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 An integrated solution for teletraining of intern
 resident specialists


      Teresa Martinez-Cañavate                            Bachelor of Medicine - Intern Resident Specialists Portal-Andalusia Spain

      Purificación Cerón                                  Bachelor of Publicity - Intern Resident Specialists Portal-Andalusia Spain

      Luis Manuel Ortigosa                                Computer Science Engineer - Intern Resident Specialists Portal-Andalusia Spain

      Jose Luis de la Rosa                                Computer Science Engineer - Intern Resident Specialists Portal-Andalusia Spain




           The Intern Resident Specialists portal (PortalEIR) is the reference web platform for training, communication and collaboration
           between the resident specialists of Andalusia and all the professionals involved in specialized training. This project started in
           2006 and is part of the Training Strategic Plan of the Andalusian Public Health System. The main feature of this platform is that it
           integrates different web solutions such as a teletraining system, a document management system and a learning management
           system, adapting them to the specialized training environment in Andalusia. Besides the technological challenges, the develop-
Abstract




           ment of this project poses important challenges regarding communication, level of use, compliance with requirements, usability
           and process automation that will be analyzed in this paper. From 2006 until today more than 8.000 users had registered in the
           portal, 5.000 of them are residents, 1.500 tutors and the rest is staff in charge of learning management. It is expected that by 2013
           the number of active users will be more than 30.000, mainly due to the incorporation of teaching collaborators.
           Key words: Human Resources Formation; Distance, Education; Intership and Residency; Preceptorship; Information Services;
           Information Systems; Social Network.

           Una solución integrada para la teleformación de especialistas internos residentes
           El portal de Especialistas Internos Residentes (PortalEIR) es la plataforma web de referencia para la formación, comunicación
           y colaboración entre los especialistas internos residentes de Andalucía y todos los profesionales implicados en la formación
           especializada. Es un proyecto nacido en 2006 que se enmarca dentro del Plan Estratégico de Formación del Sistema Sanitario
           Público Andaluz. Esta plataforma se caracteriza por integrar diferentes soluciones web, entre las que se encuentran un sistema
           de teleformación, un sistema de gestión documental y un sistema de gestión de la formación, y adaptarlos al entorno de la for-
           mación especializada en Andalucía. Al margen de los retos tecnológicos, el desarrollo de este proyecto plantea continuamente
Resumen




           importantes desafíos en lo que se refiere a la comunicación, grado de utilización, recolección de requisitos, usabilidad y auto-
           matización de procesos que se analizarán en este artículo. Desde 2006 hasta la actualidad se han registrado en el portal más de
           8.000 usuarios, de los cuales más de 5.000 son residentes, 1.500 tutores y el resto es personal responsable de la gestión de la
           formación. Se espera que antes de 2013 el número de usuarios activos supere los 30.000 debido principalmente a la incorpo-
           ración de colaboradores docentes.
           Palabras clave: Formación de Recursos Humanos; Educación a Distancia; Internado y Residencia; Tutoria; Servicios de Infor-
           mación; Sistemas de Información; Telemedicina; Red Social.

           Uma solução integrada para a teleformação de especialistas internos residentes
           O portal de Especialistas Internos Residentes (PortalEIR) é a plataforma web de referência para a formação, comunicação e co-
           laboração entre os especialistas internos residentes de Andaluzia e todos os profissionais envolvidos na formação especializada.
           O projeto teve início em 2006 dentro do Plano Estratégico de Formação do Sistema Público de Saúde de Andaluzia. Essa plata-
           forma tem como característica principal a integração de diferentes soluções web, entre elas está um sistema de teleformação,
           um sistema de gestão documental e um sistema de gestão da formação, adaptando-os ao entorno da formação especializada
           em Andaluzia. Além dos desafios tecnológicos, o desenvolvimento deste projeto coloca, continuamente, importantes desafios
Resumo




           no que diz respeito à comunicação, grau de utilização, coleta de requisitos, usabilidade e automação de processos que serão
           analisados neste trabalho. De 2006 até hoje mais de 8.000 usuários se registraram no portal, sendo 5.000 residentes, 1.500
           tutores e os demais pessoal responsável pela gestão da formação. A expectativa é que até 2013 o número de usuários ativos
           supere os 30.000, principalmente devido à incorporação de colaboradores docentes.
           Palavras-chave: Formação de Recursos Humanos; Educação a Distância; Internato e Residência; Tutoria; Serviços de Informa-
           ção; Sistemas de Informação; Telemedicina; Rede Social.



