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  1. Self-Learning and The Internet • Juan Gérvas, rural general practitioner (Canencia de la Sierra, Garganta de los Montes and El Cuadrón, Madrid, Spain), professor general practice and public health (National School of Public Health and Autonomous University, Madrid, Spain). • November 2009

  2. Self-Learning and The Internet • Presented at

  3. Self Learning and The Internet • Source: ”Gérvas, J. El auto-aprendizaje en la Red, un ejemplo prático (con pelos y señales). AMF; 2010 (in press). • Photo credits: Juan Gérvas • Technical support: Tiago Villanueva

  4. Self-Learning and The Internet • 1. Self-learning refers to auto-didacticism, a form of self-education or self directed learning. Autodidacts using the Internet spend time reading via websites, e-mails and so on.

  5. Self-Learning and The Internet • 2. Auto-didacts may or may not have designed a plan for their course of study. Auto-didacticism is sometimes associated with scepticism. It is always a pleasure and sometimes a necessity.

  6. Self-Learning and The Internet • 3. General practitioners (GP's) are stimulated to learn by their clinical activities. Trying to know about all the frequent questions GP's deal with in practice is a massive task. Having access to Internet facilitates the task of being a general specialist.

  7. Self-Learning and The Internet • 4. Self-learning is not a one time activity. Auto-didactism is a continuous activity in which GP's count with their previous knowledge to build up new one. And this new one knowledge helps going further.

  8. Self-Learning and The Internet • 5. Because self-learning is mainly a lonely activity, GP's need strong motivation to sustain self-learning throughout their whole life. The stimulus for this motivation is the ethical duty of offering the best to their patients with frequent and infrequent health problems.

  9. Self-Learning and The Internet • 6. There are many scientific questions which cannot be answered in almost every consultation, and even in one "simple" clinical encounter because of flu or because of insomnia. In fact there are no "simple" cases, no "standard" patients.

  10. Self-Learning and The Internet • 7. It helps in self-learning to have a note book where to write questions during the consultation. For example, after a consultation because of cough, what is the value of hearing no abnormal bruits for ruling out pneumonia?

  11. Self-Learning and The Internet • 8. First is to observe, to notice where we need to know more (we need to know more almost in each consultation, in all the cases, all health problems and patients). But the critical point is to transform observation into good questions, answerable questions.

  12. Self-Learning and The Internet • 9. Internet is open 24 hours a day all year round. Internet is an open door that transforms our physical solitude in a virtual community. We can open the door any time and ask aloud our clinical questions of the day.

  13. Self-Learning and The Internet • 10. Having no time for self learning is just an excuse. We need to learn because of our patients expectations and because of our dignity. After years of self compassion (having no time) we lost our self esteem and our dignity, and we offer poor clinical quality.

  14. Self-Learning and The Internet • 11. Self-learning helps in establishing a virtuous circle as it “rewards” us with better knowledge which then allows better clinical observation and more interesting questions. It merits to have time for self-learning.

  15. Self-Learning and The Internet • 12. A GP should resort to multiple sources of information on the Internet in order to come closer to the truth. No single source is enough. Contrasting different sources helps to build up our professional autonomy, our own opinion.

  16. Self-Learning and The Internet • 13. Main sources are: scientific journals, health and scientific organizations, e-mail lists, blogs and invisible colleges.

  17. Self-Learning and The Internet • 14. A few examples of scientific journals: Revista Portuguesa de Clínica Geral, British Medical Journal (BMJ), Atención Primaria, Boletín de Información Farmacoterapeútica de Navarra and so on. Most offer full free access.

  18. Self-Learning and The Internet • 15. A few examples of health and scientific institutions: European Centres for Disease Prevention and Control, NIVEL, NICE, European Medicines Agency. Most have excellent free information.

  19. Self-Learning and The Internet • 16. A few examples of e-mail lists: MGFamiliar, MEDFAM, PEDIAP, biojest, HSmembers. These lists are free and participation implies no compromise.

  20. Self-Learning and The Internet • 17. Many blogs do not merit a visit. But we can trust a few one as: saludyotrascosasdecomer, El Supositorio, Primum non nocere.

  21. Self-Learning and The Internet • 18. Invisible college refers to informal groups of scientists and thinkers that share knowledge and news. These in fact are networks of teaching and recognition. Internet helps in building up these informal communities as people can virtually very easily share documents, pictures and more.

  22. Self-Learning and The Internet • 19. Internet helps in self-learning meanly because of the “echo”. That is, when “asking” questions, answers often give more information than expected, and start a process of obtaining better and better information for more and more sources.

  23. Self-Learning and The Internet • 20. Self-learning is a moral and practical duty for GP's. The health of our patients and our own mental and “professional” health depend on this continuous activity. With the Internet, self-learning is easier than with traditional methods.