Development of the UP Med Webinars for Continuing Medical Education in the Philippines

Abstract

Objective

This study aims to describe the design, development, and implementation of the UP Med Webinars as a method for delivering continuing medical education online.

Methods

Thematic analysis was done to organize information to describe the three phases of development: design, planning, and implementation of the UP Med Webinars for the period of 2015-2021.

Results

The University of the Philippines Medical Alumni Society, in collaboration with seven units from the University of the Philippines Manila, contributed resources to the design of the UP Med Webinars. A committee on continuing medical education composed of alumni celebrating their silver jubilee led the planning each year. A total of 435 webinars were conducted from 2015 to 2021. Attendance steadily grew from less than 50 to more than 600 participants per session. These webinars covered a wide range of topics and were attended by medical professionals from different disciplines. Continuing professional development units were provided for free.

Conclusion

The UP Med Webinars was able to deliver post-graduate content online to healthcare professionals in the Philippine medical community. A well-organized set of partners collaborating to design and develop continuing medical education online was key to its continuous implementation and expansion.

INTRODUCTION

Continuing medical education (CME) is an important methodology for maintaining a corps of qualified medical professionals. By attending, professionals obtain up-to-date information to enable them to provide high standards of care to their patients. Traditionally, CMEs have been offered in physical venues packed with practicing physicians listening to updates from renowned experts. While CMEs are necessary, they are also expensive given the resources required for logistics such as venues, meals, transportation, and accommodations. There are also opportunity losses because physicians are unable to see patients during these CMEs. These challenges have spurred the development of a new methodology called the webinar.¹

As early as 2010, the University of the Philippines Manila National Telehealth Center had begun using video conferencing tools to deliver lectures to a remote audience.² This was first tested in Roxas City when experts from the National Poisons Center in PGH answered questions in realtime from barangay health workers undergoing training at the Capiz Provincial Health Office. This first experience served as the basis for the use of the same tool for disseminating health information in the Philippines. What began as a research program at the National Telehealth Center was extended to the “UP Med Webinars” - the first and largest series of online continuing medical education (CME) in the Philippines that continues to this day.

In 2016, Republic Act No. 10912 was passed.² Called the “Continuing Professional Development Act of 2016”, it required the submission of proof of continuing education to the Professional Regulatory Commission (PRC) before professionals can renew their identification card. This law created high demand for continuing professional development (CPD) activities. And with the high demand for CPD units, there was a clamor to increase the opportunities for continuing medical education.

The University of the Philippines Manila has always been at the forefront of CMEs. The Postgraduate Institute of Medicine (PGIM) was established to ensure the availability of these courses, degree, and non-degree, for physicians and other health professionals in the country.

The UP Med Webinars evolved from being a featured activity of the UP Medical Alumni Society under the stewardship of UPCM Class 1990 in 2015,³ to becoming one of the key methods for delivering continuing medical education at UP Manila. This paper describes how the UP Med Webinars were designed, developed, and implemented.

METHODS

This is a retrospective descriptive study conducted from September 2022 to August 2023 that reviewed various documents regarding the UP Med Webinars from its inception in 2015 to 2021. This study was exempted from review by the UPMREB (2022-0472-EX).

The source documents reviewed were the correspondence and memorandum of agreements between stakeholders, webinar publicity posters and programmes, evaluation summaries, and other online sources, such as the social media page of the UP Med Webinars, UPMAS, UP Manila, and College of Medicine. These documents contained the historical information on the webinars, list of topics, dates and speakers as well as aggregate counts of attendees. All authors reconstructed the activities that transpired during their tenures, as well as their reflections and insights.

The outcomes of the study were:

1. Design – conceptualization, branding, technical platform and schedule, goals, target audience, and provision of CPD units.

2. Development – lead organizer, pioneering UPCM class, collaborators/stakeholders

3. Implementation – number of webinars, attendance/participation, evolution of technical platform/social media engagement, and major challenges

Basic descriptive statistical analysis and thematic analysis were performed on available data.