                                                                         Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89             290
An integrated solution for teletraining of intern resident specialists




IntroductIon                                                             teaching staff who collaborate with tutors in teaching the
                                                                         residents. Several outcomes of the portal show a positive
     The EIRPortal is the reference web platform for train-              development over the last 12 months, such as the number
ing, communication and collaboration between the intern                  of monthly visits shown in the figure below, reaching more
resident specialists of Andalusia and all the professionals              than 15.000 per month, showing a clear upward trend.
involved in specialized training. The project started in 2006
and together with other projects is included in the Training
Strategic Plan of the Andalusian Public Health System1 pro-              Architecture
moted by the Health Department of Andalusia. In this Plan
the EIRPortal is defined as a knowledge management tool                      From an innovative standpoint, the EIRPortal contrib-
and a training platform for the development of complemen-                utes to unification in order to achieve a global solution of
tary transversal competences of the training programs of the             different integrated tools which are analyzed below and that
different especialties. The portal welcomes the design and               can be summarized as follows:
implementation of teaching methodologies, evaluation meth-                    ■■ Learning management: It is the component where the

odologies, electronic portfolios, collaboration group, etc.                      training of residents is managed and the integration of
                                                                                 the rest of components is coordinated. This compo-
                                                                                 nent is made up of a software application developed
                                                                                 according to the needs of the teaching commissions.
                                 training                                        It is developed through Django2 development frame
                                                                                 based on Python3 programming language;
                                                                              ■■ Teletraining: It is the system where courses are

          self-evaluation                          mentoring                     taught. It is based on Moodle4 and it is integrated
                                                                                 with the application of learning management to auto-
                                 resident                                        mate the student enrollment, the creation of courses
                                                                                 and the access to them;
                                                                              ■■ Collaborative System (or Social Network): It is a sys-

                                                                                 tem that integrates social network solutions applied to
                 collaboration              information
                                                                                 specialized training and professional’s collaboration.
                                                                                 This system is also integrated with the learning man-
                                                                                 agement and its goal is to welcome the intellectual
Figure 01 - Conceptual scheme of the teaching approach and                       capital of the Andalusian specialized training system;
knowledge management of the EIRPortal.                                        ■■ Document Management: It is the system that enables

                                                                                 to store all required documents for training and its
    From the technological point of view the main feature                        management. This system is based on Nuxeo 55 and
of the EIRPortal is to integrate different web solutions such                    it is completely integrated with the learning manage-
as a teletraining system, a document management system                           ment system and the social network. From a func-
and a learning management system, adapting them to the                           tional point of view, the non advanced user does not
specific environment of the specialized training in Andalusia.                   intervene directly in this system but in an indirect way
Besides the technological challenges the development of                          through the rest of the systems;
this project poses important challenges all the time regard-                  ■■ Business Intelligence System: This system is mainly ap-

ing communication, level of use, usability, compliance with                      plied for extracting information that enables the Health
requirements, process automation and standardization and                         Department to detect and determine the status of the
business intelligence that will be analyzed in this paper.                       specialized training system. It is based on an integra-
    Since 2006 until today the portal has more than 8000                         tion of Eclipse BIRT6 with the learning management
users, 5.000 of them are residents, 1.500 tutors and the                         system and it incorporates aspects that facilitate the
rest is people responsible for learning management. By                           data analysis as trend detectors. At the moment work
2013 it is expected that the number of active users will be                      is being done on an OnLine Analitycal Process (OLAP)
more than 30.000, mainly due to the incorporation of the                         model and in the definition of data mining processes.



291        Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89
An integrated solution for teletraining of intern resident specialists




Figure 02 - Number of monthly visits over the last 12 months.


