística kappa, cálculo de acurácia, especificidade e sensibilidade. A amostra estudada foi representativa e concordante com a literatura, com predomínio de homens jovens. Acidentes de trânsito e violência interpessoal foram os principais mecanismos causadores do trauma. A concordância das respostas para os achados de exame físico foi considerada substancial (kappa=0,720), para a indicação da tomografia computadorizada foi quase perfeita (kappa=0,957), para os...

The continental size of some countries and heterogeneous distributed hospital network prevent many patients who live in remote areas from getting adequate initial assessment of facial trauma. The author presents a model for trauma assessment through telemedicine, which may be an alternative to face-to-face specialized attending. The goals of this study are presenting a model for non-attending specialized assessment through video conference via smartphones, and analyzing a comparison between telemedicine and face-to-face management, the latter currently being the gold standard. Fifty patients with either a confirmed or suspected diagnosis of facial trauma (n=50) were evaluated by two teams of physicians, one face-to-face and the other one telemedicine-based. The face-to-face team, which was made up by the attending plastic surgery team in the emergency unit, attended the patients at the bedside (physical examination and CT-scan analysis). The telemedicine team was made up by an in-house general practitioner working together with an on-call plastic surgeon through videoconference via smartphones. After each evaluation, both teams answered a similar questionnaire, which contained data concerning the patient's epidemiology, physical examination, CT-scan indications and findings, and the treatment option to be followed. The data were analyzed and compared regarding the similarity of answers, with the use of kappa statistics and analysis of data accuracy, sensitivity and specificity. The sample studied was representative and consistent with the literature, showing a predominance of young males. Traffic accidents and personal violence were the main causes of trauma. The agreement of answers for physical examination findings was considered substantial (kappa=0.720). For CT-scan indications, it was considered almost perfect (kappa=0.957); for CT-scan findings, it was almost perfect (kappa=0.899); and for defining the treatment option, it was...

Aspectos esenciales en la elaboracion de las videoclases en las ciencias de la salud / Main aspects in the health sciences video lessons making

Uno de los recursos de aprendizaje más utilizado en la actualidad en los procesos docentes de las Ciencias de la Salud es la Videoclase. Para afrontar la elaboración de estos medios de enseñanza es vital proveer al profesor de herramientas de apoyo sencillas y flexibles que le permitan lograr sus objetivos pedagógicos, ofreciendo a su alumnado el soporte y apoyo adecuado para cubrir sus necesidades Este trabajo brinda una serie de recomendaciones para tratar de unificar los criterios acerca de la elaboración de las Videoclases, así como orientar a los profesores que van a enfrentar este reto dentro del proceso docente Se analizan los aspectos fundamentales que deben tenerse en cuenta en el momento de la confección de la Videoclase, así como los procesos comunicacionales que están involucrados y las características y responsabilidades que debe tener un teleprofesor.

One of the most used learning resources in the Health Science teaching process is the video lesson. To make this teaching aid, it is vital to provide the teacher with the simple and flexible tools to allow him achieve his/hr pedagogical objectives to give the learners the adequate support to satisfy their needs This paper provides a series of recommendations aimed at unifying the criteria about the making of video lessons, as well as to give some orientations to the teachers how to face this challenge within the teaching process The main aspects about the video lessons making are analyzed, and the communication problems involved and the characteristics and responsibilities a TV teacher must have.

Propuesta metodológica para valorar aspectos comunicativos en conferencias grabadas en video de Ciencias Básicas Biomédicas / Methodological proposal to valuate communicative aspects in conferences recorded by video in biomedical basic sciences

