A Train-the-Trainers (TtT) Program for Engineers for Hosting Multiparty International Clinical Teleconferences

DOI: https://doi.org/10.29086/JISfTeH.7.e16

Keywords: telemedicine, distant learning, videoconference, international, multiparty, train-the-trainer


Background: International clinical teleconferencing connecting hospitals contributes to the standardisation of medical care. Introduction: The perception that participating in international teleconferences is easy while hosting and coordinating them is difficult has limited the expansion of these kinds of programmes. We evaluated the effectiveness of a Train-the-Trainer (TtT) programme on hosting international multiparty teleconferences targeted at hospital engineers. Methods: From 2015 to 2017, 20 engineers and physicians from 17 institutions in 10 countries participated in Kyushu University Hospital’s TtT programme. Hands-on training and hosting a Training Report Conference (TRC) were conducted. The impact of the programme was assessed using questionnaires about the participants’ confidence, perception of barriers, and teleconference activity before and one year after the training period. Results: The mean training period was 16.7 days (median, 19 days). Twelve TRCs were hosted by trainees connecting 56 institutions in 11 countries. All participants gave positive evaluations of the overall programme, 19 (95%) "very good" and 1 (5%) "good", and the trainers 9 (90%) "very good" and 1 (10%) "good"). Following the TtT programme, the mean number of trainee-hosted events increased significantly (0.8 to 1.3, p<0.001), and more respondents (12/17, 71%) reported barriers to hosting a programme than participating in one (5/17, 29%, p<0.001). Trainee confidence in both hosting and participating in international teleconferences was significantly higher after TtT. Conclusion: There are more barriers to hosting than participating in international clinical teleconferences. This TtT programmes for engineers could contribute to more active hosting engagement.


Parkin DM. Global cancer statistics in the year 2000. Lancet Onco 2001;2(9):533–543. DOI: https://doi.org/10.1016/S1470-2045(01)00486-7.

Yao K, Uedo N, Muto M, et al. Development of an e-learning system for the endoscopic diagnosis of early gastric cancer: an international multicenter randomized controlled trial. EBioMedicine 2016;9:140–147. DOI: https://doi.org/10.1016/j.ebiom.2016.05.016.

Hoxha Z, Osmani K, Mora F, et al. The Contribution of the telemedicine programme of Kosova on e-learning and continuous medical education: the outcomes of the first decade. J Int Soc Telemed eHealth 2013;3:93–97. Available at: http://journals.ukzn.ac.za/index.php/jisfteh/article/view/50 accessed 30 December 2018.

Numanoglu A. Using telemedicine to teach paediatric surgery in resource-limited countries. Pediatr Surg Int 2017;33(4):471–474. DOI: 10.1007/s00383-016-4051-6.

Davis D. Continuing medical education. Global health, global learning. BMJ 1998;316(7128):385–389. DOI: https://doi.org/10.1136/bmj.316.7128.385.

Moreika A, Raul A-C, Alberto M, Jose C. Enhancing collaborative case diagnoses through unified medical language system-based diambiguation: a case study of the Zika virus. Telemed J E Heal 2016;23(7):608–614. DOI: 10.1089/tmj.2016.0203.

Scott Kruse C, Karem P, Shifflett K, et al. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare 2018;24(1):4–12. DOI: 10.1177/1357633X16674087.

Kudo K, Tomimatsu S, Houkabe Y, et al. Five-year technological changes of distant medical education in Asia. J Int Soc Telemed eHealth 2017(5):e10. Available at: http://journals.ukzn.ac.za/index.php/jisfteh/article/view/317 accessed 30 December 2018.

Santos A de F dos, Alves HJJ, Nogueira JT, Torres RM, Melo MD. Telehealth distance education course in Latin America: analysis of an experience involving 15 countries. Telemed J E Heal 2014;20(8):736–741. DOI: 10.1089/tmj.2013.0291

Krupinski EA, Weinstein RS. Telemedicine in an academic center-The Arizona Telemedicine Programme. Telemed J E Health 2013;19(5):349–356. DOI:10.1089/tmj.2012.0285.