                                                                         In the past each teaching commission had its own in-
                 PortalEIR Friendly User Interface                   dividual and isolated database for managing residents and
                                                                     tutors, causing information coherence problems, delays
                                                                     in generating reports and, from a global point of view, it
                           Learning                   Social         avoided having a globalized view of the resident’s training
        eLearning
                          Management                 Network         status. On the other hand, the management of these data-
                                                                     bases used to be centralized in each teaching commission
                                                      Document       on one or two people, resulting in work overload preventing
       Moodle         Hernel            BI                           the staff from dedicating to its own learning processes. In
                                                     Management
                                                                     order to solve this problem EIRPortal offered an Internet
                                                                     accessible web application where both managers and any
                                                                     other user could fill in the required data and participate in
        DB                      DB                        DB
                                                                     the management processes in a collaborative way. Thus,
                                                                     a typical web 2.0 philosophy had been followed, where
                                                                     users collaborate with the managers in order to keep the
                    Users and Groups Directory                       information. For example, residents participate in their own
                                                                     registration process on the platform and on the processes
                                                                     of training evaluation. Also, this participation is rewarded
Figure 03 - Layered Architecture of the EIRPortal.                   by some automated processes done by the portal, as for
                                                                     example, the system sends learning evaluation reminders
                                                                     through email in a complete automated manner. Users re-
Learning Management                                                  ply to these e-mails by web in order to obtain their grades
                                                                     in the courses taken.
    The learning management system is run by the teaching                From the learning management standpoint the portal
commissions that find in the portal tools with a high impact         is also a communication tool through which managers are
on the processes involved in this management. Below there            able to use up to four different ways to send messages.
are some of the most important processes to which the                Managers can send emails in a massive way; they can send
portal has meant a significant progress.                             SMS messages to mobile phones, publish interesting docu-



                                                                  Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89              292
An integrated solution for teletraining of intern resident specialists




ments via web and post messages on a virtual notice board                applications and assessments, information on courses
available in the personalized page of each user. Thus, each              taken, clinical sessions, bibliographic sessions, reflection
time they send something managers can select the target                  reports, etc. Furthermore, all this system is available to the
public applying different filters that take into account user´s          teaching commissions, head of studies and the Depart-
profile, specialty, class, etc. For example, a manager is able           ment of Health that can analyze how these relationships
to send a SMS to cardiology tutors in Seville or to second               are doing and thus, evaluate the mentoring system from
year dermatology residents.                                              their point of view.
                                                                             One key tool in mentoring is the Resident Electronic
                                                                         Portfolio where each student can self-evaluate his/her
collaborative Spaces                                                     learning based on competences such as citizen guidance,
                                                                         the learning attitude and continuous improvement and
     EIRPortal has working spaces where any portal user                  teamwork. The portfolio guides the resident in acquiring
can participate. These spaces are similar to the groups of               these and other competences through the tasks carried
social networks such as LinkedIn or Google Groups. The                   out and the evidences detected. The mentor participates
main difference between the working spaces of the EIR-                   guiding the resident with comments on his/her progress.
Portal and other social networks is not a technical aspect
but a social one. The main challenge faced by the EIRPor-
tal was to create the collaborative spirit of other networks             teletraining
at a professional environment that is not familiarized with
this type of solutions. This is why the EIRPortal team has                  The teletraining platform of the EIRPortal is based on
made a great effort especially on this idea, in order to take            Moodle and it is integrated with the learning management
to the highest level typical web 2.07 processes, such as                 application so that functions such as including new users,
sending informative email on the groups activity, the imple-             student enrollment and assignment of teaching staff to
mentation of an elaborate invitation process among users                 courses are completely automated. Thus, when creating a
and carrying out a special effort on all the issues related              course edition from the training management system, the
to usability. Thanks to this effort today EIRPortal has more             corresponding course in Moodle is automatically requested
than 200 working groups with more than 2.000 profession-                 based on course templates previously designed.
als involved and thousands of documents shared. These
results show a great improvement in implementing the so-
cial network in the specialized training system, although the            teaching network
team in charge of the portal expects to double this number
over the next year.                                                           The EIRPortal also offers the first tool of the Andalusian
     From the functionality point of view, the working spac-             Public Health System where the model of the training struc-
es enable to share documents, participate in debates,                    ture exists, in this particular case the structure of the spe-
send emails to the members of a same group and in-                       cialized training. Thus, the portal can be used as a guide for
vite any other person to take part in the working groups,                anybody who may need to get in touch with any teaching
among other functions.                                                   commission, teaching unit, head of studies or mentor. Also,
                                                                         the implementation of this system enables the Department
                                                                         of Health to know the structure of the teaching staff net-
Mentoring                                                                work all the time, being able to detect the proportion of
                                                                         mentors to residents in a particular area of Andalusia or at
    Through an invitation system, mentors can grant ac-                  a specific center in real time.
cess to their profile to the residents they supervise without                 One of the most relevant aspects of the implementation
the intervention of any other agent. From the assignment                 of the teaching network is that its data has been gathered
of the resident to the mentor and vice versa the EIRPor-                 by collaborative methods7, unlike what usually happens in
tal offers both a common working space and knowledge                     this type of organizations. Any user can contribute with
sharing as well as concrete tools for mentoring. Both men-               data to the teaching network enabling to gather information
tor and resident can share internal and external rotation                and updating it with great efficiency and conciseness.