RESULTS

Design

The concept of the UP Med Webinars was initially presented by a former alumnus who was also a managing director at a pharmaceutical company. He suggested that UPMAS consider offering live streaming of lectures featuring expert alumni of the UP College of Medicine renowned in their respective fields. His idea was based on webinars organized by distinguished medical institutions in the United States of America that he had attended.

The UP Med Webinars initially targeted primary care physicians, including general practitioners, family medicine practitioners, community medicine physicians, and industrial and occupational medicine practitioners. It particularly aimed to reach health workers in underserved communities and populations in the Philippines such as the Doctors to the Barrios of the Department of Health. This free online learning resource was also made available to the University of the Philippines Manila School of Health Sciences in Palo, Leyte, in Baler, Aurora, and in Koronadal, South Cotabato.

The webinars were scheduled during lunch break, from 12:00 PM to 1:00 PM, to make it easy to attend even for the busy physicians. Viewing from anywhere was possible using any Internet-connected device, like a smartphone or a tablet. In areas where stable, high speed internet connection was not readily available to everyone, group viewings were setup by some academic institutions for their medical students or physicians in-training. Attendance to the webinar was credited, if a picture of the attendees in a group viewing set-up was emailed to the PGIM.

The resource speakers usually were fielded from the silver jubilarian class of the UPMAS, and represented the different specialties, especially the major departments: Internal Medicine, Pediatrics, Surgery, and Obstetrics-Gynecology. Topics ranged from common diseases, both infectious and non-communicable, that primary care providers were likely to encounter. During the COVID-19 pandemic, controversial topics such as vaccinations found their way into the webinars. The interactive format of the webinars culminated the lecture with a question-and-answer portion where participants can post their queries and the speaker answers in real time.

Continuing professional development (CPD) units for the webinars were applied to the Professional Regulation Commission (PRC) Board of Medicine, Pharmacy, and Nursing. They were then expanded later to include midwives. The number of CPD units granted ranged from 0.5 to 1 unit per webinar.

The original logo of the UP Med Webinars was designed by Nicolo Diego F. Genuino and became an important component in branding (Figure 1). The main part of the logo is the silhouette of Rizal’s “The Triumph of Science over Death” – a nude sculpture of a young woman standing on a large skull and with both arms stretched upwards and hands holding a torch. This life-sized statue presently stands in Pedro Gil Street in Manila. Above this silhouette is a dot with the Wi-Fi icon representing the connectivity of the UPCM to the world through the Internet.

Figure 1.

The original logo of the UP Med Webinars.

Development

The UP Med Webinars was formally adopted by the UPMAS board and assigned to the Committee on Continuing Medical Education.⁴ As an organization, the UPMAS is composed of all the graduates of the UPCM, headed by a board of trustees representing different generations of alumni. A partnership with the current silver jubilarian homecoming class was established.

The first UP Med Webinars were led by the UPCM Class 1990, the UPMAS silver jubilarians for the annual college homecoming in 2015. These initial webinar series were conceptualized to bridge the knowledge gaps in medicine and health care. In addition to the first grant, the UP Med Webinars also received similar support and sponsorships from other partners. Acknowledgments and full disclosures were made for each webinar, as required by ethical guidelines set by the College of Medicine and the pharmaceutical industry.

The first UP Med Webinar was held on June 3, 2015, by Dr. Jose Pujalte, Jr., who spoke about Common Musculoskeletal Problems.⁵ There were 42 registered participants. The UPM Chancellor, Dr. Carmencita D. Padilla, gave a welcome speech at the beginning of the webinar. In the first year of the webinars up to 2016, the UPCM Class 1990 was able to organize a total of 11 webinars. Holding the first UP Med Webinars required substantial planning and pooling of resources. Aside from the UPMAS, other stakeholders were engaged to guarantee its success. A memorandum of agreement on support and collaboration was signed on February 25, 2015 and included the following stakeholders:

University of the Philippines Manila

The Chancellor of the UPM, Dr. Carmencita D. Padilla granted use of available resources of UPM, while waiving the corresponding fees. The official UPM website featured all the webinars. The UP Manila Information, Publication and Public Affairs Office, headed then by Prof. Erlyn A. Sana, helped in the marketing of the UP Med Webinars.

