An academic website in reproductive medicine.

Abstract

This article describes how the author created an academic website in reproductive medicine, and presents data on visitor profiles. The website provides access to interactive lectures, computer-generated tests, quizzes, searchable databases, and a bulletin board for approved users. The website is international in scope, collaborative, asynchronous in delivery, flexible, and responsive to learner needs. Visitors from industrialized countries accessed the lessons on polycystic ovary syndrome, amenorrhea, and infertility. In 2004, the total number of unique visitors was 21,269.

Introduction

In recent years, increasing numbers of medical institutions in the United States and abroad have incorporated innovative methods of teaching and research using the Internet technologies (Barzansky et al. 2000; Jenkins, 2002; Zondervan et al. 2002). The Association of Professors of Gynecology and Obstetrics (APGO) website reveals several medical centers in the United States and Canada have also established departmental websites (APGO, 2005). The links provide information on what other institutions are doing with regard to medical education programs, residencies and fellowships, departments and faculty, patient care and research.

Besides healthcare professionals, many infertile couples are actively using the Internet for their fertility problems (Weissman et al. 2000; Epstein et al. 2002; Haagen et al. 2003). However, posting of information on the Internet does not always undergo peer reviews or need some standard for publication. The use of standardized curriculum and innovative techniques for providing education are important steps for graduate training of future doctors in reproductive medicine (Soules, 1994; Davis et al. 1995; Jenkins, 1999; Alvero et al. 2004). The World Wide Web provides a delivery system for transferring information to many users without the barriers of time and geography (Chu & Chan, 1998). Developing web-based learning represents an evolution that needs experienced website designers, surveys of the targeted audience, focus groups, and analysis of server data or a combination of these methods (Letterie et al. 1994, 1996; Jenkins et al. 2001).

Web-based learning may be suitable setting for women's health issues because of the multidisciplinary nature and need for vertical integration throughout medical school curriculums. According to a recent study, the web-based instruction resolved barriers associated with limited curriculum time and faculty availability, provided an accessible and standard curriculum, and met the needs of adult learners in a medicine clerkship (Zebrack et al. 2005). More studies in defined clinical settings are needed to realize the full potentials of web-based learning for women's health education. Websites designed at academic institutions and departments must present authentic content, be consistent in navigation, use simple graphics, and highlight ease of maintenance (Singh, 2002). Towards this end, the department of obstetrics and gynecology at the Louisiana State Health Sciences Center in Shreveport launched the first academic website in September 1997.

This article describes how the author created an academic website in reproductive medicine, and presents data on visitor profiles to show how they used the website in recent years.

Methods

The departmental server (PowerEdge 2300, Dell Computer Corporation, Round Rock, TX) runs under Windows 2000 operating system (Microsoft Corporation, Redmond, WA). Ancillary units installed were an automated tape backup, uninterruptible power supply, an antivirus software program, and a redundant array of independent disks to provide safety measures against unexpected system failures.

The design for the website followed guidelines proposed by the Journal of American Medical Association (JAMA) core standards for publications (Silberg et al. 1997). The individual pages were created using a software that creates web pages with hypertext markup language (NetObjects Fusion, Website Pros, Inc., Jacksonville, FL). The departmental faculty and guests provided teaching materials that were tested by this author for content, consistency, and style before posting. The topics in reproductive medicine were designed in modules according to the guidelines previously described (Davis et al. 1995). Slide shows were produced using Microsoft PowerPoint and the training modules were created using Trainersoft software (San Diego, CA). Multiple-choice questions were written using Questionmark software (Stamford, CT).

The laparoscopy training videos were produced in collaboration with another institution, and edited with Camtasia Studio software (Okemos, MI). CodeCharge software (Utica, MI) was used to create backend databases for case studies on the intranet using Microsoft Access program. A bulletin board was also created to encourage private discussions among the participants.

