Best practices in Learning / mastering clinical subjects in MBBS course
description
Transcript of Best practices in Learning / mastering clinical subjects in MBBS course
Best practices in Learning / mastering clinical subjects
in MBBS course Prof. M. Daud Khan
Dec.17. 2013
Aim at creating the best possible learning and teaching / mentoring environment for medical students/graduates to enable & empower them to translate their dreams into realities.
Goal & Objective
Partnership:Based on TrustStudentsFacultyParents
Focus on emerging concepts in medical education & clinical practice.
Focus on strategies on how to adopt best practices in PIMC
Scope & Purpose
A highly motivated and responsible doctor,
equipped with necessary knowledge, skills and attitudes , committed to life long
learning and application of knowledge;
to meet the current and emerging global needs of patients and populations in a Kind ,
Caring and Compassionate
manner
The dream, the ultimate goal
We will try to educate students to become outstanding clinicians
who have the skills and passion to improve the health of the world’s
people through research, innovation, and leadership.
Mission statement
A set of basic competencies expected from a competent medical graduate ; Physician of
21st Century”Effective Communication.
Basic clinical skills.Using science to guide Diagnosis, Management,
Therapeutics & prevention.Lifelong Learning.
Self-Awareness, Self –Care & Personal Growth.The social & Community Contexts of Health Care.
Moral reasoning& Ethical judgment.Problem Solving.Professionalism
Leadership & Role Recognition.
The Knowledge TriangleIntroduction
Knowledge(Cognitive domain) Skills
(Psychomotor domain)
Attitude(Affective domain)
Acquisition of Knowledge, skill and attitude
Methods and processes of adult learning EvaluationLMS
Introduction
Stages of Maturation
Dependence
Dependence
Interdependence
Knowles six principles:1. Adults are internally motivated and
self directed2. Adults bring life experiences and Knowledge to new learning environments.3. Adults are goal oriented4. Adults are relevancy oriented5. Adults are practical6. Adult learners like to be respected
Principles of Andragogy ( Adult Learning)
Types 0f adult learners Active learners Reflective learners Theoretical learners Pragmatic learners
Andragogy
Pedagogy vs Andragogy
Pedagogy• Learner is Raw
• Learner isDependent
• Curriculum is well structured and
rather rigid• Students are Subject centered• Learning is not logic or relevance
oriented
Andragogy• Learner is experienced
• Learner isIndependent
• Curriculum is more flexible and
learning is need based
• Students are performance
centered• Learning is logic
and relevance oriented
Learning objective. Lecture plan and instructional
strategies. Expected outcomes Tutorial and small group discussions Seminars Symposia's Self directed learning Library E- learning
Class room teaching( LMS)
Class room environmentActive learningFeed backEvaluation ( formative AndSummative)
“I never try to teach my students any thing.
I only try to create an environment where they can learn”
Albert Einstein
Student-centred ---Teacher-centred Problem-based---- Information-oriented Integrated -----Discipline-based Community-based ----Hospital-based Elective ----Uniform Systematic ---Apprenticeship
SPICES Model of Medical Education
Anytime learning Any where learning Any number of times learning Customized to level of assimilation Individual or group learning Interactivity based learning – active
learning Enables group discussion across
geographical barriers. Adaptability and flexibility of the system
Learner centered - benefits
Contents divided into three categories
1. Must learn2. Useful to learn3. Interesting / Nice to
learn
Education Education in the largest
sense is any act or experience that has a formative effect on the mind, character or physical ability of an individual. In its technical sense, education is the process by which society deliberately transmits its accumulated knowledge, skills and values from one generation to another.
Act On Right to Education A right to education has been created
and recognized by some jurisdictions: since 1952, Article 2 of the first Protocol to the European Convention on Human Rights obliges all signatory parties to guarantee the right to education. At world level, the United Nations' International Covenant on Economic, Social and Cultural Rights of 1966 guarantees this right under its Article 13.
Traditional Methods of Teaching Teachers need to understand a subject
enough to convey its essence to students. While traditionally this has involved lecturing on the part of the teacher, new instructional strategies such as team-based learning put the teacher more into the role of course designer, discussion facilitator, and coach and the student more into the role of active learner, discovering the subject of the course.
What is Learning Is a relatively
permanent change in behaviour that comes about as a result of a planned experience Results from the interaction between what we already know, new information we encounter, and what we do as we learn
Education is Changing from Socratic Methods to Cyber Learning
Technology a boon to Education Technology offers
powerful learning tools that demand new skills and understandings of students, including Multimedia, and provides new ways to engage students, such as Virtual learning environments.
Med NET ; OpportunitiesBroadband networkLink medical schools, hospitals, public health centersFor
Tele-educationTelehealthBio-informaticsResearch Grid
Approach to patient. Greetings and introduction Permission for Hx taking and
examination History taking and examination: Present illness Past illness F.H Personal Hx Socio economic history
Bed side teaching, Learn from your Patient.
