Professional Training in Organ Donation Course Report

DG SANCO –EAHC 2005205 PTOD course Report

Working Group 3 / Professional Training Group

Angela Borda - University of Medicine and Pharmacy of Targu-Mures - UTM (Romania) Klara Branzaniuc - University of Medicine and Pharmacy of Targu-Mures - UTM (Romania) Peter Desatnik - Malmoe University Hospital - MUH (Sweden) Melania Istrate - University of Medicine and Pharmacy of Targu-Mures - UTM (Romania) George Kyriakides - Paraskevaidion Surgical And Transplant Center - PSTC (Cyprus) Heiner Smit - Deutsche Stiftung Organtransplantation - DSO (Germany) Ricard Valero Fundació IL3 – Universitat de Barcelona - (Spain) Ulrike Wirges - Deutsche Stiftung Organtransplantation - DSO (Germany)

First Working Meeting Intermediate Working Meeting 21st- 23rd March 2007 21st-23rd April 2008 Sant Boi de Llobregat, Barcelona, Spain Lido di Ostia, Rome, Italy

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INDEX

Course Preparation...... 4 Program design...... 4 Design of on-line modules ...... 4 On-line modules...... 4 Educational Method ...... 4 Virtual Platform ...... 5 Specific Objectives...... 5 Virtual Game...... 6 Megacase ...... 7 Course Implementation...... 7 Five Virtual Modules ...... 7 Face-to-face course ...... 8

Annex 1: Professional Training in Organ Donation Program...... 10 On-Lines Courses Contents...... 11 Donor Detection System (DDS)...... 11 Brain Death Diagnosis (BDD) ...... 11 Donor Management and Organ Viability (DMOV) ...... 11 Family Approach for Organ Donation (FAOD)...... 11 Organ Retrieval Organization, Preservation and Allocation Criteria (ORPA)...... 11 On-Line Courses Faculty Directory...... 12 Donor Detection System...... 12 Brain Death Diagnosis ...... 12 Donor Management and Organ Viability ...... 12 Family Approach for Organ Donation ...... 12 Organ Retrieval Organization, Preservation and Allocation Criteria ...... 12 Face-to-face Course Program ...... 13 Face-to-Face Course Faculty Directory...... 14 Participants Directory...... 15 Face-to-face Course Participants’ groups ...... 17 Annex 2: Course Evaluation ...... 18 Donor Detection System on-line course evaluation...... 19 Brain Death Diagnosis on-line course evaluation...... 21 Donor Management and Organ Viability on-line course evaluation ...... 23 Family Approach for Organ Donation on-line course evaluation...... 26

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Organ Retrieval Organization, Preservation and Allocation Criteria on-line course evaluation...... 29 Professional Training on Organ Donation face-to-face course evaluation ...... 32 Participants Evaluation Summary...... 36 Annex 3: Virtual Platform ...... 39 Annex 4: Virtual Game...... 43 Annex 5: Pictures ...... 45

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Course Preparation

Program design The contents of the program have been specially designed to train health professionals in charge of organizing the generation of donors and/or those due to join a Transplant Coordination Office and KDPs wishing to update their knowledge and reinforce their competences.

The program is based on the blended learning system, which considers both the on-line and the traditional face-to-face training. The contents of the 5 on-line modules consist mainly in theoretical knowledge, including some practical exercises, whereas the face-to-face course is mainly practical, with simulations that emulate the whole donation process.

Design of on-line modules Five e-learning modules were carried out. Two of the modules, Donor Management and Organ Viability (DMOV) and Organ Retrieval Organization, Preservation and Allocation Criteria (ORPA) have been fully developed together with Working Group 3 (WG3) and the contents of the rest, Donor Detection System (DDS), Brain Death Diagnosis (BDD) and Family Approach for Organ Donation (FAOD), have been updated together with WG3.

In all the modules, the Coordinator was in charge of the faculty and the daily development of the courses.

WG3 asked the partners during the second working meeting in Rome to participate in the pilot versions of both courses in order to assure the contents, structure and time availability to answer all the proposed activities.

On-line modules Educational Method The learning method used in these on-line courses is highly interactive. The use of the Internet as the basic transmission channel of knowledge allows more students to take part. Barriers in time and geographical location are overcome, facilitating individualized and interactive contact between all members of the virtual community.

Each course develops a core structure with factual information based on written materials and audiovisual support, which promotes learning by emphasising the key concepts.

Contents are structured in modules for a better association and assimilation of concepts. General and specific debates through the course forum help participants to share their points of view and put their own knowledge to the test.

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General Objectives:  To respond to the increasing demand for continuing education related to the procurement and transplantation of organs and tissues by overcoming time and distance constraints.  To offer high quality courses, both in content and methodology, adapted to current needs for an active and effective system capable of detecting all potential donors within target units.

Virtual Platform All the virtual modules were implemented in English through the Universitat de Barcelona Virtual Community. A username and password were formerly provided to each participant to allow them to log in the virtual course. Therefore, only the registered participants could enter the course. Tutors and lecturers also had their own log in data in order to access the modules. (See Annex 3)

Specific Objectives Donor Detection System (DDS)

 To be trained on potential donor evaluation and to be able to: excluding biological risk factors; performing laboratory screening tests and medical history evaluations, and clarifying the aetiology of death.

 To present different systems to improve the quality of donor detection, causes of donor loss and analysis of all donor detection procedures.

 To establish an understanding of the expansion of the donor criteria such as age, previous diseases and ischemia times in order to enlarge the donor pool.

Brain Death Diagnosis (BDD)

 To coach and guide in diagnosis of brain death, to consult in the identification of the neurophysiologic and cerebral perfusion tests used to diagnose brain death.