293        Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89
An integrated solution for teletraining of intern resident specialists




Methodology for gathering requirements                                with the central government. This aspect is extremely im-
                                                                      portant in Spain where the allocation system of vacancies
     With more than 50 teaching commissions in Andalu-                for specialized training is coordinated at the central Minis-
sia, there is the urgent need to standardize the processes            try, whereas healthcare issues are delegated to the regional
implemented in the portal, so that it will be possible to es-         governments.
tablish a common communication channel between all the                     One of the most important components of the EIRPortal
commissions, residents, mentors and the Health Depart-                is teletraining and this is why there are plans for incorpo-
ment. The team of experts that analyzes the needs of the              rating new supports to implement teaching methodologies
portal found here an important challenge to overcome: to              such as mobile learning, personal learning, rapid learning,
develop a global portal through the proactive contribution            3D learning, etc.
of needs by all the users at the same time that the pro-                   The importance of social networks in internet also re-
cesses are standardized and improved.                                 quires a dissemination and communication strategy for
     When gathering requirements we had to face the need              them. The integration with networks such as Facebook,
of having to do re-engineering of essential processes of              Twitter and others is expected.
the learning management in order to have in its definition
the new tool to be developed. This meant to re-define a
great amount of processes completely. It was necessary to             reFerenceS
make an analysis of the requirements that should have the
participation of a huge amount of people. In order to solve           1. Andalucia. Consejería de Salud. Junta de Andalucía. Plan
                                                                         Estratégico de Formación Integral del Sistema Sanitario
this inconvenient working and requirement gathering meth-
                                                                         Público de Andalucía. Sistema Sanitario de Andalucía. Sevilla:
odologies were applied based on quick processes9. These                  Consejería de Salud, 2009. [Cited 2010 20 feb]. Available from:
processes enable to give fast and efficient answer to spe-               http://www.juntadeandalucia.e     s/agenciadecalidadsanitaria/
cific needs of the users the evaluation of the result including          formacionsalud/export/sites/default/galerias/descarga_
within the process itself, enabling a continuous improve-                documentacion_referencia/Plan_Formacion.pdf
ment process, which is really innovative in this environment.         2. Django. The web framework for perfectionists with
     In order to achieve a proactive attitude from the users,            deadlines. [Cited 2010 20 feb]. Available from: http://www.
                                                                         djangoproject.com/
the team prioritized the needs to be able to quickly optimize
                                                                      3. Python. Python Programming Language, Official Website.
processes and increase the efficiency of the training man-
                                                                         [Cited 2010 20 feb]. Available from: http://www.python.org/
agement, so that users could see reliable results in a short
                                                                      4. Moodle. Moodle community. Course Management System
term making them more confident in the system and get-                   (CMS), Learning Management System (LMS), Virtual Learning
ting more involved in the improvement process.                           Environment (VLE). [Cited 2010 20 feb]. Available from: http://
                                                                         www.moodle.org
                                                                      5. Nuxeo 5. Nuxeo Community Site. Nuxeo EP™ is an open
Future                                                                   source, standards-compliant, Java EE-based platform for
                                                                         Enterprise Content Management (ECM), both server-side and
                                                                         client-side. [Cited 2010 20 feb]. Available from: http://www.
     The EIRPortal project is funded by the European Social
                                                                         nuxeo.org
Fund until 2013, that is why there are many expectations
                                                                      6. Eclipse BIRT. Business Intelligence and Reporting Tools.
regarding its final progress. The main improvements that                 [Citado en 2010 20 feb]. Available from: http://www.eclipse.
will be done during this period of time are presented below.             org/birt/phoenix/
     Due to the need of guaranteeing the authenticity of              7. Web 2.0 [Cited 2010 20 feb]. Available from: http://es.wikipedia.
documents, it is planned to integrate the digital signature              org/wiki/Web_2.0
of documents through the use of the electronic Identity               8. Forte A, Bruckman A. Why do people write for wikipedia?
Number in all training management processes, such as                     Incentives to Contribute to Open-Content Publishing. Georgia:
yearly evaluations, final evaluation of the specialty, signing           Georgia Institute of Technology, College of Computing; 2005
                                                                         [Cited 2010 20 feb]. Available from: http://www.andreaforte.
of records, etc.
                                                                         net/ForteBruckmanWhyPeople Write.pdf
     In a very near future the integration of the EIRPortal with
                                                                      9. Beck K, Grenning J, Martit RC. Agile manifesto. [Cited 2010
the systems of the Ministry of Health will be a reality, en-             20 feb]. Available from: http://agilemanifesto.org/principles.html
abling to exchange all data on specialized training directly



