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Headache School
According to its mission statement, one of the goals of the European Headache Federation (EHF) is to “educate Europe” about headache through the teaching of the key players, such as young doctors and all those involved in headache management about the seriousness of headache disorders.
The close geographical relationship in Europe is the prerequisite to foster the exchange of faculty and participants. This was the successful working mechanism for the past years.
Headache schools have been organized in different European countries since 1992: Antalya (Turkey), Stresa (Italy), Oporto (Portugal), Cambridge (UK), Copenhagen (Denmark), Kiel (Germany), and Vilnius (Lithuania).
More recently, Headache schools were held in Castrocaro terme(FC), Italy (2006), Copenhagen, Denmark (2007), in Mykonos, Greece (2007), in Baku, Azerbaijan (2008), Nice, France (2008) and Palma de Mallorca, Spain (2009).
In the last decade a "patronage activity" was also set up in the way that two countries (one developed, one developing) exchanged doctors and students for training. This activity was successfully endorsed by Austria, Bulgaria, Croatia, Slovakia, Italy, Norway, Albania, Slovenia, Russia and Lithuania. In some settings, clinical and research practices were organised for long term reaching a higher standard of training and creating "clusters" of people with particular interest in headache in Europe.
However, the fast expansion of insight into headache (new molecules, new headache categories etc.) contributes to widen the gap between developing and developed countries. Moreover, we have evidence that during the last few years, due to the relative restriction of the national/international drug company’s budget, only relatively inexpensive teaching courses could be organised. Under such circumstances, countries that were developing a medical culture on headache would be more and more impaired.
EHF aim to present guidelines to promote education about headache in Europe on a national basis organising courses that should meet standardised requirements of excellence and guarantee (code of conduct), both as investment and increase in knowledge. We have a strong feeling that the proposal of a headache teaching format might help in distributing knowledge and understanding of headache in European countries.
The guidelines, presented here, specify the ideal length of a headache course, the number of lectures it should include, as well as the ideal number of participants and teachers. A sample course outline is provided, together with a checklist to help the organisers meet the criteria for an EHF approved headache school.
Click here to download the article published in Functional Neurology – 2005
“Guidelines for the organisation of headache education in Europe: the headache school”
Guidelines for organising headache school
Teaching Course Format
Download PDF version
Headache Video School
To download the EHF Requirements in the organisation of a teaching programme in headache click here.
To download the Suggested School format sample (3-days course) click here.
- Target of the guidelines
These guidelines are aimed at institutions, such as National Neurological and/or Headache Societies, European Neurological Societies or allied scientific organizations that are planning to organize headache teaching courses at postgraduate level.
- Aim of the course
The aim of the course is to enable participants to gain knowledge, skills, and understanding in the area of primary and secondary headache as well as the organization of headache care, and thereby contribute to their personal and professional development. By the end of the course, they should have enhanced their clinical skills, including their capacity to interact appropriately with affected individuals. Ideally, this should translate into an enhanced quality of life for headache sufferers. The key aim is that the knowledge gained from the course can be applied in the participants’ various professional fields. The National Society/Research Group hosting the course will apply to the appropriate authorities, national or European, for continuous medical education (CME) credits. In this way, the participants will be attending a certified course that can be a contribution to the university career. The target audience may include general practitioners with special interest in headache, general neurologists, clinical pharmacologists, and internal medicine specialists; the course brochure specifying which of these is aimed at and planned accordingly. The teaching course must be specifically designed to help participants to:
- recognize the various clinical presentations of headache;
- become familiar with the ‘‘red flags’’ and ‘‘comfort signs’’ approach to diagnosing secondary headaches;
- understand the latest concepts in headache pathophysiology;
- develop treatment plans for helping patients with all aspects of their headache treatment needs;
- formulate a headache management ‘‘toolbox’’ for patients, incorporating acute and preventive treatment approaches;
- devise strategies in order to help patients understand headache treatment tactics and improve patient compliance with therapeutic plans;
- provide strategies and plans for organization of national headache care.
- Topics
Each day of the course, which should cover both primary and secondary headaches, must incorporate both theory and practical teaching. The organizers should ensure that any slides used are kept as concise as possible, given that it takes at least 40–60 s to explain and understand a slide. Speakers must submit their slides in plenty of time so that they can be printed or downloaded on an electronic media (USB-stick, CD-ROM or website) and available for distribution, on a daily basis, during the course. Patient demonstrations and interviews by the participants in small groups (6–8 per group) in rotation are the best medium for practical training under qualified supervision of the lectures. Alternatively video recordings are valuable for presenting illustrated case reports on both simple and complex cases and for making sure that the participants retain the information given. Ten minutes interview or video plus 10–15-min discussion time are usually enough to become familiar with a clinical history. At least two patient demonstrations, two videos or hands-on demonstrations of non-pharmacological treatment strategies per day should be included in the program.
- Venue
The course should preferably be organized in a hospital/university setting, providing optimal facilities for demonstrations of patients, non-pharmacological treatment strategies or research laboratories.
- Duration of the Course
The ideal/minimum duration of a course is 3 days with at least 6 h/day theoretical teaching. Concise 1-day courses can be organized under the supervision, or with the advice of the EHF, on condition that the recommended ratio of practical/theoretical teaching is respected. Due to the necessity of a minimal set of education (especially for general practitioner) we are currently working on a 6-h format Headache School that is the minimum for obtaining European and national CME credits.