 To learn the most adequate strategies to solve conflictive situations in the diagnosis and perform and present objective methodology for diagnosing every brain dead patient

Donor Management and Organ Viability (DMOV)

 To provide participants with the knowledge needed to face the donor clinical management challenges and their proper treatment

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 To design and optimize clinical pathways for organ donor maintenance and management as well as for evaluating every potential donor objectively with the purpose of achieving the highest possible organ yielding per donor

 To enable participants to build skills in optimizing of the donor’s organ function in order to improve the transplant outcome

 To establish an understanding of organ viability criteria clinically applicable in the daily practise

Family Approach for Organ Donation (FAOD)

 To provide the communicative skills and tools and the strategies to handle emotions required to successfully carry out the bad news intake interview

 To learn a systematic process to obtain consent for organ donation through a successful family intake interview

 To acquire the competence to handle a bad-news situation, helping the family to work through the most adjustable grieving process

 To provide the knowledge needed to broadcast society about donation and transplantation and its medical and legal aspects.

Organ Retrieval Organization, Preservation and Allocation Criteria (ORPA)

 To enable the participants to know all the steps involved in the multi-organ retrieval organization process and the human and technical resources required

 To establish an understanding of the principles and goals of organ preservation

 To provide the opportunity to build skills and confidence in the current preservation techniques and organ transportation procedures

 To identify the principles of organ sharing and allocation criteria

Face-to-face Course

 To put into practice the theoretical contents acquired through the 5 on-line modules through the practice simulations and the clinical cases, concerning each step of the donation process

 To attend a complete simulation of the donation process in the mega-case practice:

Virtual Game This simulation of virtual reality meets the scientific and technical criteria adapted to the IT technology to use it for the donor detection and evaluation.

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The pedagogical contents are:

 To identify the different donor types and the organs and tissues that can be used.

 To describe the main characteristics of each donor type.

 To illustrate the key point for the donor detection.

 To identify the different methods that can be used for the donor detection for organs and tissues.

 To illustrate the different possibilities of donor detection in generating units: ICU, ER and other departments.

 To identify the key point that may lead to the lost of potential donors of organs and tissues.

The Virtual Reality Game entails in detecting the most suitable donor, however the main purpose is to evaluate the user’s attitude to accomplish it. Therefore, all the decisions made will also be taken into consideration for the final result. If the user identifies a donor before the time limit, their mark will depend on all the procedures done and whether or not the identified donor is suitable. (Annex 4)

Megacase The Megacase practice has been specially designed for the face-to-face course. It is a complete practice that allows participants to follow the consecutive steps leading to convert a possible donor into a real donor. Participants were divided in small groups of 3 or 4 persons, so they could all participate and also learn to work in groups, one of the main skills of the transplant coordinator. The activity started with the alert of a potential donor in the ICU of their fictional hospital. Through the performance of the brain death diagnosis, the required clinical tests and the family interview, all groups managed to convert the potential donor into an effective donor. The whole task was summarized by the faculty at the end of the simulation.

Course Implementation

Five Virtual Modules The 5 modules were implemented through the Universitat de Barcelona Virtual Community between May and November 2008. They were structured and implemented according to the steps of the donation and transplantation process. Each Virtual Module lasted one month with a total duration of 10 academic hours.

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The purpose of the 5 virtual modules was to provide the 49 Junior Transplant Coordinators with the theoretical knowledge of the donation and transplantation process.

The dates of the virtual modules were as follows:  Donor Detection System: 5th may – 2nd June 2008  Brain Death Diagnosis: 2nd June – 30th June 2008  Donor Management and Organ Viability: 8th September – 6th October 2008  Family Approach for Organ Donation: 6th October – 6th November 2008  Organ Retrieval Organization, Preservation and Allocation Criteria: 3rd November – 1st December 2008 As the ETPOD Project was launched in 2007, some of the partners chose the participants in time to attend 2 virtual modules in 2007.  Brain Death Diagnosis evaluation: 3rd October – 16th November, 2007  Family Approach for Organ Donation: 12th November – 20th December, 2007 Since it was the beginning of the program and the scheduled courses were set in 2008, those who were not certified in these two modules had the opportunity to repeat them in 2008. After each on-line course, the certified participants were rewarded with a certificate of achievement issued by IL3.

(Annex 2 includes the course evaluation of the virtual modules held in 2008).

Face-to-face course The Training for Professional Training on Organ Donation face-to-face course was implemented in St. Hilari Sacalm, Barcelona, Spain 1st – 4th December 2008. As part of the blended program, the purpose of this course was to complement the knowledge acquired through the on-line modules with more practical sessions.

The course lasted 3 days with a total duration of 24 academic hours. 38 participants from 23 different TA attended the training. Both the participants and tutors had the opportunity to meet in person.

The course included three theoretical plenary sessions of 45 minutes of duration followed by 15 minutes of open discussion: Donation after cardiac death, Bioethics and Legislation in the donation process and EC directive/ EU policy on substances of human origin.

In the practical part, participants were divided in ten small groups of 3 to 4 persons. Half of the groups were attending the workshops, which lasted 1 hour and 15 minutes (each) and covered the following topics: Donor detection, Brain death diagnosis, Donor management, Family approach and Organ retrieval organization. Simultaneously, the other half were participating in the megacase and the Donorplus: improving organ donor potential rates

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Each workshop was located in a different room, equipped with updated simulations materials adequate to the real settings. All the workshops were structured according to the pedagogical advice: starting with a short review of the theoretical contents, the practice simulation itself and feedback with discussion in the end.

At the end of simulation session the participants’ performance was evaluated by the tutor.