University of the Philippines College of Medicine

The Dean of the UPCM, Dr. Agnes D. Mejia allowed the use of available resources and manpower of the UPCM, without fees. A page on the website of UPCM featured information regarding the UP Med Webinars.

UPCM Post-graduate Institute of Medicine (PGIM)

The Post-graduate Institute of Medicine of the UPCM, headed then by Dr. Lenora C. Fernandez, served as the UP Med Webinars’ official provider of Continuing Professional Development (CPD) Programs, as recognized by the Philippine Regulation Commission and the CPD Council, pursuant to Republic Act No. 10912. As the CPD provider, the PGIM took charge of the timely submission of all requirements set by the PRC for UP Med Webinars as a CPD Program. The PGIM also applied for accreditation of CME units with the Philippine Medical Association, pursuant to the PMA Code for Continuing Medical Education.⁶ The PGIM staff, Ms. Cyrille Panaglima-Santos, organized the list of registered participants for each webinar and sent individual electronic certificates of attendance, with the corresponding number of CPD units approved by the CPD Council of Medicine and the number of CME units approved by the Philippine Medical Association, to all webinar participants.

National Telehealth Center (NTHC)

The NTHC, under the leadership of Dr. Portia Fernandez-Marcelo, together with the Asia eHealth Information Network (AeHIN) provided the technical expertise in using the GoToWebinar platform.⁷ GoToWebinar was a web-based, by-subscription digital platform for hosting webinars. An NTHC personnel, Ms. Charisse Orjalo, was assigned to supervise the webinars. Ms. Orjalo taught the UP Med Webinars team technical skills on webinar set up and program, including welcome, speaker introduction, moderating and conducting discussions, and closing the webinar using the webinar platform.

UPM Information Management Service (IMS)

Under the leadership of Prof. Ariel S. Betan, the UPM IMS provided the needed bandwidth and technical support for hosting the UP Med Webinars, at the time when adequate internet speed was a challenge in most parts of the Philippines. The Video Conference Room 1 on the second floor of the IMS Building along Padre Faura Street, Manila was the assigned venue for the UP Med Webinars, hosting the speakers and moderators. Broadcasting the UP Med Webinars from a central location guaranteed the smoother programming of the webinars. Speakers and other members of the webinar team were also allowed to participate remotely, if they met the minimum technical requirements during a pilot test done prior to the day of the broadcast. The adjacent Video Conference Room 2 was made available for live participants and for those who wanted to view the live streamed webinar. The UPM website, www.livestream.upm.edu.ph, became the alternative to the GoToWebinars website for viewing the live stream of the UP Med Webinars. This UPM website was developed in coordination with Mr. Bayani Benjamin R. Lara of the Department of Science and Technology Advanced Science and Technology Institute.

UPCM Medical Informatics Unit (MIU)

The MIU, under the leadership of Dr. Iris Thiele I. Tan and through its administrative staff, Ms. Isis M. Alva, assisted in the dissemination of the UP Med Webinars through its networks and occasionally provided technical and content advice to optimize the goals of the UP Med Webinars.

Implementation

A total of 435 webinars were conducted from 2015 to 2021, steadily increasing from an initial number of 9 to 135 webinars per year by the end of 2021 (by 1400%) (Figure 2). The webinars stopped briefly for a week due to the COVID-19 pandemic lockdown on March 15, 2020, but resumed soon after. Instead of streaming the webinars physically from the UPM-Information Management Service Building, the speakers, reactors, and moderators, participated from their homes as the webinars were completely held online through the newly acquired UP Manila Zoom platform.