Data on the website visits from January through December 2004 were analyzed using a commercial log analysis program (WebTrends Log Analyzer, Version 6.5; NetIQ Corporation, San Jose, CA). The study features included the number of successful hits, page views, most popular pages viewed, number of visits and the duration of each visit, number of visitors, and country. Results were interpreted using the terminology described in the software manual. When tracking the traffic on the website, the term unique visitor refers to a person who visits the website more than once within a mentioned period.

Results

As of December 2004, the main departmental site includes 238 pages with 3,771 links, including 467 found on 99 external servers providing women's healthcare education. The department website provides links to various sections that include administrative and teaching materials. The Lessons and the Visiting Professors sections contain modular topics in reproductive medicine such as menstrual disorders, polycystic ovary syndrome, endometriosis, infertility, and laparoscopy. The Library section is an online source for teaching materials and learning materials in reproductive medicine.

In 2004, the website had received 657,195 successful hits in 172,444 page views during 61,309 visits. The total number of unique visitors, those who visited the site more than once, was 21,269. The average duration of the visit lasted about 14 minutes. The top five countries that accounted for the majority (71.5%) of visits were the United States (41,317 visits), the Netherlands (968 visits), Canada (694 visits), United Kingdom (423 visits), and Japan (416 visits). Visitors from Africa and Central America had the lowest total scores. The visitors mainly accessed the site from the home page, which accounts for 7,063 visits. Other common pages accessed for the endocrinology and infertility modules were the polycystic ovary syndrome page with 1,665 visits, amenorrhea page (1,348 visits) and infertility page (1,118 visits).

Discussion

This article describes how the author created an academic websites using standard methods, and shows the feasibility of providing online education in reproductive medicine. The website provides access to interactive lectures, computer-generated tests, quizzes, searchable databases, and a bulletin board for approved users. Streaming videos for laparoscopy training are the most recent addition currently undergoing usability testing.

The author created this website using the JAMA core standards for publication. The site was tailored to meet the needs of medical students and residents in the department. This study extends our previous experience, which shows a consistent growth of the department website since inception eight years earlier (Singh, 2002). Collaborative learning is an important learning principle, yet online programs are mostly completed in a one-on-one relationship between the computer and the learner. This model limits opportunities for reflective learning, and does not access the rich learning available from interacting with peers.

The website described in this article presents web-based education. Using the browser alone, students and residents can review the educational content, send electronic mails to the faculty, provide feedback, and participate in bulletin boards for information exchange. They can also view and download lecture materials on their computers for future reference. The website provides links to textbooks in reproductive medicine, online journals, and teaching files for further education. Academic institutions, government agencies, professional organizations, and commercial enterprises today provide enormous amount of information on women's healthcare (Feingold et al. 1977; Cole, 1999). Previous studies using the Internet technologies have shown promising results about resident education in women's health care for endocrinology and infertility (Letterie et al. 1994, 1996; Jenkins, 1999; Jenkins et al. 2001). However, providing high quality online education in distant locations creates special challenges.

Advances in information technology have important implications for medical education. Such advances bring new opportunities and challenges to medical education. The plethora of information available on the web is overwhelming, and both students and staff need to be taught how to manage it effectively (Ward et al. 2001). Although online teaching is increasingly used in medical education, few studies have reported on the value of online learning in postgraduate training. In a recent study, web-based education proved effective, well accepted, and efficient for internal medicine residents. It facilitated effective and satisfying learning experience without requiring faculty involvement (Cook & Dupras 2004; Cook et al. 2005). By consistently employing principles of effective learning, educators will soon unlock the full potential of the web to provide online medical education.

Conclusion

Academic websites designed in-house can provide online education in reproductive medicine to a global audience. The use of standardized curriculum and innovative techniques for providing online education are important steps for graduate training of future doctors in reproductive medicine. More studies are needed on its effectiveness in changing the clinical practices of the participants.

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Endnote 

[1] The department website created by the author is located at http://obg.lsumc.edu/obg/ index.html. Accessed October 11, 2005.

Krishna B. Singh, Louisiana State University 

Dr. Singh is an Associate Professor in the Department of Obstetrics and Gynecology at the Health Sciences Center, Shreveport