Group photo of the Professional Training on Organ Donation participants and the ETPOD staff

(Annex 1 includes the agenda of the course, the faculty directory and the participants’ directory)

(Annex 2 includes the course evaluation)

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Annex 1: Professional Training in Organ Donation Program

Annex 1

Professional Training in Organ Donation Program

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On-Lines Courses Contents

Donor Detection System (DDS)  Organ viability  Types of donors o General viability criteria  Donor detection systems o Expanded criteria  Donor clinical evaluation o Abdominal organs  Expanded criteria o Thoracic organs  Quality assurance in the donor detection Family Approach for Organ process Donation (FAOD) Brain Death Diagnosis (BDD)  Breaking bad news  Criteria for the brain death diagnosis  The grieving process and healthcare  Death as a process workers  Brain death concepts  Communication skills  Whole brain death  The supportive relationship Request for donation process: family interview  Brainstem death  Social-medical history: biological risk  Higher brain death formulation  Relatives’ refusal: reasons and strategies  The brain in brain death for withdrawing refusals  Clinical examination of brain dead  Living donor patients  Public education: society and organ  Instrumental tests donation  Conflictive situations  Transplants and media Donor Management and Organ  Ethical and legal issues Viability (DMOV)  Bioethics in organ donation and  Donor management transplantation o Cardiovascular management Organ Retrieval Organization, o Temperature and endocrine Preservation and Allocation Criteria disorders (ORPA) o Respiratory management  Organ retrieval organization o Coagulation abnormalities and  Organ preservation solutions and infections techniques o Intra-Operative management  Organ sharing and allocation criteria  National and international registry systems

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On-Line Courses Faculty Directory

Donor Detection System Duque, Edison Hurtado, Paola Transplant Coordination Anaesthesiology Department Hospital Universitario San Vicente De Paul Hospital Clínic i Provincial de Barcelona Colombia Spain

Gómez, Maria Paula Family Approach for Organ Transplant coordinator Donation Hospital Clínic i Provincial de Barcelona Spain Coco Tina Manager Guasch, Xavier Queenslanders Donate Intensive Care Unit Princess Alexandra Hospital Hospital de la Plana- Vilareal Australia Spain Marmisa, Gema Brain Death Diagnosis Transplant Coordination Regional Office Madrid Cancio, Beatriz Spain Intensive Care Unit Hospital dos de Mayo Pont, Teresa Spain Transplant coordinator Hospital Universitari de la Vall d’Hebron Domínguez, José María Spain ICU Traumatology Department Hospital Virgen Del Rocío Ricart, Assumpta Spain ER department Hospital General De L'Hospitalet Valero, Ricard Spain Anaesthesiology Department Hospital Clínic i Provincial de Barcelona Organ Retrieval Organization, Spain Preservation and Allocation Criteria Donor Management and Organ Gómez, Maria Paula Viability Transplant coordinator Biomedical research Abdelnour, Tina Hospital Clínic i Provincial de Barcelona Senior donation coordinator Spain LifeSource United States of America Van Gelder, Frank TPM Scientific Consultant Charpentier, Julien IL3 - Institute for LifeLong Learning Transplant coordinator Spain Hospital Cochin, AP-HP France Vernert, Dagmar Transplant Coordinator Gilbert, Carlene Swisstransplant Organization Donation coordinator Switzerland LifeSource United States of America

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Face-to-face Course Program Hotel Vilars Rurals, St Hilari Sacalm (Spain) 1st – 4th December 2008

1st December, Monday

Check in Registration / Hotel reception Welcome cocktail Dinner

2nd December, Tuesday

Course presentation Practice-simulations

3rd December, Wednesday

Donation after cardiac death (DCD) Practice-simulations

4th December, Thursday

Bioethics and Legislation in the donation process EC directive/ EU policy on substances of human origin Final remarks

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Face-to-Face Course Faculty Directory

Borrás, Carmen Nicolás, Josep Maria Transplant Services Foundation University of Barcelona Barcelona Medical Department Spain Spain

Dalfino, Lidia Páez, Gloria I.C.U. Consultant TPM Project Manager Universitary Hosptial Policilinico Bari IL3 – Institute for LifeLong Learning Italy Spain

Fruh, Simone Pavlou, Anna SRA Nord-Est - Strasbourg European Commission Agence de la Biomédecine Belgium France Valero, Ricard Guasch, Xavier Anaesthesiology Department Intensive Care Unit Hospital Clínic i Provincial de Barcelona Hospital de la Plana- Vilareal Spain Spain Van Gelder, Frank Marmisa, Gema TPM Scientific Consultant Transplant Coordination Regional Office IL3 - Institute for LifeLong Learning Madrid Spain Spain Villamor, Alberto Menoudakou, Georgia Emergency services Hellenic Transplant Organization Hospital Clínic i Provincial de Barcelona Athens Spain Greece

Local organization IL3 – Institute for LifeLong Learning Spain

Project Director Scientific secretariat Martí Manyalich Carmen Blanco Maria del Río Course Directors Xavier Guasch Audiovisual Assistance Ricard Valero Juan María Puerta

Educational Coordinator Organization Committee Gloria Páez Kasia Adamowicz Maria del Río Online courses Coordinator Alberto Villamor Kasia Adamowicz

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Participants Directory

Anastasiou Pizi, Maria Elmet, Katrin Nicosia General Hospital Tartu University Clinics Insive Care Unit Neuroanasthesiology Cyrpus Estonia

Atinga, Ali Ale Ermio, Caterina Wojewódzki Szpital Brodnowski Azienda Sanitaria ASP 6 Anaesthesiology and Intensive Therapy Neurology Poland Italy

Bardac, Ovidiu Gül, Yeliz Sibiu County Hospital Ataturk Devlet Hastanesi First Clinic of Surgery Regional Allocation Center Romania Turkey

Börner, Carsten Inciuraite, Laima Ludmillenstift Meppen Intensive Care Unit Intensive Care Unit Lithuania Germany Kristo, Ivan Cardoso, José Guilherme AKH Wien, AWOTP Hospital Egas Moniz (H.E.M.) General surgery General surgery Austria Portugal Kuşçu, Sema Çelik, Nuket Manisa Il Saglik Mudurlugu Dokuz Eylul University Hospital Organ Transplant Centre Turkey Turkey

