Today the Internet penetrated in every part of modern life.
Bill Gates in his monograph “Business at the speed of thought”
wrote “… with the introduction of Internet in the life of a person
to answer the question how much earns the specialist of this or
that sphere, it will be enough to ask: “what is his education?”
. First of all it is due to the fact that the Internet wipes off the
borders of space, of time, of language and the social borders.
Today a man, who is familiar with Internet technologies, can
freely communicate on-line with his colleagues, create associations
not only for spending free time, but for conducting business,
scientific work and education.
Taking into consideration that in the whole world modern
technologies of professional education system changed from
the principle “education for the whole life” to the principle
“education through the whole life”, such an idea as continuing
medical education is used very actively. That is why nowadays
receiving new quickly changing information in time is urgent as
More and more doctors prefer to find sources of knowledge
in the Internet . And it is reasonable. The emergence of new
printed publications, especially full-size scientific books, remains
behind in time from emergence of current information in global
net. Prices for subscription of periodical printed publications
remain rather high.
The World Health Organization conducted a research in
2003 and discovered that in 75 poor countries of the world
56% of Medical Institutions did not have an access to academic
medical journals over the last 5 years. That is why it is especially
pertinent to use the Internet for continuing education in developing
countries and regions, which are far from Educational
Medical Centers .
The Internet wipes the borders between states and nations,
and judging from this it becomes evident that Russia remains
behind other countries. Our gap in Internet-technologies is not
exclusion. United States of America is the doubtless and indisputable
leader in the development of global network, on its territory
emerged the Internet itself. Then go European countries.
But, recently in our country a positive tendency was exhibited,
and nowadays the Internet in Russia is developing very rapidly.
Everything that is happening to the World Wide Wed in
Russia has already happened to it in developed countries. And
we should not reject this great experience, but pay attention to
their important accumulations in this sphere.
The Internet is great source of valuable information. But one
should know how to find this information. In this context the
Internet can be compared to a big city, where there is everything
from libraries that contain world masterpieces to stalls that
That is why any work in the Internet begins with searching
necessary information. From this point of view we will try to
characterize briefly the sources of information in the Internet,
but we do not pretend to give full explanation of them.
To begin with it should be said that information in different
languages will be different. If the Internet wipes off the borders, it means that a user has an access to all national
sources. The most common language of the Internet is English.
The most valuable information and the greatest amount of it is
According to the sources, where one can find this information,
it can be divided into several chapters.
Extensive research databases
MedLine is one of the largest and most famous scientific
databases. It is supported by the American National Medical
Library of the National Institute of Health. It contains abstracts
almost of all periodical scientific printed and electronic publications
since 1950 to nowadays. It is nearly 15000000 journal
articles from nearly 5000 journals. The access to this database
can be received with the help of several Internet resources. The
best variant to do it is to use the site of National Medical Library
of America by visiting PubMed.
From this website one can make an unlimited number of
requests using intuitively understandable language, which syntax,
by the way, is very rich and allows very complicated enquires.
It is free of charge and does not need any registration. The
base for this language is Boolean algebra. This Internet service
provides a great set of abilities not only for searching but for
saving its results, making further work easier. All information in
MadLine database is in English.
The sites of Cochrane Collaboration also contain a great amount
of information, based on principles of evidentiary medicine.
Cochrane Collaboration is not only collection of information;
it is Medical Scientific Association, which deals not only with
selection of data, but also defines its scientific value, using the
principles of evidentiary medicine. Greater part of full-text information
is closed for unregistered users.
There is a number of other sources, which allow to find
scientific medical information in the Internet, but in most cases
they are based on these databases.
For the initial search one can use special search servers,
which are similar to search servers as Google, Yahoo, Yandex
and others. Search on these servers is called vertical search, the
search, which is limited by certain subject area, in our case it is
“medicine”, “urology”, “andrology” (Table I).
At all these sites the information is searched in Englishspeaking
sector of the Internet.
In the Russian-speaking sector of the Internet one vertical
search server in the chapter “Urology and Andrology” should
be noted, it is the site Explorer.UroWed.ru – urology researcher
To find these sites different mechanisms are used: databases
of global search servers, abstracts databases. Some of them
have their spiders (programs, which indexes information that
was found at the medical sites), and also use a combination of
these technologies. So, after finding the necessary information, reading the title
of the article and its abstract it is possible, using suggested reference,
to find its origin.
In this regard it is possible to define the next chapter of
Network representation of scientific printed
and electronic publications
In reality there are a lot of sources of information, but we will speak
only about those, which are purposeful scientific medical resources.
First of all, periodical printed publications – magazines are of
a great scientific and practical interest. Almost all representative
publishing houses have electronic versions of printed publications,
which are published at the same time and do not remain
behind printed versions according to the date of publishing.
Table II presents a short list of the most popular periodical
publishing houses that concern urology and andrology and are
available in the Internet.
The access to information at many of the resources listed in
Table 2 is chargeable. Mostly it concerns Internet representatives
of printed publishers. Sometimes, with a view to advertise it is
possible to receive some magazine fascicles and/ or some articles
free of charge. But, even Russian specialists can afford to subscribe
electronic versions of magazines. Some scientific associations that
are the owners of these magazines give a reduction for interested
specialists from Russia. Such a reduction can be given at the site of
European Association of Urologists (http://www.uroweb.org/).