                                                                   Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89               294

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An integrated solution for teletraining of intern resident specialists

  • 1. English An integrated solution for teletraining of intern resident specialists Teresa Martinez-Cañavate Bachelor of Medicine - Intern Resident Specialists Portal-Andalusia Spain Purificación Cerón Bachelor of Publicity - Intern Resident Specialists Portal-Andalusia Spain Luis Manuel Ortigosa Computer Science Engineer - Intern Resident Specialists Portal-Andalusia Spain Jose Luis de la Rosa Computer Science Engineer - Intern Resident Specialists Portal-Andalusia Spain The Intern Resident Specialists portal (PortalEIR) is the reference web platform for training, communication and collaboration between the resident specialists of Andalusia and all the professionals involved in specialized training. This project started in 2006 and is part of the Training Strategic Plan of the Andalusian Public Health System. The main feature of this platform is that it integrates different web solutions such as a teletraining system, a document management system and a learning management system, adapting them to the specialized training environment in Andalusia. Besides the technological challenges, the develop- Abstract ment of this project poses important challenges regarding communication, level of use, compliance with requirements, usability and process automation that will be analyzed in this paper. From 2006 until today more than 8.000 users had registered in the portal, 5.000 of them are residents, 1.500 tutors and the rest is staff in charge of learning management. It is expected that by 2013 the number of active users will be more than 30.000, mainly due to the incorporation of teaching collaborators. Key words: Human Resources Formation; Distance, Education; Intership and Residency; Preceptorship; Information Services; Information Systems; Social Network. Una solución integrada para la teleformación de especialistas internos residentes El portal de Especialistas Internos Residentes (PortalEIR) es la plataforma web de referencia para la formación, comunicación y colaboración entre los especialistas internos residentes de Andalucía y todos los profesionales implicados en la formación especializada. Es un proyecto nacido en 2006 que se enmarca dentro del Plan Estratégico de Formación del Sistema Sanitario Público Andaluz. Esta plataforma se caracteriza por integrar diferentes soluciones web, entre las que se encuentran un sistema de teleformación, un sistema de gestión documental y un sistema de gestión de la formación, y adaptarlos al entorno de la for- mación especializada en Andalucía. Al margen de los retos tecnológicos, el desarrollo de este proyecto plantea continuamente Resumen importantes desafíos en lo que se refiere a la comunicación, grado de utilización, recolección de requisitos, usabilidad y auto- matización de procesos que se analizarán en este artículo. Desde 2006 hasta la actualidad se han registrado en el portal más de 8.000 usuarios, de los cuales más de 5.000 son residentes, 1.500 tutores y el resto es personal responsable de la gestión de la formación. Se espera que antes de 2013 el número de usuarios activos supere los 30.000 debido principalmente a la incorpo- ración de colaboradores docentes. Palabras clave: Formación de Recursos Humanos; Educación a Distancia; Internado y Residencia; Tutoria; Servicios de Infor- mación; Sistemas de Información; Telemedicina; Red Social. Uma solução integrada para a teleformação de especialistas internos residentes O portal de Especialistas Internos Residentes (PortalEIR) é a plataforma web de referência para a formação, comunicação e co- laboração entre os especialistas internos residentes de Andaluzia e todos os profissionais envolvidos na formação especializada. O projeto teve início em 2006 dentro do Plano Estratégico de Formação do Sistema Público de Saúde de Andaluzia. Essa plata- forma tem como característica principal a integração de diferentes soluções web, entre elas está um sistema de teleformação, um sistema de gestão documental e um sistema de gestão da formação, adaptando-os ao entorno da formação especializada em Andaluzia. Além dos desafios tecnológicos, o desenvolvimento deste projeto coloca, continuamente, importantes desafios Resumo no que diz respeito à comunicação, grau de utilização, coleta de requisitos, usabilidade e automação de processos que serão analisados neste trabalho. De 2006 até hoje mais de 8.000 usuários se registraram no portal, sendo 5.000 residentes, 1.500 tutores e os demais pessoal responsável pela gestão da formação. A expectativa é que até 2013 o número de usuários ativos supere os 30.000, principalmente devido à incorporação de colaboradores docentes. Palavras-chave: Formação de Recursos Humanos; Educação a Distância; Internato e Residência; Tutoria; Serviços de Informa- ção; Sistemas de Informação; Telemedicina; Rede Social. Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89 290
