We evaluated various aspects of grand rounds videoconferenced from a tertiary care hospital to a regional hospital in Nova Scotia. During a five-month study period, 29 rounds were broadcast (19 in medicine and 10 in cardiology). The total recorded attendance at the remote site was 103, comprising 70 specialists, nine family physicians and 24 other health-care professionals. We received 55 evaluations, a response rate of 53%. On a five-point Likert scale (on which higher scores indicated better quality), mean ratings by remote-site participants of the technical quality of the videoconference were 3.0-3.5, with the lowest ratings being for ability to hear the discussion (3.0) and to see visual aids (3.1). Mean ratings for content, presentation, discussion and educational value were 3.8 or higher. Of the 49 physicians who presented the rounds, we received evaluations from 41, a response rate of 84%. The presenters rated all aspects of the videoconference and interaction with remote sites at 3.8 or lower. The lowest ratings were for ability to see the remote sites (3.0) and the usefulness of the discussion (3.4). We received 278 evaluations from participants at the presenting site, an estimated response rate of about 55%. The results indicated no adverse opinions of the effect of videoconferencing (mean scores 3.1-3.3). The estimated costs of videoconferencing one grand round to one site and four sites were C dollars 723 and C dollars 1515, respectively. The study confirmed that videoconferenced rounds can provide satisfactory continuing medical education to community specialists, which is an especially important consideration as maintenance of certification becomes mandatory.

Videoconferencing has been used for continuing medical education (CME) in Nova Scotia since a pilot project to four communities in 1995. The Nova Scotia Telehealth Network was developed after the pilot project. Using the network, the videoconferenced CME programme expanded over the next few years until in, 2000 1, 66 programmes were broadcast to 38 sites. During the expansion of the programme, we improved video quality and developed efficient methods of: scheduling and planning the content of the videoconferences; training faculty presenters in videoconferencing techniques; and evaluation. We consider this programme represents a success. However, several aspects could be improved. Faculty members still need encouragement to make visual aids legible by videoconference and to provide handouts. Also, there has been little upgrading of equipment over the past four years and some reduction in the reliability of connections.

Videoconferencing has been used to provide distance education for medical students, physicians and other health-care professionals, such as nurses, physiotherapists and pharmacists. The Dalhousie University Office of Continuing Medical Education (CME) has used videoconferencing for CME since a pilot project with four sites in 1995-6. Since that pilot project, videoconferencing activity has steadily increased; in the year 1999-2000, a total of 64 videoconferences were provided for 1059 learners in 37 sites. Videoconferencing has been well accepted by faculty staff and by learners, as it enables them to provide and receive CME without travelling long distances. The key components of the development of the videoconferencing programme include planning, scheduling, faculty support, technical support and evaluation. Evaluation enables the effect of videoconferencing on other CME activities, and costs, to be measured.

Videoconferencing has been used to provide distance education for medical students, physicians and other health-care professionals, such as nurses, physiotherapists and pharmacists. The Dalhousie University Office of Continuing Medical Education (CME) has used videoconferencing for CME since a pilot project with four sites in 1995-6. Since that pilot project, videoconferencing activity has steadily increased; in the year 1999-2000, a total of 64 videoconferences were provided for 1059 learners in 37 sites. Videoconferencing has been well accepted by faculty staff and by learners, as it enables them to provide and receive CME without travelling long distances. The key components of the development of the videoconferencing programme include planning, scheduling, faculty support, technical support and evaluation. Evaluation enables the effect of videoconferencing on other CME activities, and costs, to be measured.

This study demonstrated the willingness on the part of one academic center to videoconference grand rounds to community specialists and interest from community specialists in participating. It raises logistical and educational issues, including scheduling and how to effectively include community physicians in needs assessment and planning. As requirements for specialists to participate in accredited learning activities become more rigorous, videoconferencing grand rounds may be one way to increase access to important learning activities.