- Participants and structure of lectures
Overcrowded courses prevent the participants from interacting with the lecturers and clearly lower the general level of attention. Around 50 participants should be admitted, ideally divided into two or more parallel sections. The attention of the participants is negatively correlated with the length of the lecture. On the basis of prevailing experience, duration of 20–25 min (+5 min for questions) is recommended. The course program should schedule 7–8 teaching hours per day (approximately 15 lectures/case reports). A key element in courses of this kind is the practical demonstrations, patient interviews, panel discussion or discussion groups, which should never be missing from the program. Participants have to be neurologists, general physicians, or psychiatrists or ophthalmologist or ENT (either registrants or young fellows) with a general knowledge on headache field or which to get one. Participants have to be either beginners or with a general knowledge on headache field.
- Teaching staff
The course should provide participants with an opportunity to share in the experience of international scientists and to exchange opinions and ideas. A 3-day course should have a teaching staff of 3–5 foreign lecturers (local finances permitting), who should each be given the opportunity to give at least two lectures and demonstrate patient interviews. The local organizers will give the remaining lectures and organize the patient demonstrations and the practical treatment sessions. The discussion at the end of each lecture or at the end of a session gives all the participants an opportunity to express their ideas, considerations, second thoughts, etc. Therefore, each session should have at least two chairmen, whose role is to raise controversial issues and questions, requesting the speaker to express his own personal opinion, or international opinion, on certain topics.
- Official Language
The official language of the course should possibly be English; in certain situations, national languages can be used, provided that students or doctors are offered simultaneous translation.
- Teaching Material
Slide handouts and relevant scientific publications including state of the art reviews for each major topic selected by the lecturer as well the EHF-guidelines for the management of common headache disorders in general practice [3] should be available at the beginning of the course, either in paper or electronic format. The course material should also include brief curriculum vitae of each lecturer. The EHF secretariat may eventually help the local congress organizer in the assembling of the teaching material and e-mail that to the local secretariat.
- Evaluation test and diploma
A standardized multiple choice questionnaire should be filled in by each participant at the beginning and at the end of the course. The evaluation test should include 2–3 questions relating to each lecture. The test results will be mailed to the participants after the course if requested. The EHF may provide an evaluation questionnaire if requested by the organizers. In order to gain CME credits, the participant should attend 80% of the scheduled activity. CME should be based on European authorities mainly and if the organizers suggest to national as well. All participants will receive a personal diploma, where the name, the objective, and the CME credits are displayed. The participants will also be asked to give their evaluation of the speakers and lecturers.
- Miscellaneous
The course format should be included in the preliminary and final program brochure. In order to be formally approved by the EHF, the course format should be mailed to the president of the European Headache Federation who will distribute the application to the federation’s board members for approval. The EHF may offer financial support covering registration and accommodation to 2–3 participants from each country included in the developing countries list with limited local funding after a written recommendation from their national EHF-representative. The local organizing committee and the course chairman are fully responsible for promoting and marketing the course locally. EHF distributes the program via the website and mails directly to the national representatives at least 2–3 months in advance. The EHF congress secretariat may help the local congress company with logistical organization if requested.
The EHF can, upon request, provide the following material:
- IHS classification slide kit;
- evaluation test;
- standard 3-day program;
- currently available teaching materials (booklets, manuscripts, guidelines, patient brochures, etc.);
- diploma
- Applications
1. A complete program and a preliminary budget for European Schools should be submitted and approved by EHF board at least 6 months before announcement. After approval, the EHF logo and the EHF patronage should appear clearly on the program.
2. The national EHF representative should add a letter of recommendation of each candidate for the EHF grant together with the application.
3. The organizing national headache society (or societies) is fully responsible for the finances and EHF only secure the academic standard and support with the present grants according to the rules mentioned above.
Headache Video School
Besides the frontal headache education described in the present document, the previous version of the guidelines for organizing a headache school needs to be updated on the basis of new media education technologies. The EHF has recently collected all the lectures presented at the European Headache School held in Mallorca on 12–14 March 2009 in a DVD. Such material is the core for a Video School available on request from countries that want a ‘low cost’ education program to be held. Therefore, a video school format has been constructed providing approximately 3-h video teaching (with a local chairman) and 1-h online discussion with an international chairman two times a day for 3 days. The advantage of such school for the applying country are: low cost for local organizers (no cost for speakers), excellence of the faculty, participation of a larger number of local doctors than those who are able to attend a school abroad (i.e. 2–3 per country on EHF finances). A fast band internet connection (ADSL) should be checked well in advance for online discussion at the end of each session. The request of such school material to the EHF is free until October 2010. After that date, due to the necessity of updating/replacing some lectures, a small royalty needs to be paid to the EHF. The request for the European Headache Video school has to be directed to the EHF president. Due to the necessity of a minimal set of education (especially for general practitioner), we are currently working on a 6-h format Headache School that is the minimum for obtaining European and national CME credit (see above). Information for frontal and video headache school is constantly updated at EHF web site.
Concluding remarks
In order to promote education on the very prevalent headache disorders, EHF organizes and endorses educational courses meeting uniform standards of excellence. Based on recent summer schools’ valuable experience, the guidelines have been revised and updated. A detailed review and validation process is planned after five additional headache schools. The primary goals to increase knowledge, skills, and understanding of headache disorders are emphasized. Likewise, organization of headache care, education, and research are important key elements to be implemented in future summer schools.
Conflict of interest None.
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