  • 2. An integrated solution for teletraining of intern resident specialists IntroductIon teaching staff who collaborate with tutors in teaching the residents. Several outcomes of the portal show a positive The EIRPortal is the reference web platform for train- development over the last 12 months, such as the number ing, communication and collaboration between the intern of monthly visits shown in the figure below, reaching more resident specialists of Andalusia and all the professionals than 15.000 per month, showing a clear upward trend. involved in specialized training. The project started in 2006 and together with other projects is included in the Training Strategic Plan of the Andalusian Public Health System1 pro- Architecture moted by the Health Department of Andalusia. In this Plan the EIRPortal is defined as a knowledge management tool From an innovative standpoint, the EIRPortal contrib- and a training platform for the development of complemen- utes to unification in order to achieve a global solution of tary transversal competences of the training programs of the different integrated tools which are analyzed below and that different especialties. The portal welcomes the design and can be summarized as follows: implementation of teaching methodologies, evaluation meth- ■■ Learning management: It is the component where the odologies, electronic portfolios, collaboration group, etc. training of residents is managed and the integration of the rest of components is coordinated. This compo- nent is made up of a software application developed according to the needs of the teaching commissions. training It is developed through Django2 development frame based on Python3 programming language; ■■ Teletraining: It is the system where courses are self-evaluation mentoring taught. It is based on Moodle4 and it is integrated with the application of learning management to auto- resident mate the student enrollment, the creation of courses and the access to them; ■■ Collaborative System (or Social Network): It is a sys- tem that integrates social network solutions applied to collaboration information specialized training and professional’s collaboration. This system is also integrated with the learning man- agement and its goal is to welcome the intellectual Figure 01 - Conceptual scheme of the teaching approach and capital of the Andalusian specialized training system; knowledge management of the EIRPortal. ■■ Document Management: It is the system that enables to store all required documents for training and its From the technological point of view the main feature management. This system is based on Nuxeo 55 and of the EIRPortal is to integrate different web solutions such it is completely integrated with the learning manage- as a teletraining system, a document management system ment system and the social network. From a func- and a learning management system, adapting them to the tional point of view, the non advanced user does not specific environment of the specialized training in Andalusia. intervene directly in this system but in an indirect way Besides the technological challenges the development of through the rest of the systems; this project poses important challenges all the time regard- ■■ Business Intelligence System: This system is mainly ap- ing communication, level of use, usability, compliance with plied for extracting information that enables the Health requirements, process automation and standardization and Department to detect and determine the status of the business intelligence that will be analyzed in this paper. specialized training system. It is based on an integra- Since 2006 until today the portal has more than 8000 tion of Eclipse BIRT6 with the learning management users, 5.000 of them are residents, 1.500 tutors and the system and it incorporates aspects that facilitate the rest is people responsible for learning management. By data analysis as trend detectors. At the moment work 2013 it is expected that the number of active users will be is being done on an OnLine Analitycal Process (OLAP) more than 30.000, mainly due to the incorporation of the model and in the definition of data mining processes. 291 Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89
  • 3. An integrated solution for teletraining of intern resident specialists Figure 02 - Number of monthly visits over the last 12 months. In the past each teaching commission had its own in- PortalEIR Friendly User Interface dividual and isolated database for managing residents and tutors, causing information coherence problems, delays in generating reports and, from a global point of view, it Learning Social avoided having a globalized view of the resident’s training eLearning Management Network status. On the other hand, the management of these data- bases used to be centralized in each teaching commission Document on one or two people, resulting in work overload preventing Moodle Hernel BI the staff from dedicating to its own learning processes. In Management order to solve this problem EIRPortal offered an Internet accessible web application where both managers and any other user could fill in the required data and participate in DB DB DB the management processes in a collaborative way. Thus, a typical web 2.0 philosophy had been followed, where users collaborate with the managers in order to keep the Users and Groups Directory information. For example, residents participate in their own registration