Shimizu S, Nakashima N, Okamura K, et al. International transmission of uncompressed endoscopic surgery images via superfast broadband Internet connections. Surg Endosc 2006;20(1):167–170. DOI: https://doi-org.ukzn.idm.oclc.org/10.1007/s00464-005-0282-7..

Assemi M, Mutha S, Hudmon KS. Evaluation of a train-the-trainer programme for cultural competence. Am J PharmEduc 2007;71(6):110. 2007. PMID: 19503694

Stratos GA, Katz S, Bergen MR, Hallenbeck J. Faculty development in end-of-life care: evaluation of a national train-the-trainer programme. Acad Med 2006;81:1000–1007. DOI: 10.1097/01.ACM.0000242475.41549.66.

Lee SWH, Mak VSL. Train-the-trainer programme on cardiovascular health for community pharmacists in Malaysia. Int J Clin Pharm 2017;39(6):1166–1170. DOI: 10.1007/s11096-017-0540-5.

Minh CD, Shimizu S, Antoku Y, et al. Emerging technologies for telemedicine. Korean J Radiol 2012;13(Suppl 1):S21–30. DOI: 10.3348/kjr.2012.13.S1.S21.

Fatehi F, Armfield R N, Dimitrijevic M, Gray C L. Technical aspects of clinical videoconferencing: a large scale review of the literature. J Telemed Telecare 2015;21(3):160–166. DOI: 10.1177/1357633X15571999.

Telemedicine Development Center of Asia, About Med-hok. Available at: http://www.temdec.med.kyushu-u.ac.jp/medhok_min/about_00outline.html accessed 30 December 2018.

Panganiban KM, Jeffrey D. The first telemedicine network of the Philippines “Beyond Borders.” Surg Endosc 2017; 31(Suppl 1):68. DOI: https://doi.org/10.1007/s00464-017-5448-6.

Zhang K, Liu W-L-L, Locatis C, Ackerman M. Mobile videoconferencing apps for telemedicine. Telemed J E Health 2016;22(1):56–62. 2016. DOI: https://www.liebertpub.com/doi/10.1089/tmj.2015.0027.

Samelli AG, Rabelo CM, Sanches SGG, Aquino CP, Gonzaga D. Tablet-based hearing screening test. Telemed J E Health 2017;23(9):747–752. DOI: 10.1089/tmj.2016.0253.

Walker TWM, Chadha A, Rodgers W, Mills C, Ayliffe P. Electronic follow-up of developing world cleft patients: a digital dream? Telemed J E Health 2017;23(10):847–851. DOI: 10.1089/tmj.2017.0012.

Johnston MJ, King D, Arora S, et al. Smartphones let surgeons know WhatsApp: An analysis of communication in emergency surgical teams. Am J Surg 2015;209(1):45–51.DOI: http://dx.doi.org/10.1016/j.amjsurg.2014.08.030.

Stolyar V, Lukianova E, Amcheslavskaya M, et al. Modern Approach to the study of telemedicine technologies in the Medical Institute. J Int Soc Telemed eHealth 2018(6):e12. Available at: https://journals.ukzn.ac.za/index.php/JISfTeH/article/view/505 accessed 31 January 2019.

Ho SH, Rerknimitr R, Kudo K, et al. Telemedicine for gastrointestinal endoscopy: The Endoscopic Club E-conference in the Asia Pacific Region. Endosc Int Open 2017;5(4):E244–252. DOI: https://doi.org/10.1055/s-0043-102935.

How to Cite
Kudo, K., Moriyama, T., Tomimatsu, S., Ueda, S., & Shimizu, S. (2019). A Train-the-Trainers (TtT) Program for Engineers for Hosting Multiparty International Clinical Teleconferences. Journal of the International Society for Telemedicine and EHealth, 7, e16 (1-8). https://doi.org/10.29086/JISfTeH.7.e16
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