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Albert Singer - E-learning and distance learning. How we supervise it
Dr Albert Singer
EFC Satellite Meeting and Training the
Trainers, 15-16 December 2017, Brussels
E LEARNING AND DISTANCED LEARNING /SUPERVISION
PROFESSOR ALBERT SINGER
UNIVERSITY OF LONDON ,LONDON UK
HOW DO WE TEACH COLPOSCOPY
 APPRENTICE SYSTEM (WITH TUTORS AND COACHES)
 COURSES
Basic
Advanced
 E LEARNING COURSES ON LINE
+
 MONOCULAR TECHNOLOGY
Local / Distant
 ACCREDITATION SYSTEM BY BSCCP (1990s)
KNOWLEDGE | COMPETENTCY | ASSESSMENT
COLPOSCOPY TEACHING COURSES (LONDON UK)
Basic and Advanced since 1981 (114 COURSES)
HAVE WE SUCCEEDED?
• YES?
 33 YEARS (APPROX 3000 STUDENTS WORLDWIDE )
 114 COURSES (JUNE. 2015)
 CANDIDATES’ EVALUATION 8.7/10
NO LONG TERM DISTANT FOLLOW UP
OR SUPERVISION
THE FUTURE OF
COLPOSCOPY TEACHING
1 PROBLEMS
2 HOW DO WE OVERCOME THESE
PROBLEMS
THE FUTURE OF
COLPOSCOPY TEACHING
• PROBLEMS
Increase in world Cervix Cancer rates
Not enough trained teachers/coaches
Accreditation difficult /unrealistic
HPV screening means more colposcopy
HOW DO WE OVERCOME THESE
PROBLEM
1 Training more experienced
teachers/coaches (difficult and unrealistic in
many centres)
2 E LEARNING COURSES ON LINE
3 Mobile colposcopy (Local Distant)
WHY E LEARNING COURSES
• REACHING CENTRES WHERE NO TEACHING
/TRAINING EXIST
• WITH HPV TESTING AN INCREASED NEED TO
EXAMINE THE CERVIX (COLPOSCOPY)
• WITH MODERN TECHNIQUES CAN OFFER
HIGH QUALITY TEACHING WHICH CAN BE
MULTILINGUAL
WHAT ARE E LEARNING COURSES
E-LEARNING COURSES
Developed from the experience of face to
face courses and using latest technologies
and teaching aids

Albert Singer - E-learning and distance learning. How we supervise it
Colposcopy Course
Foundation E-learning course:
•
Normal Cervix
Detection of cervical precancer
– Pathology of cervical precancer
– Screening for cervical neoplasia :cytotogy and introduction
to HPV testing
Colposcopy of abnormal cervical epithelium
a Diagnosis
b Methods of detection
HPV: Causation of cervical neoplasia
– Biology
– Clinical role in diagnosis
– Vaccination
Treatment: Why, how and when and management
algorithms
Interactive session: To discuss diagnosis and treatment
PROGRESS OF E LEARNING COURSES
(COLPOSCOPYCOURSES.COM)
• The 10 hour on line course in 3 1/2 years has
.400 users in 39 countries reaching centres
were no teaching or training exists with
enthusiastic and positive feedback .It is now
part of a number of teaching programs being
used prior to and in conjunction with practical
coplposcopy training .It has BSCCPapproval in
relation to accereditation
HOW DO WE OVERCOME THE PROBLEM OF
DISTANCED LEARNING / SUPERVISION
(QUALITY CONTROL)
• E LEARNING COURSES ON LINE
+
MOBILE COLPOSCOPY
Mobile Colposcopy
Visual examination by fixed
colposcopy is expensive, bulky and
requires hard-to-use equipment
Mobile colposcopes are affordable
and easy-to use.