process on the platform and on the processes of training evaluation. Also, this participation is rewarded Figure 03 - Layered Architecture of the EIRPortal. by some automated processes done by the portal, as for example, the system sends learning evaluation reminders through email in a complete automated manner. Users re- Learning Management ply to these e-mails by web in order to obtain their grades in the courses taken. The learning management system is run by the teaching From the learning management standpoint the portal commissions that find in the portal tools with a high impact is also a communication tool through which managers are on the processes involved in this management. Below there able to use up to four different ways to send messages. are some of the most important processes to which the Managers can send emails in a massive way; they can send portal has meant a significant progress. SMS messages to mobile phones, publish interesting docu- Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89 292
  • 4. An integrated solution for teletraining of intern resident specialists ments via web and post messages on a virtual notice board applications and assessments, information on courses available in the personalized page of each user. Thus, each taken, clinical sessions, bibliographic sessions, reflection time they send something managers can select the target reports, etc. Furthermore, all this system is available to the public applying different filters that take into account user´s teaching commissions, head of studies and the Depart- profile, specialty, class, etc. For example, a manager is able ment of Health that can analyze how these relationships to send a SMS to cardiology tutors in Seville or to second are doing and thus, evaluate the mentoring system from year dermatology residents. their point of view. One key tool in mentoring is the Resident Electronic Portfolio where each student can self-evaluate his/her collaborative Spaces learning based on competences such as citizen guidance, the learning attitude and continuous improvement and EIRPortal has working spaces where any portal user teamwork. The portfolio guides the resident in acquiring can participate. These spaces are similar to the groups of these and other competences through the tasks carried social networks such as LinkedIn or Google Groups. The out and the evidences detected. The mentor participates main difference between the working spaces of the EIR- guiding the resident with comments on his/her progress. Portal and other social networks is not a technical aspect but a social one. The main challenge faced by the EIRPor- tal was to create the collaborative spirit of other networks teletraining at a professional environment that is not familiarized with this type of solutions. This is why the EIRPortal team has The teletraining platform of the EIRPortal is based on made a great effort especially on this idea, in order to take Moodle and it is integrated with the learning management to the highest level typical web 2.07 processes, such as application so that functions such as including new users, sending informative email on the groups activity, the imple- student enrollment and assignment of teaching staff to mentation of an elaborate invitation process among users courses are completely automated. Thus, when creating a and carrying out a special effort on all the issues related course edition from the training management system, the to usability. Thanks to this effort today EIRPortal has more corresponding course in Moodle is automatically requested than 200 working groups with more than 2.000 profession- based on course templates previously designed. als involved and thousands of documents shared. These results show a great improvement in implementing the so- cial network in the specialized training system, although the teaching network team in charge of the portal expects to double this number over the next year. The EIRPortal also offers the first tool of the Andalusian From the functionality point of view, the working spac- Public Health System where the model of the training struc- es enable to share documents, participate in debates, ture exists, in this particular case the structure of the spe- send emails to the members of a same group and in- cialized training. Thus, the portal can be used as a guide for vite any other person to take part in the working groups, anybody who may need to get in touch with any teaching among other functions. commission, teaching unit, head of studies or mentor. Also, the implementation of this system enables the Department of Health to know the structure of the teaching staff net- Mentoring work all the time, being able to detect the proportion of mentors to residents in a particular area of Andalusia or at Through an invitation system, mentors can grant ac- a specific center in real time. cess to their profile to the residents they supervise without One of the most relevant aspects of the implementation the intervention of any other agent. From the assignment of the teaching network is that its data has been gathered of the resident to the mentor and vice versa the EIRPor- by collaborative methods7, unlike what usually happens in tal offers both a common working space and knowledge this type of organizations. Any user can contribute with sharing as well as concrete tools for mentoring. Both men- data to the teaching network enabling to gather information tor and resident can share internal and external rotation and updating it with great efficiency and conciseness. 293 Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89