Figure 2.

Line graph showing the total number of webinars per year for the first seven years of the UP Med Webinars.

(Based on the information from https://cm.upm.edu.ph/p/med-webinar/ and https://www.facebook.com/upmedwebinars).

Beginning with just 42 participants in June 2015, attendance steadily grew. In its second year in 2016, the average attendance doubled; and in 2017, the average attendance reached 200 per webinar which exceeded the capacity of the online platform. This constrained the organizers to seek other mechanisms to accommodate the enlarging audience.

Social media initially played the role of promoting the UP Med Webinars beyond the UPCM and the UPM community. The use of Facebook, Twitter, and Viber enabled the sharing of the webinar schedules and electronic posters to a wider audience. The easy sharing of the registration link and QR code to each webinar made the registration process more user friendly. The main Facebook page⁸, UP Med Webinars, has remained immensely popular, with more than 64,000 followers⁹. A search done on Facebook of the term “webinar” showed UP Med Webinars on the top of the results.

In addition, the use of Facebook Live added a larger space for live streaming and real time interaction between the audience and the webinar team. In 2022, the live streaming on Facebook was migrated to a private Facebook group, UP Med Webinars 2022, which allowed for a more secure setting for discussion among its more than 5,000 members.

With this new expanded platform, the greatest number of registered participants on record was in 2018 for the UP Med webinar on the dengue vaccine with 680 participants. As the attendance increased, there was also a corresponding increase in the demand for more webinars. This resulted in a steady increase in the total number of webinars per year that was seen in the first seven years of the UP Med Webinars.

DISCUSSION

The main findings are:

1. Design and Conceptualization

   • The UP Med Webinars originated from the idea of an alumnus who proposed live streaming of expert alumni lectures, inspired by similar initiatives in the United States.
   • UPMAS initiated the UP Med Webinars in partnership with the silver jubilarian homecoming class of UPCM.
   • The webinars aimed to bridge knowledge gaps in medicine and healthcare.
   • A Memorandum of Agreement was signed between various stakeholders, and acknowledgments and disclosures were made in adherence to ethical guidelines.
   • The UP Med Webinars were successfully launched, featuring expert speakers and generating substantial participation.
2. Development

   • UPMAS, representing UPCM graduates, formally adopted UP Med Webinars and assigned it to the Committee on Continuing Medical Education.
   • The first webinars were led by UPCM Class of 1990 and were institutionalized as part of the annual college homecoming.
3. Implementation

   • Various stakeholders, including UPM, UPCM, PGIM, NTHC, IMS, and MIU, collaborated to ensure the success of every webinar.
   • Technical expertise, infrastructure support, and promotional efforts were provided by these stakeholders.
   • The organizational structure and collaboration facilitated the efficient execution of webinars, aligning with professional development requirements.

Strengths and Challenges

The success of the UP Med Webinars may be attributed to its long roster of alumni, who served as the speakers, reactors, and moderators. Considered as one of the biggest assets of the UPCM, these graduates have become excellent leaders in their respective fields. They serve as a deep pool of renowned resource speakers on various topics of the webinars. The wide range of topics were chosen because of the interest they sparked and the timeliness in the current health landscape, especially during the COVID-19 pandemic.

The concept of the UP Med Webinars has inspired other organizations in the UPM to start their own webinar series. More webinars were conducted by other organizations such as the Mu Sigma Phi Sorority which launched the Mu Webinars that advocated wellness in the geriatric population. The continued success of these webinars to date is a manifestation of how the model set by the UP Med Webinars can be duplicated effectively.¹⁰