Fixed
colposcope
(7.5Kg)
Mobile
colposcope
(400 grams)
Mobile ODT
450 grams Gynocular
from Gynius (Sweden)
CEASED TRADING 2017
Mobile Colposcopy
• Easy flexible and mobile stand
• Excellent optics and documentation
system
• Light weight carrying case making it ideal
for screening and documentation in remote
areas
“Colposcopy Telemedicine: Live Swede score versus
Static Swede score and accuracy in detecting
CIN2+”
Conclusions: Close correlation of live colposcopic expert
examination and expert static evaluators
Authors: Taghavi, Strander, Singer, Shemer
PRESENTED AT IFCCP MEETING, ORLANDO MARCH 2017
Examples of high quality usage:
*
Agreement between mobile and fixed colposcope
Kappa value 0.998 and p-value < 0.001
Agreement between doctoors and nurses using mobile
colposcopy
Mobile colposcopy: combining hardware
and software to facilitate complete care
White
Mobile App Data storage &
analytics
Colposcope Online services
for quality
assurance
App on Mobile Colposcope
An easy-to-use APP installed on the included
smartphone enables:
• Video and image capture with image
annotations
• Documentation of clinical decision making
• Integrated real-time remote consultation
• Secure storage of patient data
Mobile colposcopy allows for documentation of the findings with capture of
cervical images: ideal for teaching
Real-time consultation : the basis of quality control
Consult in real time or asynchronously with remote
experts for decision support:
Providers can request consultation
from within the application
The expert will be
notified of providers’
request
The recommended
diagnosis is sent back to
the provider
DISTANCED LEARNING /SUPERVISION
Easily shared patient cases
within or outside your
organization for peer-reviews,
consultation and training
•Multiple reviewers can
collaborate on case review
•Cases and discussions
remain confidential, through
tracked log-in of credentialed
users
2 Secure case sharing & peer review
PROPOPSED SHANGHAI COLPOSCOPY TRAINING PROGRAM
(PROF.SUI LONG (SHANGHAI): PROF.ALBERT SINGER (LONDON)
• 1 E LEARNING COURSE (MANDARIN) GIVEN TO 6 CENTRES IN
SHANGHAI AREA FOR 8 WEEKS
• 2 DOCTORS COME TO SHANGHAI FOR HALF DAY TO COLLECT AND
GET INSTRUCTED IN MOBILE COLPOSCOPE HANDLING
• 3 AFTER 2 MONTHS OF SUPERVISED COLPOSCOPY (DAILY /WEEKLY)
• RETUN TO SHANGHAI FOR 3 DAYS OF EVALUATION ON PATIENTS
• 4 SUBMITTED TO OSCI TYPE EXAM (BSCCP) AT END OF EVALUATION
PERIOD AND IF SUCCESSFUL GIVEN TRAINERS CERTIFICATE
High quality colposcopy is possible in the DIAGNOSIS
and TEACHING using mobile colposcopy
• No significant differences between colposcopy
trained VIA nurses or doctors using fixed or mobile
colposcopies in detecting high grade cervical
lesions in high or low resource setting.
• In low resource settings nurse-colposcopist can be
employed with instant peer review.
• High quality supervised colposcopy can be
TAUGHT and administered under minimal
infrastructural requirement and at limited
economical setting with mobile colposcopy
SUMMARY

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Albert Singer - E-learning and distance learning. How we supervise it

  • 3. EFC Satellite Meeting and Training the Trainers, 15-16 December 2017, Brussels E LEARNING AND DISTANCED LEARNING /SUPERVISION PROFESSOR ALBERT SINGER UNIVERSITY OF LONDON ,LONDON UK
  • 4. HOW DO WE TEACH COLPOSCOPY  APPRENTICE SYSTEM (WITH TUTORS AND COACHES)  COURSES Basic Advanced  E LEARNING COURSES ON LINE +  MONOCULAR TECHNOLOGY Local / Distant  ACCREDITATION SYSTEM BY BSCCP (1990s) KNOWLEDGE | COMPETENTCY | ASSESSMENT
  • 5. COLPOSCOPY TEACHING COURSES (LONDON UK) Basic and Advanced since 1981 (114 COURSES)
  • 6. HAVE WE SUCCEEDED? • YES?  33 YEARS (APPROX 3000 STUDENTS WORLDWIDE )  114 COURSES (JUNE. 2015)  CANDIDATES’ EVALUATION 8.7/10 NO LONG TERM DISTANT FOLLOW UP OR SUPERVISION
  • 7. THE FUTURE OF COLPOSCOPY TEACHING 1 PROBLEMS 2 HOW DO WE OVERCOME THESE PROBLEMS
  • 8. THE FUTURE OF COLPOSCOPY TEACHING • PROBLEMS Increase in world Cervix Cancer rates Not enough trained teachers/coaches Accreditation difficult /unrealistic HPV screening means more colposcopy
  • 9. HOW DO WE OVERCOME THESE PROBLEM 1 Training more experienced teachers/coaches (difficult and unrealistic in many centres) 2 E LEARNING COURSES ON LINE 3 Mobile colposcopy (Local Distant)
  • 10. WHY E LEARNING COURSES • REACHING CENTRES WHERE NO TEACHING /TRAINING EXIST • WITH HPV TESTING AN INCREASED NEED TO EXAMINE THE CERVIX (COLPOSCOPY) • WITH MODERN TECHNIQUES CAN OFFER HIGH QUALITY TEACHING WHICH CAN BE MULTILINGUAL