Mane scientific and educational institutions have free access
to this information.
As the rule, full electronic versions are contained in convenient
pdf format. These files can be “downloaded” on your
computer and printed almost in the same way this article was
presented in the magazine. From this point of view html-versions
(it is the look of all the Internet sites) are much worse, because
they contain a lot of unnecessary information.
The site UroToday also should be paid attention. It contains a
lot of useful full-text information for urologists and andrologists,
which is updated every day. The site is always kept up to date.
But, the main part of information is available in English. The information of electronic publications is very valuable,
and the confidence is provided by scientific associations, which
are the editors and moderators of these editions.
A good example is given by Professional Association of
Andrologists in Russia (PAAR), which gives an opportunity to
become familiar with some articles of its regular printed publication
“Urology and Genital Surgery” and announcements of
the publication at the site http://www.andronet.ru. Also Russian
Society of Oncologists (http://www.roou.ru/) gives Internet users
a possibility to read some articles from the magazine “Oncology”
and subscribe for its printed version free of charge at the site
One can find the list of articles, published in the magazine
“Urology” at the site of the Institute of Scientific Research of
Electronic representative offices of professional
urological and andrological associations
The information, available at sites of professional urological
and andrological associations and also scientific-educational institutions and medical centers should be paid much attention.
North America (USA and Canada) and Europe are well represented
in the Internet
Legislators of fashion in the sphere electronic of Urology
(e - urology) are:
• The American Association of Urologists - and http://www.
• The European Association of Urologists - http://www.
• There are quite enough of andrology resources in the
• American Society of Andrologists - http://www.andrologysociety.
• The American Society of Reproductive Medicine - http://
• European Society of Sexual Medicine - http://www.essm.org/
• European Society of Reproduction and Embryology -
• British Scientific Society of Andrologists - http://www.
• British Society of Sexual Medicine - http://bssm.org.uk/
Also at these sites one can find useful information about
educational and scientific work of these centers.
Table 3 presents a short list of educational-scientific institutions.
The plenty of highly specialized directions in urology,
which are also widely represented in the Internet, is impressive
There is a great amount of information at these sites even
for people who are not members of these organizations. First of
all the recommendations of associations regarding management
of a patient are of a special value. As the rule they are available
for free “downloading”. Full-text scientific articles, the information regarding past and forthcoming conferences are of a great
If you are a member of professional association, you receive
a great support at these large sites. You receive an access to different
and very valuable information.
For such distant and big countries as Russia, Ukraine,
Byelorussia Internet representatives of leading urology and
andrology associations are very important from the educational
point of view. In this case with low prizes the speed of data
delivery is indisputably higher.
Russian scientific urological associations also have their sites,
which are listed in the table 5.
The full list of professional Russian-speaking sources of urology
one can find at the site http://www.uroweb.ru/resourse.
But one should be very careful with the
information received in the Internet
Availability and simplicity of Internet technologies give a
rise to great number of sites that contain a little amount of
information; it is so-called “Internet-noise”. This is the noise of
a big city.
Nowadays every user for a reasonable sum of money can get
any virtual area, where he can easily create and place his pages
and open a site in every place of the world (USA, China, Russia,
Iran and others).
With a help of few simple methods it is possibly to define
reliable source of information. We will try to name some of
A. Domein name of a site, which contains the information.
• The site, which has a domein name of a second level,
is more reliable then the site, placed as the domein of third
or higher level in the area that is free of charge. For example,
domein name of the American Urological Association (http://
www.auanet.org/) is better then domein name of the site,
placed in free of charge area like http://www.foo.narod.ru/
(http:// is a protocol, according to which the site works, it is not
interested for ordinary user, www is a definer of a global net,
auanet is the domain of a second level, org is a domain of the
first level, it can not be registered free of charge).
• It is a good sign if a site is placed at the national domain
of the first level. For Russia it is “ru”, for Byelorussia it is “by”.
But domeins org, com, net, edu are common domains, where
different useful sites can be placed.
• It is very positive if the name of a site reflects its context.
For example the site of American Urological Association auanet.
org shows that “aua” is an abbreviation of AUA (American
Urological Association), and “net” means a representation of
American Urological Association in the Internet.
This information is not obligatory, but if it is present, the site
becomes more reliable.
B. It is a positive feature, if a site contains the information
about its authors. Anonymous author is one of the signs,
which should put a user on his guard, because an honest
author has nothing to hide. It is very good to have a separate
page for this. This page should contain a return address; it is
preferable to have not only e-mail. Many authors of sites are
not ashamed to put their photos, what makes the user trust
this site more C. It is also very nice to have information concerning policy
of safety and rules of using the site.
D. Site without grammatical errors is a good tone and a sign
that the information on the site is being tested.
