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Release: Immediate

UI doctor teaches Viennese medical residents via interactive tele-education project

IOWA CITY, Iowa -- Occasionally, Dr. Robert Folberg doesn't mind teaching to an empty classroom, as long as he knows his students are following him closely -- nearly 5,000 miles away.

For two years Folberg, Frederick C. Blodi Professor of Ophthalmology at the University of Iowa College of Medicine, has been delivering 20 interactive ocular pathology sessions a year to ophthalmology residents at West Virginia University, using telecommunications technology. Last month, Folberg and his colleagues extended the scope of their sophisticated medical telecasts to students at the Allegmeines Krankenhaus in Vienna, Austria. A third year of the 20-session program is planned for West Virginia in the fall, and two sessions will be given to the Viennese ophthalmology residents in June.

Incorporating a live, two-way video and audio hookup, a video-equipped microscope, slides of case study pathology, computer graphics via CD-ROM, and the UI's F.C. Blodi Eye Pathology Laboratory's World Wide Web page, Folberg displays and explains eye pathology to future ophthalmologists. The residents view the presentation on a large-screen monitor. When questions arise, they speak up as if in a traditional classroom, and Folberg responds.

"It's truly a unique experience," Folberg says. "We're using live discussion, computer-generated images, text, slides of specimens -- the students get all the trappings of a 'real' class. There is homework, it's just now done over the web, and assignments are submitted by email. But overall, it's not much different than what I'd be doing if I were in the classroom live."

During a session, Folberg sees almost all the dozen or so ophthalmology residents on his own video screen from the Braley Conference Room at the UIHC, as well as a smaller subscreen of the image being beamed to the students. Randy Verdick, the ophthalmology department's media coordinator, cues up images and monitors transmission levels from the lecture room booth. UIHC Telecommunications Services and NEC America, Inc. provide the technology and support.

The project is a cost-efficient innovation for ophthalmology training programs that do not have an eye pathologist on staff. Typically, these institutions pay for a qualified ocular pathologist to travel to their site and present the lectures. For less time and money, the UI project enables an institution hundreds or thousands of miles away to benefit from a UI professor's expertise. Likewise, institutions in the same city or state could someday develop collaborative projects that share faculty and reduce duplication of training programs.

"The goal was to create a new model for postgraduate medical education, one in which faculty are shared," Folberg says. "The Allegmeines Krankenhaus is well-respected for its world-class ophthalmology program, but they do not have an ocular pathologist at this time. Based on the success of our West Virginia collaboration, we both saw this as a good opportunity."

Interestingly, the late Dr. Frederick Blodi, a noted eye pathologist and former head of the UI ophthalmology department, trained at the Allegmeines Krankenhaus, as did Dr. Hansjoerg Kolder, UI emeritus professor of ophthalmology and distinguished cataract surgeon.

Folberg notes that the project is not really telemedicine. "We're not making diagnoses over the wire. It would be possible to make diagnoses by telemedicine, but in our program, a patient's biopsy samples or slides are sent to us for diagnosis, and we use this material in our teaching session."

Folberg actually ran into one of the Viennese ophthalmologists while attending a research conference in Florida recently. The student had positive feedback about the UI-delivered program, as well as a particularly unique case, and asked to send it to Folberg. "I said sure," he says. "A tele-education project like this builds teaching-learning relationships and, ultimately, consultative relationships."

The favorable responses Folberg receives about the program are due to the fact that the sessions are not treated as video lectures. A week or two before each session, students may email Folberg their ideas for themes to be discussed. If the topic is the cornea, for example, Folberg gathers actual patient cases that deal with the cornea, cases that also teach principles of ocular pathology. He could have chosen to simply deliver these concepts in a lecture format, but a "talking head" on a TV screen is not as effective -- or as fun-- for the students.

"Sometimes I feel like the Wizard of Oz. I'm behind this panel, pulling all the strings. I can bring a video pointer in, switch to a computerized image, switch to a pathology slide, run computer-generated animation and ask for student feedback," Folberg says. "We've been doing this long enough now that we sort of know how long to stay with an image, or myself talking, before the students start to get bored. We try to keep it as 'back and forth' as possible."

But Folberg emphasizes that the project "is not about technology. It's about using technology to solve educational and economic problems."

This September, Folberg will travel to Beijing as a guest of the Chinese government to explore the possibility of long-term educational and research collaborations between his laboratory and a facility in the Chinese capital.

For more information on Folberg's distance learning tele-education efforts, visit the Blodi Eye Pathology Laboratory Web site at


NOTE TO EDITORS: Dr. Folberg will deliver tele-education sessions to Viennese ophthalmologists on June 4 and June 25, beginning at 9 a.m. in the Braley Conference Room at the UIHC. If you are interested in covering/photographing one of these sessions, please contact Dave Pedersen at (319) 335-8032.