Cerniauskiene, Viktorija Lamann, Dorothee Vilnius University Emergency Hospital Unversitatsklinin Munster Intensive Care Unit Germany Lithuania Magafosis, Dimitrios Copotoiu, Ruxandra Evangelismos - Neurosurgery University Emergency County Hospital of Greece Targu Mures Anasthesia and Intensive Care Małecki, Zbigniew Romania Jan Bziel Memorial Hospital Intensive Care Unit Edyko, Piotr Poland WSS im. M Kopernika Nephrology Mavrommati, Loukia Poland Nicosia General Hospital Intensive Care Unit Ellerbeck, Wolfgang Cyprus Evangelisches Krankenhaus Oldenburg Anaesthesiology and Intensive care Moragues Ribes, Concepción Germany Hospital La Plana Intensive Care Unit Spain

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Nenkov, Miroslav Szederjesi, Janos Military Medical Academy Clinical County Hospital of Targu Mures Intensive Care Unit Anesthesiology and Intensive Care Bulgaria Romania

Oels, Martin Tiburzi, Simona Paola University Hospital Düsseldorf Pugliese Hospital Nephrology- Internal medicine Anaesthesiology and reanimation Germany Italy

Pedonomos, Michalis Tsakni, Katerina General Hospital of Athens. G. Dennimatas G. Hospital Ippokpateio Thessaloniki Intensive Care Unit Transplant unit Greece Greece

Persson, Lena Uranjek, Jasna Ljungby Hospital General Hospital Slovenj Gradec Intensive Care Unit Anasthesiology and Intensive Care Sweden Slovenia

Poglajen, Gregor Välja, Tiiu University Clinical Center Ljubljana North-Estonian Regional Hospital Cardiology Intensive Care Unit Slovenia Estonia

Pones, Mario Wrigge, Hermann General Hospital Vienna University of Bonn General surgery Anaesthesiology and Intensive care Austria Germany

Rákász, Lukas Yanik, Özlem Szpital Bielanski Warsaw Akdeniz University Neurosurgery Transplant Center Poland Turkey

Rebanda, Jorge Zacharoudi, Dimitra Centro Hospital Lisboa Ocidental- H.S.F. Ahepa Hospital Surgery Greece Portugal

Siedlecki, Zygmunt Dr. A. Jarusz University Hospital in Bydgoszcz Neurosurgery and neurotraumatology Poland

Subirà Cuyàs, Carles Hospital Universitari Germans Trias i Pujol Intensive Care Unit Spain

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Face-to-face Course Participants’ groups Group A Group F Sema Kuşçu Caterina Ermio NRL Concepción Moragues ICU Jasna Uranjek ANE Ali Ale Atinga ANE Ivan Kristo SRG Martin Oels NEPH Zygmunt Siedlecki NSRG

Group B Group G Nuket Çelik Yeliz Gül Lena Persson ICU RN Tiiu Välja ICU Ovidiu Bardac SRG Dimitrios Magafosis NRL Mario Pones SRG Janos Szederjesi ICU ANE

Group C Group H Viktorija Cerniauskiene ICU Laima Inciuraite ICU Katerina Tsakni Özlem Yanik Carsten Börner ICU Zbigniew Małecki ICU PHYS Lukas Rákász NSRG Hermann Wrigge ICU ANE

Group D Group I Ruxandra Copotoiu ANE Dorothee Lamann Simona Paola Tiburzi ANE Michalis Pedonomos ICU Piotr Edyko NEPH Gregor Poglajen CARD Jorge Rebanda SRG José Guilherme Cardoso SRG

Group E Group J Katrin Elmet NSRG ANE Maria Anastasiou Pizi ICU RN Loukia Mavrommati ICU RN Dimitra Zacharoudi Wolfgang Ellerbeck ANE Miroslav Nenkov ICU ANE Carles Subirà Cuyàs ICU

ICU Intensive Care Unit ANE Anesthesiology TSRG Transplant Surgery NEPH Nephrology SRG Surgery NSRG Neurosurgery NRL Neurology PHYS Physician CARD Cardiology RN R Nurse Bold Transplant Coordinator

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Annex 2: Course Evaluation

Annex 2

Course Evaluation

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Donor Detection System on-line course evaluation 5th may – 2nd June 2008

COURSE SUMMARY Number of participants: 54 Number of Certified participants: 31 Participant Countries: Austria, Bulgaria, Cyprus, Estonia, Germany, Greece, Italy, Lithuania, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden, Turkey COURSE GRADES (out of 10) All participants Certified participants Average Quiz Grade: 8,4 8,7

Course Participation Grade: 5,3 7,0

Global Course Grade: 4,5 7,3

Scoring: 1=Poor; 2=Average; 3=Good; 4= Very Good; 5= Excellent

Training Accuracy & Contents Contents Accomplishment Interest of objectives 1, Types of Donors 4,3 4,3 4,4

2, Donor Detection System 4,5 4,5 4,5

3, Donor Clinical Evaluation 4,3 4,4 4,6

4, Expanded Criteria Donors 4,3 4,3 4,5

5, The Spanish quality assurance in the donor 4,4 4,4 4,5 detection process Activities Accuracy & Topics Contents Accomplishment Interest of objectives Activity 1, Presentation 4,2 4,2 4,1

Activity 2, Video activity 4,2 4,2 4,4

Activity 3, Checklist activity 4,1 4,2 4,3

Activity 4, Hospital Activity Evaluation p, 1 4,2 4,1 4,1

Activity 5, Hospital Activity Evaluation p, 2 4,3 4,3 4,2

Activity Clinical Cases 4,2 4,1 4,4

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Organization

Contents Rate

Syllabus 4,3

Glossary 4,0 Structure of the course Evaluation system (quiz) 4,3

Bibliography 4,4

Sending of tasks 3,9

Texts 4,6

Didactical material Graphics 4,5

Video-Audio 4,1

Coordination

Topics Rate

Timeliness in delivering course instructions and previous materials for the course 3,8

Virtual community quality (access to forums, chats, discussions, conferences...) 4,3

Technical infrastructure of the course (access to documents, downloads...) 4,4

Effectiveness in performing web-based applications 4,4

Faculty / Tutors

Topics Rate

Ability and efficacy in solving pedagogical issues 4,4

Ongoing feedback provided by tutors 4,4

Monitoring of personal learning by teaching staff 4,1

Technical Support

Topics Rate

Efficiency of the online technical assistance 4,0

Technical expertise of the teaching staff 4,3

Global Evaluation

Topics Rate

Applicability to my job 4,3

Please, assess the overall course 4,3

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Brain Death Diagnosis on-line course evaluation