Usability of a site (it is a number of programme and design
decisions, which make the usage of a site convenient) also is
a sign of professionalism. But inconvenient site is not always
E. Electronic article you are reading at a site should contain
• The title
• Date of publication (date of publication at the site; it is one
of the important parameters, because the documents can live in
the network for a long time and titles like “Modern questions in
curing and diagnosing… ” can be not appropriate if the article
was published 10 years ago)
This list can be enlarged and detailed.
Search and examination of information in the Internet for self
education is one of the most frequent, convenient and popular
ways of continuing medical education. Internet technologies in
education go much further than the usual static presentation of
information. The peculiarity of these technologies allows not
only providing textual information, but also multimedia data,
organizing interactive communication, which makes the information
richer. Using the principle of a feedback gives a possibility
to get distance education.
According to many authors the usage of on-line learning
and videoconferencing improves access of doctors to qualified
continuing education , shows better results for self education,
and at the same time the programme on the basis is less
If to look at the hierarchy of the effectiveness of various
methods of learning in medicine, it becomes clear that on-line
training is on the first place (level).
• Level 1 - interactive clinical training
• Level 2 (a) - interactive training in the classroom
• Level 2 (b) – didactic clinical training
• Level 3 – didactic training in the classroom or standard
With the emergence of affordable high-speed links the Internet
provides an increasingly effective environment for interactive learning.
This interactive training web-based technology allows a doctor
to examine complex information in the absence of restrictions
in time and venue of education and allows the student to set for
himself the pace and depth of the material studied [7,9].
The 27th of August, 2001 RF Ministry of Health and Russian
Academy of Medical Sciences produced the Order No 344/76
“The concept of telemedicine technology development in
Russian Federation and the plan of its realization.” The document
states that the distance education used during preparation
of postgraduate medical staff has a number of advantages over
the traditional system of raising skills level. The needs of practical
health care system in educational services are met more fully,
the flexibility of postgraduate education system for practitioner,
the economic effectiveness, high quality of education, ability
to attract professionals from various regions of the country as
teachers, as well as practical opportunities for postgraduate
practitioner to get continuing education without moving somewhere
or leaving a place of work. Taking into consideration the
huge territory of the country and the presence of a large number
of very remote regions, this type of education would allow much
more doctors and nurses to regular training.
If to touch the technology of distant education briefly, it is
possible to identify some key points.
1. Registration and application for taking an interactive training
2. Process of education, which may consist of several ways
of learning the material.
a. Distant receiving of training materials and studying outside
the global networks (it is so-called off-line mode). Electronic
versions of programs a trainee can receive by e-mail or download
from other sources Internet and run them on his computer without
connecting with the global network.
b. Examination of the material on-line, ie being at the site,
which provides material for education. Not only common
static information (text, graphics, etc.) is used, but training in
connection with the training program, installed on the remote
computer, also is conducted.
c. Teleconferences are a direct connection with the teacher.
One can use text link (forums, chat, etc.), an audio or video conferences.
Videoconference is the most effective, and, therefore,
is the most valuable, if to speak about education, but it is quite
expensive, because it requires high-speed Internet channels.
3. Summarizing of education. Summarizing of education
can be discrete, ie after learning one topic and passing it successfully
a student can begin to study the next part of the programme.
At the end of the whole course one should pass a final
exam. It can be passed:
b. or teachers and students meet face-to-face.
A great variety of continuing medical education using
Internet technologies is presented in North America. Thus the
American Urological Association conducts continuing education
courses, which can be taken on not only by the members of the
association, but by urologists from other countries (http://www.
auanet.org/cme/). Subject certification courses regarding the problems of urology
are held at the site medscape.com (http://www.medscape.
com/urology/cme). And courses can be taken on not only by
doctors, but also by nurses.
European Urological Association conducts continuing medical
education, part of which could be accomplished with the
use of the Internet technologies of distance education. The site
http://www.eu-acme.org/ site. is devoted entirely to this issue.
There are not so many educational Internet centres in Russia;
especially those centres, which would conduct the education of
andrologists and urologists.
The bright example of distance education is the “Internetcentre
of distance education for doctors”, whish is sponsored
by the Smolensk Department of Clinical Pharmacology GMA
(FAC) and the Smolensk Research Institute of Antimicrobial
Chemotherapy GMA (IAC) (http://www.antibiotic.ru/rus/re/ ).
At the same site one can find a list of documents that regulate
the usage of Distant Education - http://www.antibiotic.ru/rus/re/
The Department of Urology in Rostov LGU (Head Professor
Kohan MI) is conducting face-to-face and in absentia thematic
courses in the sphere of urology very successfully. In absentia
part of these courses is conducted on-line, for the classroom part
a user comes to the department and passes the final exam there
Such a system of medical education allows the listeners not
to leave their place of work for a long time, helps to increase the
number of participants, makes the work of teachers easier and
reduces the real cost of courses[5,6,7,8].
The rapid development of information and communication
technologies and their active usage in practice reduces the price
of the hardware, connections and software significantly. It
makes an interactive on-line education available. That is why in
the near future we can hope that such training programs on the
basis of the institutions, leading departments and major clinical
centres, which train the specialists in urology and andrology, will
emerge in Russia. You can also expect the emergence of new
professional Russian-speaking sources of information, which will
deal with urology and andrology.