European Heart Journal (2014) 35, 1089–1094 doi:10.1093/eurheartj/ehu118

The European Society of Cardiology Webinars A new tool and a step forward into the future of medical education in Cardiology Education is the most powerful weapon which you can use to change the world Nelson Mandela

1. High-quality scientific content based on ESC Guidelines: all webinars are based on the ESC Guidelines, with a strong focus on how to apply them in clinical practice. The programme covers all areas of knowledge in Cardiovascular Science, from disease prevention to end-stage heart failure. Top experts and key opinion leaders are invited to review the new evidence and discuss the best approaches in several clinical scenarios. According to survey questionnaires, .95% of the attendees rated the webinars as good or excellent for improving their clinical practice. 2. Clinical case based: all webinars are based on the discussion of one or several real clinical cases from our everyday clinical practice. The best approach to the patient, the recommended diagnostic test, and the best treatment alternative are discussed in each case. 3. Interactivity: the webinars are transmitted live in real time and, therefore, it is possible to directly interact with the speakers. To improve the attendees’ experience, throughout the webinar it is possible to vote on several multiple-choice questions, comment on the pooled results, and send online questions to the experts. 4. Watch them ‘live’ or ‘on demand’: most webinars are transmitted in the evening and for this interactive experience they should be attended live. However, for people not able to attend the live event, it is possible to watch the recording at any time by going to the Archives. Attending the webinars in groups at hospitals or university can be more fun and they can be used to trigger a local discussion of a particular topic. 5. Portability: all webinars can be watched using an Internet connection on computers, iPads, tablets, and other mobile devices. So wherever people are, it is possible to learn while having fun. 6. Accredited by European Board for Accreditation in Cardiology (EBAC): the webinars can be used for continuous medical education and are accredited by the EBAC. 7. Free: during this season all 11 webinars on general cardiology are completely free of charge. Only a pre-registration is needed using an ESC account.

Figure 1 Remaining schedule for the 2013 – 14 European Society of Cardiology webinars on general cardiology. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2014. For permissions please email: [email protected]

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Cardiology is a fast-moving medical specialty, which creates an increasing demand for continuous medical education. In the modern era, since the introduction of the Internet, the ways we communicate, interact, work, and behave have changed. Education in Cardiology is no exception and new tools for online

education (‘e-learning’) are now one of the mainstreams of medical education. Keeping pace with these new trends, the European Society of Cardiology (ESC) has created an innovative tool to improve medical education in Cardiovascular Medicine: The ESC Webinars on general cardiology. This programme consists of a series of monthly scientific and highly educational sessions that are transmitted live via the Internet, to a virtual and worldwide audience (Figure 1).

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Figure 2 Example of the European Society of Cardiology webinar on ‘Stable Coronary Artery Disease’: live transmission through the Internet from a TV studio. Peter Kearney, University College Cork, Ireland (left). Gilles Montalescot, Pitie´-Salpe´trie`re Hospital, France (right).

Cardiologists urged to reduce inappropriate radiation exposure Radiation from cardiology procedures equals that from more than 50 chest X-rays per person each year Cardiologists were urged to reduce patient radiation exposure in a European Society of Cardiology (ESC) position paper that outlines doses and risks of common cardiology examinations for the first time. The paper was published on 9 January 2014 in the European Heart Journal.1 Lead author Dr Eugenio Picano, FESC, said: ‘Cardiologists today, are the true contemporary radiologists. Cardiology accounts for 40% of patient radiology exposure and equals more than 50 chest X-rays per person per year’. He added: ‘Unfortunately, radiation risks are not widely known to all cardiologists and patients and this creates a potential for unwanted damage that will appear as cancers, decades down the line. We need the entire cardiology community to be proactive in minimising the radiological friendly fire in our imaging labs’. The paper lists doses and risks of the most common cardiology examinations for the first time. Computed tomography, percutaneous coronary intervention (PCI), cardiac electrophysiology, and

nuclear cardiology deliver a dose equivalent to 750 chest X-rays (with wide variation from 100 to 2000 chest X-rays) per procedure. These procedures are performed daily in all cardiology in- and outpatient departments, usually more than one procedure per admission. They are used for all forms of cardiac disease, from congenital to heart failure, but more intensively and frequently for ischaemic heart disease. Percutaneous coronary intervention for dilation of coronary artery stenosis totals almost 1 million procedures per year in Europe. The additional lifetime risk of fatal and non-fatal cancer for one PCI ranges from 1 in 1000 to 1 in 100 for a healthy 50-year-old man. Risks are 1.38 times higher in women and four times higher in children. Dr Picano said: ‘Even in the best centres, and even when the income of doctors is not related to number of examinations performed, 30 to 50% of examinations are totally or partially inappropriate according to specialty recommendations. When examinations are appropriate, the dose is often not systematically audited and therefore not optimised, with values which are 2 to 10 times higher than the reference, expected dose’.

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The aim is to help cardiologists (and other medical specialists) to improve the care of patients with cardiovascular diseases, according to the most recent ESC recommendations. The programme is designed for cardiologists willing to update their scientific knowledge, for clinicians seeking to acquire new tools to improve their daily clinical practice, and for young doctors in their training for Cardiovascular Medicine. The new Webinars programme, which started in September 2013, is transmitted live from a TV studio (see Figure 2) and has several key features. The webinars in general cardiology are complementary to the webinars in the subspecialties, which are also organized in cooperation with the ESC Associations (EACVI, EHRA, and ACCA) and are part of the e-learning offering provided by the ESC: webinars, e-learning platform, interactive clinical cases, and webcasts. In conclusion, the new web-based learning technologies are here to stay. The major advantages include overcoming barriers of distance and time at lower cost. This can be particularly relevant in times when economic, regulatory, and professional constraints are putting increasing pressure on physician travel and continuous medical education. The audience can be worldwide: new targets can be reached and more cardiologists can be updated with the new recommendations. The main goals are to improve patient care and to ‘reduce the burden of cardiovascular disease’ in Europe and throughout the world.

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He added: ‘The smart patient and the smart cardiologist cannot be afraid of radiation since it is essential and often lifesaving. But they must be very afraid of radiation negligence or unawareness. This paper will help to make cardiology wards and laboratories a safer place for patients and doctors through an increase of radiation awareness and knowledge’. Prof. Patrizio Lancellotti, FESC, president of the European Association of Cardiovascular Imaging (EACVI) of the ESC, said: ‘The radiation issue was first brought to the attention of the international cardiology community by European cardiologists and now it is right and fitting that the ESC delivers this paper’. ESC Press Office Andros Tofield

Reference 1. Picano E, Van˜o´ E, Rehani MM, Cuocolo A, Mont L, Bodi V, Bar O, Maccia C, Pierard L, Sicari R, Plein S, Mahrholdt H, Lancellotti P, Knuuti J, Heidbuchel H, Di Mario C, Badano LP. The appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular Imaging, Percutaneous Cardiovascular Interventions and Electrophysiology. Eur Heart J 2014;35:665–672.

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The European Society of Cardiology Webinars.

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