2nd June – 30th June 2008

COURSE SUMMARY Number of participants: 42 Number of Certified participants: 19 Participants’ Countries: Austria, Bulgaria, Cyprus, Estonia, Germany, Greece, Italy, Lithuania, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden, Turkey COURSE GRADES (out of 10) All participants Certified participants Average Quiz Grade: 8,5 8,6

Course Participation Grade: 3,7 6,8

Global Course Grade: 4,3 7,8

Scoring: 1=Poor; 2=Average; 3=Good; 4= Very Good; 5= Excellent

Training Accuracy & Global Contents Accomplishment of Interest result objectives Contents

1, The concepts and definitions of brain death 4,4 4,3 4,2 4,3

2, The diagnosis of brain death applied to brainstem death concept and the whole brain 4,5 4,3 3,9 4,2 death concept

Activities

Accuracy & Global Contents Accomplishment of Interest result objectives Topics

Activity 1. Presentation 4,0 4,1 4,2 4,1

Activity 2. Brain Death Concept 4,4 4,3 4,3 4,3

Activity 3. Brain Death Diagnosis Worldwide 4,4 4,3 4,4 4,4

Activity 4. Conceptual map 4,1 4,1 4,1 4,1

Activity 5. Video muscular responses in brain 4,3 4,2 4,2 4,2 death

Activity 6. Clinical cases 4,4 4,5 4,4 4,4

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Organization

Contents Rate

Syllabus 3,9

Glossary 4,2

Structure of the course Evaluation system (quiz) 4,3

Bibliography 4,2

Sending of tasks 4,2

Texts 4,2

Didactical material Graphics 4,3

Video-Audio 4,2

Coordination

Topics Rate

Timeliness in delivering course instructions and previous materials for the course 4,0

Virtual community quality (access to forums, chats, discussions, conferences...) 4,2

Technical infrastructure of the course (access to documents, downloads...) 4,3

Effectiveness in performing web-based applications 4,2

Faculty / Tutors

Topics Rate

Ability and efficacy in solving pedagogical issues 4,2

Ongoing feedback provided by tutors 4,4

Monitoring of personal learning by teaching staff 4,4

Technical Support

Topics Rate

Efficiency of the online technical assistance 4,2

Technical expertise of the teaching staff 4,4

Global Evaluation

Topics Rate

Applicability to my job 4,3

Please, assess the overall course 4,4

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Donor Management and Organ Viability on-line course evaluation

8th September – 6th October 2008

COURSE SUMMARY Number of participants: 49 Number of Certified participants: 32 Participant Countries: Austria, Bulgaria, Cyprus, Estonia, Germany, Greece, Italy, Lithuania, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden, Turkey COURSE GRADES (out of 10) All participants Certified participants Average Quiz Grade: 7,8 7,8 Course Participation Grade: 7,1 7,6 Global Course Grade: 5,2 7,7

Scoring: 1=Poor; 2=Average; 3=Good; 4= Very Good; 5= Excellent

Training Accuracy & Global Contents Accomplishment Interest result Contents of objectives

Cardiovascular Management 4,2 4,1 4,6 4,6

Temperature and Endocrine 4,1 4,2 4,2 4,1 Disorders

Respiratory Management 4,0 4,1 4,1 4,1

Coagulation Abnormalities 4,2 4,0 4,4, 4,2 and Infections

M1. Donor Management Other aspects 3,7 3,7 4,1 3,8

Intra-Operative Management 3,4 4,2 4,3 4,0

General Viability Criteria and 4,0 4,3 4,6 4,3 Exclusion Criteria

Abdominal Organs Viability 4,2 4,3 4,4 4,3 Criteria

Thoracic Organs Viability 4,2 4,2 4,4, 4,3 Criteria M2. Organ Viability Expanded Criteria Donors 3,8 3,8 4,3 4,0

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Activities Accuracy & Global Contents Accomplishment Interest result Topics of objectives

Activity 1. Presentation 4,1 4,1 4,3 4,1

Activity 2. Key points Donor Management 3,7 3,8 4,2 3,9

Activity 3. Clinical Cases Donor Management 3,3 3,3 4,4 3,7

Activity 4. Clinical Cases Organ Viability 4,1 4,1 4,4 4,2

Activity 5. Chat 4,1 4,1 4,4 4,2

Organization

Contents Rate

Syllabus 4,2

Glossary 4,3

Structure of the course Evaluation system (quiz) 4,1

Bibliography 4,0

Sending of tasks 4,0

Texts 4,0

Didactical material Graphics 3,9

Video-Audio 3,7

Coordination

Topics Rate

Timeliness in delivering course instructions and previous materials for the course 4,2

Virtual community quality (access to forums, chats, discussions, conferences…) 4,1

Technical infrastructure of the course (access to documents, downloads…) 4,3

Effectiveness in performing web-based applications 4,3

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Faculty / Tutors

Topics Rate

Ability and efficacy in solving pedagogical issues 4,5

Ongoing feedback provided by tutors 4,4

Monitoring of personal learning by teaching staff 4,1

Technical Support

Topics Rate

Efficiency of the online technical assistance 4,5

Technical expertise of the teaching staff 4,4

Global Evaluation

Topics Rate

Applicability to my job 4,6

Please, assess the overall course 4,3

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Family Approach for Organ Donation on-line course evaluation

6th October – 6th November 2008

COURSE SUMMARY Number of participants: 25 Number of Certified participants: 7 Participant Countries: Austria, Bulgaria, Cyprus, Estonia, Germany, Greece, Italy, Lithuania, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden, Turkey COURSE GRADES (out of 10) All participants Certified participants Average Quiz Grade: 7,7 7,8 Course Participation Grade: 5,9 8,2 Global Course Grade: 2,8 6,8

