EHA-ESH Tutorials on Diagnostics in Hematological Malignancies: A Didactic Model for Training Programs in Hematology in Developing Countries

Tutorials are yearly diagnostic courses on Hematological Malignancies organized by the European School of Hematology (ESH) and the European Hematology Association (EHA), in close collaboration with the Catholic University of Rome and “La Sapienza” University of Rome, carried out from 2004 and accredited by the European Council for Accreditation in Hematology (ECAH). For the first 4 years, Tutorials were also supported by a grant from the Marie Curie EC action. The main innovative aspect is the use of technological support for interactive self-evaluation sessions, prepared by the speakers, with real-time performance assessment. For technical reasons, the number of participant in each Tutorial is limited to 100. Tutorial sessions are organized around three different didactical tools:

• nine sessions of formal lectures during which the speakers move from principles of blood cytomorphology in the different categories of hematology malignancies according to the WHO classification to the analysis of the usability of gene profiling in class discovery and class prediction,

• nine sessions of tutored clinical case presentations: the same speakers present two to three interactive clinical cases, each going through the diagnostic pathway with special attention to differential diagnosis, different treatment opportunities and patient follow-up. A detailed final case-comment is also provided for all cases together with an updated and specific list of references,

• five sessions of self-evaluation tests: for each session, four clinical cases are presented in a standard format of six multiple choice questions with a list of five possible answers for each question.

Each trainee has a personal ID number to enable participation in the interactive tests by selecting one response to each question. At the end of the tests, results are anonymously and actively discussed with the authors. Speakers are leading European hematologists selected according to their specific competence in a specific field. The user appreciation and the validity of the didactic model is attested to by the worldwide participation: during these years, participants have come from 40 different countries from all five continents. EHA and ESH have been requested to duplicate these courses: the scientific material is organized on medial support and can be represented in other venues. From the year 2006, three Tutorials were successfully repeated in Brazil in association with the Escola Brasileira de Hematologia (the fourth is planned for October 2008). The organization of the repeated Tutorials (so called Type II Tutorials) is simpler than for the original ones: the local chair involves mainly local speakers for the lectures, while the didactic material (clinical cases and test cases) is the same as was used in the original Tutorial (Type I), with the support of just one or two faculty members from the original type I tutorial who have had experience in managing the didactic material.

The organization of the courses is expensive and technically complex: the didactic material of each course is uploaded on an intranet platform connected with 25 PC stations (one for every four participants). For this reason, the Tutorial held in Paris in February 2008 was technically organized with a specially developed software connected to a Voting Boxes System (VBS), which is portable and allows the same course interactivity; this system will be used in forthcoming years. In addition, the VBS will easily permit the organization of Type II Tutorials for training programs in hematology in developing countries. This will represent one of the forthcoming didactic programs of EHA and ESH.