Entre las transformaciones de la Enseñanza Media y Superior están las conferencias grabadas en video (videoclases); aunque existe poco conocimiento aún entre los docentes, quienes las realizan, y sobre los requerimientos didácticos de la técnica; y de cómo evaluar los videos ya producidos, con respecto a la comunicación educativa. Con el propósito de proponer una guía para valorar aspectos comunicativos de conferencias grabadas en video y evaluar una muestra de esa modalidad de conferencias de las Ciencias Básicas Biomédicas, se acomete el presente trabajo. Se hizo un estudio bibliográfico acerca de la temática; se revisaron los documentos normativos para su uso y se analizó, al menos, una de las videoclases de cada profesor que participó en su confección, en Ciencias Básicas Biomédicas (Fisiología, Bioquímica, Anatomía, Embriología e Histología) del primer año de la carrera de Medicina (n=46). Se propone instrumento (guía) para evaluar aspectos de la comunicación educativa, particularmente, de la función informativa de la comunicación. Se analizan las principales dificultades comunicativas. Existen diferentes tendencias en las asignaturas relacionadas con las videoclases que deben analizarse en forma sistémica; aunque respetando particularidades de cada asignatura. Desde la perspectiva de la comunicación educativa, debe existir mayor asesoría metodológica en su confección y evaluarse su uso para perfeccionamiento ulterior.

Among the transformations done in secondary schools and higher education are the use of video lessons, although there is a little knowledge among teachers that produce and use those video lessons about the didactic requirements of the techniques and how to evaluate the produced videos in relation to educational communication. With the purpose to propose a guide to assess communicative aspects of lectures recorded in videos and to assess a sample of lectures recorded in videos of Bio medics Basic Sciences this project is presented. The bibliographic review was done, we saw at least one video lessons of each teacher that participated in its making ( Physiology, Biochemistry, Anatomy, Embryology and Histology) of the first year in Medicine career (sampling, n: 46). The instrument proposed to assess some aspects of the educative communication particularly of the informative function of communication. The main difficulties in the video lessons were analyzed by the authors. There are different tendencies in the mentioned subjects with the video lessons that must be analyzed in a systemic form by taking into consideration the peculiarity of each subject. From the perspective of the educative communication should have a major methodological advice during the preparation of the video lessons and evaluate its use for further improvement.

Videoconferências: sistematização e experiências em telemedicina / Videoconferences: systematization and experiments in telemedicine

A telemedicina é definida como a troca de informações utilizando tecnologia de informação e de comunicação em saúde e a distância. Entre as diversas modalidades da telemedicina incluem-se as videoconferências, que permitem a integração em tempo real, recebendo e enviando áudio e vídeo de alta qualidade entre pontos distantes geograficamente. O objetivo deste trabalho é descrever, de maneira simplificada, os sistemas de videoconferências, destacando-se suas aplicações no contexto da telemedicina. Para a realização de videoconferências são necessários equipamentos que façam captura e reprodução de áudio e vídeo, e que tenham possibilidade de conexão com equipamentos similares, como microcomputadores e equipamentos dedicados. Os tipos de conexão para uma videoconferência são: via ISDN (integrated services digital network) ou via IP (internet protocol). A qualidade do áudio e do vídeo e a velocidade são críticas para o sucesso da videoconferência. Experiências internacionais na utilização de equipamentos de videoconferência, inclusive na radiologia e diagnóstico por imagem, já são uma realidade. No Brasil, relatos mostram iniciativas isoladas de telemedicina, em sua maioria incluindo redes universitárias. A videoconferência representa uma excelente ferramenta para a capacitação e atualização do profissional médico, além de proporcionar grande impacto nos custos do atendimento à população.

Telemedicine refers to the delivery of health care services over a distance. Videoconference is one of the different modalities of telemedicine, allowing real-time interaction. The present study is aimed at describing videoconference systems in a simplified way, focusing on their application in telemedicine. Videoconference involves the necessity of equipment for audio and video capture and reproduction, besides a communication link for connection with similar equipment through ISDN (integrated services digital network) or IP (internet protocol). Video and audio quality is essential for the success of a videoconference. Experiments using videoconferencing equipment in radiology and other fields of medicine are a reality at international level. In Brazil, reports account for some isolated initiatives in this field, most of them involving universities networks. Besides its remarkable impact on costs of medical care delivery for the population, videoconference represents an invaluable tool for physicians in their education and knowledge updating.