Scoring: 1=Poor; 2=Average; 3=Good; 4= Very Good; 5= Excellent

ASSESSMENT QUESTIONNAIRE TRAINING

Accuracy & Global Contents Contents accomplishment Interest result of objectives

1, Breaking bad news 5,0 4,8 4,8 4,9

M1: Breaking 2, The grieving process and 4,8 4,8 4,8 4,8 bad news healthcare workers

3, The supportive relationship 4,8 4,8 4,8 4,8 and communicative skills

4. Request for donation 4,6 4,6 4,8 4,7 process: family interview M2: Family 5, Social-medical history: approach in 4,2 4,4 4,2 4,3 transplant biological risk coordination 6, Relative's refusals: reasons and withdrawal of 4,8 4,8 4,8 4,8 refusals 7, Public education: Society and organ donation & Mass 4,6 4,6 4,6 4,6 media 8, Bioethics and 4,8 4,8 4,8 4,8 M3: Social Transplantation awareness 9, The living donor 4,8 4,6 4,6 4,7

10, Ethical and legal issues in 4,8 4,8 4,4 4,7 tissue banking

Annex 2 http://etpod.il3.ub.edu 26 DG SANCO –EAHC 2005205 PTOD course Report

ACTIVITIES

Accuracy & Global Contents accomplishment Interest result of objectives

Activity 1 Forum Message 3,8 3,8 3,5 3,7

Activity 2 Transcription of an interview 4,5 4,5 4,5 4,5

Activity 3 Video analysis 4,3 4,3 4,3 4,3

Activity 4 Family refusals 4,5 4,3 4,3 4,3

Activity 5 Mass media 4,3 4,3 4,0 4,2

ORGANIZATION

Contents Rate

Syllabus 4,6

Glossary 4,2

Structure of the Evaluation system (quiz) 4,0

Sending of tasks 4,0

Bibliography 4,2

Texts 4,8

Didactical material Graphics 4,4

Video-Audio 4,0

COORDINATION

Topic Rate

Timeliness in delivering course instructions and previous materials for the course 4,5

Virtual community quality (access to forums, chats, discussions, conferences...) 3,8

Technical infrastructure of the course (access to documents, downloads...) 4,5

Effectiveness in performing web-based applications 4,5

Annex 2 http://etpod.il3.ub.edu 27 DG SANCO –EAHC 2005205 PTOD course Report

FACULTY / TUTORS

Topics Rate

Ability and efficacy in solving pedagogical issues 4,8

Ongoing feedback provided by tutors 4,5

Monitoring of personal learning by teaching staff 4,3

TECHNICAL SUPPORT

Topics Rate

Efficiency of the online technical assistance 3,8

Technical expertise of the teaching staff 4,2

GLOBAL EVALUATION

Topics Rate

Applicability to my job 4,4

Please, assess the overall course 4,8

Annex 2 http://etpod.il3.ub.edu 28 DG SANCO –EAHC 2005205 PTOD course Report

Organ Retrieval Organization, Preservation and Allocation Criteria on-line course evaluation

3rd November – 1st December 2008

COURSE SUMMARY Number of participants: 48 Number of Certified participants: 31 Participant Countries: Austria, Bulgaria, Cyprus, Estonia, Germany, Greece, Italy, Lithuania, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden, Turkey COURSE GRADES (out of 10) All participants Certified participants Average Quiz Grade: 8,8 8,8 Course Participation Grade: 7,0 7,5 Global Course Grade: 5,0 7,2

Scoring: 1=Poor; 2=Average; 3=Good; 4= Very Good; 5= Excellent

Training Accuracy & Global Contents Contents Accomplishment of Interest result objectives

Planning before the retrieval 4,1 3,9 3,9 4,0 M1, Organ Retrieval Organization during the retrieval 4,1 4,0 4,1 4,1 Organization Communication 3,8 3,8 3,7 3,7

Renal and multi-organ preservation 4,1 3,9 4,2 3,9

M2, Organ Types of hypothermic storage 3,9 3,9 3,9 3,9 Preservation Solutions and Techniques Clinical aspects of organ preservation 3,8 3,8 4,3 4,0 Preservation Techniques: Hipothermic and Normothermic 3,9 3,9 3,9 3,9 Pulsatile Perfusion From Organ Sharing to Organ Allocation Optimization: an historical 4,0 3,9 4,2 4,0 perspective The geographical diversity of Organ 4,1 4,0 3,8 4,0 M3, Organ Allocation Policies Sharing and Allocation Organ Allocation procedures 4,1 4,1 3,9 4,0 Criteria Organ Allocation Criteria 4,3 4,2 4,2 4,3

Organ Allocation: new challenges 4,0 3,9 4,0 4,0

UNOS Data Registry 4,0 3,9 3,9 3,9 M4, UNOS Data Registry Data Verification and Processing 4,0 3,9 3,8 3,9

Annex 2 http://etpod.il3.ub.edu 29 DG SANCO –EAHC 2005205 PTOD course Report

Activities

Accuracy & Global Topics Contents Accomplishment Interest result of objectives

Activity 1. Presentation 4,0 3,9 3,9 3,9

Activity 2. Cold Ischemia Limits 3,8 3,1 4,3 3,7

Activity 3. Preparing Organ Retrieval 4,2 3,8 4,2 4,1

Activity 4. Organ allocation system 4,2 4,0 4,2 4,2

Activity 5. Clinical Cases: Organ Allocation 4,4 4,2 4,2 4,3

Activity 6. Chat 3,6 3,7 3,8 3,7

Organization

Contents Rate

Syllabus 4,1

Glossary 4,1

Structure of the course Evaluation system (quiz) 3,9

Sending of tasks* 4,4

Bibliography 3,9

Texts 4,0

Didactical material Graphics 3,9

Video-Audio* 3,7

Coordination

Topics Rate

Timeliness in delivering course instructions and previous materials for the course 3,8

Virtual community quality (access to forums, chats, discussions, conferences...) 4,1