  • 5. An integrated solution for teletraining of intern resident specialists Methodology for gathering requirements with the central government. This aspect is extremely im- portant in Spain where the allocation system of vacancies With more than 50 teaching commissions in Andalu- for specialized training is coordinated at the central Minis- sia, there is the urgent need to standardize the processes try, whereas healthcare issues are delegated to the regional implemented in the portal, so that it will be possible to es- governments. tablish a common communication channel between all the One of the most important components of the EIRPortal commissions, residents, mentors and the Health Depart- is teletraining and this is why there are plans for incorpo- ment. The team of experts that analyzes the needs of the rating new supports to implement teaching methodologies portal found here an important challenge to overcome: to such as mobile learning, personal learning, rapid learning, develop a global portal through the proactive contribution 3D learning, etc. of needs by all the users at the same time that the pro- The importance of social networks in internet also re- cesses are standardized and improved. quires a dissemination and communication strategy for When gathering requirements we had to face the need them. The integration with networks such as Facebook, of having to do re-engineering of essential processes of Twitter and others is expected. the learning management in order to have in its definition the new tool to be developed. This meant to re-define a great amount of processes completely. It was necessary to reFerenceS make an analysis of the requirements that should have the participation of a huge amount of people. In order to solve 1. Andalucia. Consejería de Salud. Junta de Andalucía. Plan Estratégico de Formación Integral del Sistema Sanitario this inconvenient working and requirement gathering meth- Público de Andalucía. Sistema Sanitario de Andalucía. Sevilla: odologies were applied based on quick processes9. These Consejería de Salud, 2009. [Cited 2010 20 feb]. Available from: processes enable to give fast and efficient answer to spe- http://www.juntadeandalucia.e s/agenciadecalidadsanitaria/ cific needs of the users the evaluation of the result including formacionsalud/export/sites/default/galerias/descarga_ within the process itself, enabling a continuous improve- documentacion_referencia/Plan_Formacion.pdf ment process, which is really innovative in this environment. 2. Django. The web framework for perfectionists with In order to achieve a proactive attitude from the users, deadlines. [Cited 2010 20 feb]. Available from: http://www. djangoproject.com/ the team prioritized the needs to be able to quickly optimize 3. Python. Python Programming Language, Official Website. processes and increase the efficiency of the training man- [Cited 2010 20 feb]. Available from: http://www.python.org/ agement, so that users could see reliable results in a short 4. Moodle. Moodle community. Course Management System term making them more confident in the system and get- (CMS), Learning Management System (LMS), Virtual Learning ting more involved in the improvement process. Environment (VLE). [Cited 2010 20 feb]. Available from: http:// www.moodle.org 5. Nuxeo 5. Nuxeo Community Site. Nuxeo EP™ is an open Future source, standards-compliant, Java EE-based platform for Enterprise Content Management (ECM), both server-side and client-side. [Cited 2010 20 feb]. Available from: http://www. The EIRPortal project is funded by the European Social nuxeo.org Fund until 2013, that is why there are many expectations 6. Eclipse BIRT. Business Intelligence and Reporting Tools. regarding its final progress. The main improvements that [Citado en 2010 20 feb]. Available from: http://www.eclipse. will be done during this period of time are presented below. org/birt/phoenix/ Due to the need of guaranteeing the authenticity of 7. Web 2.0 [Cited 2010 20 feb]. Available from: http://es.wikipedia. documents, it is planned to integrate the digital signature org/wiki/Web_2.0 of documents through the use of the electronic Identity 8. Forte A, Bruckman A. Why do people write for wikipedia? Number in all training management processes, such as Incentives to Contribute to Open-Content Publishing. Georgia: yearly evaluations, final evaluation of the specialty, signing Georgia Institute of Technology, College of Computing; 2005 [Cited 2010 20 feb]. Available from: http://www.andreaforte. of records, etc. net/ForteBruckmanWhyPeople Write.pdf In a very near future the integration of the EIRPortal with 9. Beck K, Grenning J, Martit RC. Agile manifesto. [Cited 2010 the systems of the Ministry of Health will be a reality, en- 20 feb]. Available from: http://agilemanifesto.org/principles.html abling to exchange all data on specialized training directly Latin Am J Telehealth, Belo Horizonte, 2009; 1 (1): 78-89 294