  • 11. WHAT ARE E LEARNING COURSES E-LEARNING COURSES Developed from the experience of face to face courses and using latest technologies and teaching aids 
  • 13. Colposcopy Course Foundation E-learning course: • Normal Cervix Detection of cervical precancer – Pathology of cervical precancer – Screening for cervical neoplasia :cytotogy and introduction to HPV testing Colposcopy of abnormal cervical epithelium a Diagnosis b Methods of detection HPV: Causation of cervical neoplasia – Biology – Clinical role in diagnosis – Vaccination Treatment: Why, how and when and management algorithms Interactive session: To discuss diagnosis and treatment
  • 14. PROGRESS OF E LEARNING COURSES (COLPOSCOPYCOURSES.COM) • The 10 hour on line course in 3 1/2 years has .400 users in 39 countries reaching centres were no teaching or training exists with enthusiastic and positive feedback .It is now part of a number of teaching programs being used prior to and in conjunction with practical coplposcopy training .It has BSCCPapproval in relation to accereditation
  • 15. HOW DO WE OVERCOME THE PROBLEM OF DISTANCED LEARNING / SUPERVISION (QUALITY CONTROL) • E LEARNING COURSES ON LINE + MOBILE COLPOSCOPY
  • 16. Mobile Colposcopy Visual examination by fixed colposcopy is expensive, bulky and requires hard-to-use equipment Mobile colposcopes are affordable and easy-to use. Fixed colposcope (7.5Kg) Mobile colposcope (400 grams) Mobile ODT 450 grams Gynocular from Gynius (Sweden) CEASED TRADING 2017
  • 17. Mobile Colposcopy • Easy flexible and mobile stand • Excellent optics and documentation system • Light weight carrying case making it ideal for screening and documentation in remote areas
  • 18. “Colposcopy Telemedicine: Live Swede score versus Static Swede score and accuracy in detecting CIN2+” Conclusions: Close correlation of live colposcopic expert examination and expert static evaluators Authors: Taghavi, Strander, Singer, Shemer PRESENTED AT IFCCP MEETING, ORLANDO MARCH 2017 Examples of high quality usage: * Agreement between mobile and fixed colposcope Kappa value 0.998 and p-value < 0.001 Agreement between doctoors and nurses using mobile colposcopy
  • 19. Mobile colposcopy: combining hardware and software to facilitate complete care White Mobile App Data storage & analytics Colposcope Online services for quality assurance
  • 20. App on Mobile Colposcope An easy-to-use APP installed on the included smartphone enables: • Video and image capture with image annotations • Documentation of clinical decision making • Integrated real-time remote consultation • Secure storage of patient data
  • 21. Mobile colposcopy allows for documentation of the findings with capture of cervical images: ideal for teaching
  • 22. Real-time consultation : the basis of quality control Consult in real time or asynchronously with remote experts for decision support: Providers can request consultation from within the application The expert will be notified of providers’ request The recommended diagnosis is sent back to the provider DISTANCED LEARNING /SUPERVISION
  • 23. Easily shared patient cases within or outside your organization for peer-reviews, consultation and training •Multiple reviewers can collaborate on case review •Cases and discussions remain confidential, through tracked log-in of credentialed users 2 Secure case sharing & peer review
  • 24. PROPOPSED SHANGHAI COLPOSCOPY TRAINING PROGRAM (PROF.SUI LONG (SHANGHAI): PROF.ALBERT SINGER (LONDON) • 1 E LEARNING COURSE (MANDARIN) GIVEN TO 6 CENTRES IN SHANGHAI AREA FOR 8 WEEKS • 2 DOCTORS COME TO SHANGHAI FOR HALF DAY TO COLLECT AND GET INSTRUCTED IN MOBILE COLPOSCOPE HANDLING • 3 AFTER 2 MONTHS OF SUPERVISED COLPOSCOPY (DAILY /WEEKLY) • RETUN TO SHANGHAI FOR 3 DAYS OF EVALUATION ON PATIENTS • 4 SUBMITTED TO OSCI TYPE EXAM (BSCCP) AT END OF EVALUATION PERIOD AND IF SUCCESSFUL GIVEN TRAINERS CERTIFICATE
  • 25. High quality colposcopy is possible in the DIAGNOSIS and TEACHING using mobile colposcopy • No significant differences between colposcopy trained VIA nurses or doctors using fixed or mobile colposcopies in detecting high grade cervical lesions in high or low resource setting. • In low resource settings nurse-colposcopist can be employed with instant peer review. • High quality supervised colposcopy can be TAUGHT and administered under minimal infrastructural requirement and at limited economical setting with mobile colposcopy SUMMARY