Technical infrastructure of the course (access to documents, downloads...) 4,5

Effectiveness in performing web-based applications 4,3

Annex 2 http://etpod.il3.ub.edu 30 DG SANCO –EAHC 2005205 PTOD course Report

Faculty / Tutors

Topics Rate

Ability and efficacy in solving pedagogical issues 3,9

Ongoing feedback provided by tutors 4,3

Monitoring of personal learning by teaching staff 3,9

Technical Support

Topics Rate

Efficiency of the online technical assistance 4,1

Technical expertise of the teaching staff 4,3

Global Evaluation

Topics Rate

Applicability to my job 4,0

Please, assess the overall course 4,0

Annex 2 http://etpod.il3.ub.edu 31 DG SANCO –EAHC 2005205 PTOD course Report

Professional Training on Organ Donation face-to-face course evaluation Hotel Vilars Rurals, St Hilari Sacalm (Spain) 1st – 4th December 2008

Scoring: 1=Poor; 2=Average; 3=Good; 4= Very Good; 5= Excellent

CONFERENCE EVALUATION Questions Lecture Contents Presentation Average answered Course presentation 4,47 4,47 4,70 4,55

Non-heart beating donors 4,55 4,55 4,76 4,62

Bioethics & Legislation in the donation process 4,50 4,54 4,56 4,53 EC directive/EU policy on substances of human 3,83 3,71 4,04 3,86 origin

PRACTICAL EVALUATION Questions Lecture Contents Presentation Average answered Donor Detection 4,45 4,63 4,59 4,56

Brain Death Diagnosis 4,61 4,39 4,52 4,51

Donor Management 4,53 4,41 4,42 4,45

Family Approach 4,71 4,62 4,73 4,68

Organ Retrieval Organization 4,15 4,24 4,24 4,21

Mega Case Study 4,68 4,71 4,61 4,66

Donor Plus 4,48 4,48 4,52 4,50

Annex 2 http://etpod.il3.ub.edu 32 DG SANCO –EAHC 2005205 PTOD course Report

MEGA CASE STUDY EVALUATION Rate

Presentation 4,51

Organization 4,49

Materials 4,71

Development 4,54

Dynamics 4,56

Timing 4,34

Logistics 4,51

ICU team 4,63

Applicability to my job 4,23

Interest 4,57

Overall 4,56

COURSE EVALUATION

Level of organization 4,76

Level of teaching 4,67

Technical direction 4,66

Audiovisual support 4,69

Secretariat 4,74

COURSE INFORMATION

Pre-registration 4,09

Post-registration 4,31

During the Course 4,60

ACCOMMODATION

Rooms 4,00

Meals 4,26

Transport 3,97

GENERAL EVALUATION

Applicability to my job 4,34

Overall course assessment 4,46

Annex 2 http://etpod.il3.ub.edu 33 DG SANCO –EAHC 2005205 PTOD course Report

PARTICIPANTS PROFILE Total Number of Participants 38 Gender:

Women 18 Men 20 Origin:

Austria 2 Bulgaria 1 Cyprus 2 Estonia 2 Germany 5 Greece 4 Italy 2 Lithuania 2 Poland 5 Portugal 1 Romania 3 Slovenia 2 Spain 2 Sweden 1 Turkey 4 Title:

Medical Doctor 35 Registered Nurse 3

Specialities Anaesthesiology 4 Cardiology 1 Intensive Care Unit 11

Nephrology 2 Neurology 2 Neurosurgery 3 Registered Nurse 3 Surgery 3 Transplant Coordination 9

Annex 2 http://etpod.il3.ub.edu 34 DG SANCO –EAHC 2005205 PTOD course Report

PRACTICE SIMULATIONS AVERAGE GRADES OF PARTICIPANTS (out of 10)

Donor Detection 8,95

Brain Death Diagnosis 8,41

Donor Management 9,47

Family Approach 10,00

Organ Retrieval Organization 8,97

Mega Case Study 8,61

Donor Plus 8,26

Annex 2 http://etpod.il3.ub.edu 35 DG SANCO –EAHC 2005205 PTOD course Report

Participants Evaluation Summary ID Name Surname TA Country DDS BDD DMOV FAOD ORPA Face-to-face 1 Ivan Kristo AU1 Austria Certified Certified Certified Not certified Certified Attended 2 Mario Pones AU1 Austria Certified Certified Certified Not certified Certified Attended 3 Miroslav Nenkov BG1 Bulgaria Not certified Not certified Certified Certified 2007 Certified Attended 4 Ivo Stefanov BG1 Bulgaria Not certified Not certified Not certified Not certified Not certified Not attended 5 Maria Anastasiou Pizi CY1 Cyprus Certified Certified Certified Certified 2007 Certified Attended 6 Loukia Mavrommati CY1 Cyprus Certified Certified Certified Certified 2007 Certified Attended 7 Katrin Elmet EE1 Estonia Certified Certified 2007 Certified Certified 2007 Certified Attended 8 Tiiu Välja EE1 Estonia Certified Certified 2007 Certified Certified 2007 Certified Attended 9 Martin Oels DE1 Germany Certified Certified Certified Certified 2007 Certified Attended 10 Hartmut Schmidt DE1 Germany Certified Not certified Not certified Not certified Not certified Not registered 11 Dorothee Lamann DE1 Germany Not registered Not registered Not registered Not registered Not registered Attended 12 Ares K. Menon DE2 Germany Not certified Not registered Not registered Not registered Not registered Not registered 13 Frank Stüber DE2 Germany Not registered Not registered Not registered Not registered Not registered Not registered 14 Hermann Wrigge DE2 Germany Not registered Not certified Certified Certified Not certified Attended 15 Wolfgang Ellerbeck DE3 Germany Certified Certified Certified Certified Certified Attended 16 Frank Logemann DE3 Germany Not certified Not certified Certified Not certified Not certified Not registered 17 Carsten Börner DE3 Germany Not registered Not registered Not registered Not registered Not registered Attended 18 Georgios Koukoulitsios GR1 Greece Not certified Not certified Not certified Certified 2007 Not certified Not registered 19 Dimitrios Pistolas GR1 Greece Not registered Not certified Not registered Not certified Not certified Not registered 20 Dimitrios Magafosis GR1 Greece Not registered Not registered Not registered Not registered Not registered Attended 21 Michalis Paidonomos GR1 Greece Not registered Not registered Not registered Not registered Not registered Attended 22 Katerina Tsakni GR2 Greece Not certified Not certified Not certified Not certified Not certified Attended 23 Dimitra Zacharoudi GR2 Greece Not certified Not certified Not certified Not certified Not certified Attended 24 Roberto Anaclerio IT1 Italy Not certified Not certified Certified Not certified Certified Not attended 25 Antonio Civita IT1 Italy Not certified Not certified Not certified Not certified Not certified Not attended 26 Caterina Ermio IT2 Italy Not registered Not certified Not certified Not certified Certified Attended 27 Simona Paola Tiburzi IT2 Italy Certified Not certified Certified Certified 2007 Certified Attended 28 Viktorija Cerniauskiene LT1 Lithuania Certified Certified Certified Certified 2007 Certified Attended 29 Laima Inciuraite LT1 Lithuania Certified Certified Certified Certified 2007 Certified Attended 30 Piotr Edyko PL1 Poland Certified Certified Certified Certified Certified Attended