Another strength of the UP Med Webinars was that it catered to primary care providers and health workers in the grassroots of the Philippine health system. Networking through the various primary care medical societies, the DOH Doctors to the Barrios, and the UP Manila School of Health Sciences in the three major island groups (Luzon, Visayas, and Mindanao) proved to be a major strategy to gain a wide following. Providing CPD units also aligned with the PRC Resolution 2016-990, entitled Amendments to the Revised Guidelines on the Continuing Professional Development Program (CPD) for all Registered and Licensed Professionals.¹¹ This Resolution set the minimum required number of CPD units to 45 CPD units every 3 years for physicians renewing their PRC license. All physicians were required upon renewal of their PRC license to submit certificates of attendance to educational activities that were approved by the CPD Council of Medicine. As a free webinar that issued electronic certificates of attendance compliant with the regulations of the PRC, the UP Med Webinars saw a steady increase in the number of registered participants, mostly from the alumni of the UPCM. The convenience of online webinars held during one’s lunch break was also a key strength since it did not interfere with day-to-day tasks. As smartphones became widely used even in far-flung provinces and the internet became available and affordable as “Piso-Wifi’ at the sari-sari stores, healthcare workers could easily log in to these free webinars.

When the COVID-19 pandemic was declared, the UP Med Webinars mechanism was in place to assist in disseminating reliable information to health professionals. At the height of the pandemic, the sessions doubled compared to the pre-pandemic years. In response to the clamor for authoritative information, UP Med Webinars featured various topics related to COVID-19.

Future Thrusts

Through the UPMAS, the UP Med Webinars had been able to adapt to the changing times by instituting policy modifications that addressed the changing needs of its audience. Regular review of its scientific content is important for the UP Med Webinars to remain relevant to its audience. Integration of the UP Med Webinars scientific content with the curriculum of medical and paramedical schools in the countryside, such as the UPM School for the Health Sciences in Baler, Koronadal, and Leyte, would benefit institutions that need to complement their roster of faculty members. The webinars can be designed to supplement and enrich the content of medical and allied medical education, especially in the field of medical innovations.

As a vehicle to earn CPD credits required by the PRC for renewal of license, the UP Med Webinars can possibly be converted to webinars-on-demand that can target international healthcare professionals, like Overseas Filipino Workers, who live in different time zones and cannot view the sessions live. This model of remote learning, however, would have challenges like the identification and authentication of the asynchronous participants.

Evaluating the effectiveness of online methods of CMEs is a challenge. After seven years, it is essential to truly gauge the degree of learning from the webinars as an educational activity. Evaluation forms after each webinar is the only tool that is currently available, and this only gathers qualitative information on certain aspects of the webinars like overall perception on applicability of the topic to the work of the participant, fulfillment of the objectives set by the speaker, ease of use of webinar platform, quality of the audio-visual presentations, and suggestions for future topics. Evaluation of the strengths and weaknesses of the webinar program in terms of educational value and audience reach is important in assuring the continued success of future webinars. Pre-tests and post-tests could be given prior to issuance of electronic certificates.

Limitations

Logistical, financial, administrative, and demand generation challenges were not explored and may be done in future qualitative studies using key informant interviews or focus group discussions of stakeholders. Two of the authors (RFG, ABM) were involved in the organization and launching of the UP Med Webinars in 2015 while all three authors (including MPY) oversaw the UP Med Webinars either as webinar coordinator (RFG) or presidents of the UPMAS during their respective terms. Potential bias in identifying strengths, weaknesses, and challenges were minimized by consensus discussions on the gathered information and emerging themes.

CONCLUSION

The UP Med Webinars has successfully evolved from being a featured experimental activity to becoming one of the main sources of continuing medical education in the Philippine healthcare field. Webinars carry the advantage of reaching a wider audience at a lower operating cost per participant. The interactive add-ons of the different streaming platforms have enabled the participants to connect to the presenters in real time.

Future thrusts include integrating the content into rural medical school curricula and exploring webinars-on-demand for an international audience. Evaluating the program's educational value through measures like pre-tests, post-tests, and participant feedback is crucial for sustained success.

Statement of Authorship

All authors certified fulfillment of ICMJE authorship criteria.

Author Disclosure

All authors declared no conflicts of interest.

Funding Source

The study was funded by the authors.