Annex 2 http://etpod.il3.ub.edu 36 DG SANCO –EAHC 2005205 PTOD course Report

ID Name Surname TA Country DDS BDD DMOV FAOD ORPA Face-to-face 31 Damian Obrzut PL1 Poland Not registered Not registered Not registered Not registered Not registered Not registered 32 Tomasz Wiśniewski PL1 Poland Not certified Not certified Not certified Not certified Not certified Not attended 33 Ali Ale Atinga PL2 Poland Certified Certified Certified Certified 2007 Certified Attended 34 Marta Sikora PL2 Poland Certified Certified Not certified Certified 2007 Not certified Not registered 35 Lukas Rákász PL2 Poland Not registered Not registered Not registered Not registered Not registered Attended 36 Zbigniew Małecki PL3 Poland Certified Certified Certified Certified Certified Attended 37 Zygmunt Siedlecki PL3 Poland Not certified Certified Not certified Not certified Not certified Attended 38 José Guilherme Cardoso PT1 Portugal Not certified Not certified Not certified Not certified Not certified Not attended 39 Jorge Rebanda PT1 Portugal Certified Certified 2007 Certified Certified 2007 Certified Attended 40 Ruxandra Copotoiu RO1 Romania Certified Certified 2007 Certified Certified 2007 Certified Attended 41 Janos Szederjesi RO1 Romania Certified Certified 2007 Certified Certified 2007 Certified Attended 42 Ovidiu Dorin Bardac RO2 Romania Certified Certified 2007 Certified Certified 2007 Certified Attended 43 Minerva Boitan RO2 Romania Certified Certified Certified Not certified Not certified Not attended 44 Miloš Kapusta SK1 Slovak Republic Not certified Not certified Not certified Not certified Not certified Not attended 45 Blažej Palkóci SK1 Slovak Republic Not certified Not certified Not certified Not certified Not certified Not attended 46 Gregor Poglajen SI1 Slovenija Certified Certified Certified Certified 2007 Certified Attended 47 Jasna Uranjek SI1 Slovenija Certified Certified Certified Certified 2007 Certified Attended 48 Concepció Estadella ES1 Spain Certified Certified Certified Certified 2007 Certified - 49 Maria Pilar Gracia-Arnillas ES1 Spain Not certified Certified Certified Certified Certified - 50 Beatriz Catalan ES2 Spain Not certified Not certified Not certified Not certified Not certified - 51 Patricia Sánchez Rico ES2 Spain Certified Certified 2007 Certified Certified 2007 Certified - 52 Concepción Moragues Ribes ES1 Spain Not registered Not registered Not registered Not registered Not registered Attended 53 Carles Subirà Cuyàs ES2 Spain Not registered Not registered Not registered Not registered Not registered Attended 54 Anders Engevall SE1 Sweden Not certified Not certified Not certified Not registered Not registered Not registered 55 Lena Persson SE1 Sweden Certified Not certified Certified Certified 2007 Certified Attended 56 Yeliz Gül TR1 Turkey Certified Certified Certified Certified 2007 Certified Attended 57 Özlem Yanik TR1 Turkey Not certified Not certified Not certified Certified Certified Attended 58 Nükhet Çelik TR2 Turkey Certified Certified Certified Certified 2007 Certified Attended 59 Sema Kuscu TR2 Turkey Not registered Not registered Certified Certified Certified Attended 60 Alpay Yildiz TR2 Turkey Not certified Not certified Not registered Certified 2007 Not registered Not registered

Annex 2 http://etpod.il3.ub.edu 37 DG SANCO –EAHC 2005205 PTOD course Report

DE1 Dr. Hartmut Schmidt was replaced by Dr. Dorothee Lamann for the face-to-face DE2 Dr. Ares K. Menon resigned from the ETPOD Project. He was not replaced DE2 Dr. Frank Stüber was replaced by Dr. Hermann Wrigge DE3 Dr. Frank Logemann was replaced by Dr. Carsten Börner for the face-to-face GR1 Dr. Georgios Koukoulitsios was replaced by Dr. Dimitros Magafosis for the face-to-face GR1 Dr. Dimitrios Pistolas was replaced by Dr. Michalis Paidonomos for the face-to-face PL1 Dr. Damian Obrzut was replaced by Dr. Tomasz Wisniewski for the face-to-face PL2 Dr. Marta Sikora was replaced by Dr. Lukas Rákász for the face-to-face SE1 Dr. Anders Engevall resigned from the ETPOD Project. He was not replaced. TR2 Dr. Alpay Yildiz was replaced by Dr. Sema Kuscu after the BDD