Listen patiently & carefullyRecordClarifyCross questions
According to Causes: Infectious/ Communicative diseases
Non Infective Diseases( NCDs) Life style Diseases Deficiency Diseases Hereditary Diseases Genetic Diseases
Types of Diseases
General physical Examination: Level of consciousness, level of
Orientation, Any sign of Pain and agony.
Pulse, BP, Skin color, cyanosis, anemia, jaundice, facial appearance, swellings, neck veins, pitting edema.
Lymph nodes Data collection, synthesis and
analysis arriving at History based DX
History taking and examination:
Exam. Of GIS Exam. Of RS Exam. Of CVS Exam. Of NS Exam. Of GUS Sensory organs Data Synthesis, Analysis and arriving
at Provisional DX
Systemic examination
Basic data: Urine CBE Other system based essential
investigations ( Lab., Radiological, Ultrasonic, 3 Ds, etc.) Data Synthesis Data Analysis Arriving at Final Dx.
Relevant investigations
Create a strong habit f co relating your patient S/S , and clinical findings with the typical book picture of the disease.
Note the steps of medical intervention. Note the steps of emergency treatment Note the indications and steps taken for
surgical intervention Explanation to patients /family and The
consent form Carefully read the details of surgical
intervention and co relate it with details in the book
Co relation between theory and practice
Emergency Non Emergency Indoor Out door Ambulatory/ non Ambulatory Criteria for admission Criteria for special care, ICU, Isolation
Management
Management Treatment plan
PrognosisMo
nitoring
progress
Discharge &
Follow up
In Partnership withPatient/ FamilyConsent formInvasiveNon InvasiveUrgencySafe Efficient EffectiveAffordable
Prognostication
Preventive strategy
Discharge & Follow up Home treatment Domiciliary support Letter to primary physician Follow up Transport support
Management
Record keeping Statistical analysis Research Publication Quality Assurance Internal Audit External audit Cost Analysis
Management
QuantityQuality Customer’s satisfaction
Bereavement
EmpathyKindnessCompassion
Monthly Mortality conference Analytical review Negligence Errors of Judgment Letigations Lessons learnt Quality management
Management
Why bother with the future?
The point is not to predict the future but to prepare for it and to shape it
Dr.T.V.Rao MD
Looking to the future: common mistakes
People consistently overestimate the effect of short term change and underestimate the effect of long term change.Ian Morrison, former president of the Institute for the Future
Dr.T.V.Rao MD
Bring in Change or You are Lost ?
If you think that you can run an organisation in the next 10 years as you've run it in the past 10 years you're out of your mind."CEO, Coca Cola
Dr.T.V.Rao MD
Role of Doctor is Changing
Old world: Doctors practice primarily as individuals
New world: Doctors work predominantly in teams
Dr.T.V.Rao MD
Definition of Knowledge is Changing
Old world: Source of knowledge is expert opinion
New world: Source of knowledge is systematic review of evidence
The Learner Is the Center
CME MissionTo providing medical education programs that
are responsive to the needs of physicians and that offer opportunities for ongoing intellectual stimulation and professional renewal.
Medical Informatics Medical informatics has
been also defined as the field that "concerns itself with the cognitive, information processing, and communication tasks of medical practice, education, and research, including information science and the technology to support these tasks
Health (Medical) Informatics a Rapidly developing science
Medical informatics is the rapidly developing scientific field that deals with resources, devices and formalized methods for optimizing the storage, retrieval and management of biomedical information for problem solving and decision making.Edward Shortliffe, M.D., Ph.D. What is medical informatics? Stanford University, 1995.
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Computer make the Diagnostic-Therapeutic Cycle,
Simplified
Patient
Data collection:-History-Physical examinations-Laboratory and other tests
Decisionmaking
Planning
Information
Diagnosis/assessment
Therapyplan
Data
About.comwww.about.com
The site contains the greatest collections of information on diseases and conditions on the Net. It spans the globe and provides interactive chats and forums for experts and patients to come together. This site not only directs you to outside sources, but also takes each topic and gives you the rundown from top to bottom.
Best Doctors www.bestdoctors.com
Find the best doctors and provide the best content on a site that others can access free of charge. Founded by a man who was diagnosed with an inoperable tumor and wanted the best doctors to treat him, he set out to empower other patients through information.
Healthcommunities.com www.healthcommunities.com
his site is specifically designed to give you disease-related information through what it calls channels. It's one of the most interactive medical portals on the Net, offering chats, discussion forums, and clinical trials. This site enables you to access the world of medicine in seconds.
Health finder www.healthfinder.gov
This government portal opens the world of Internet medicine. Whether it's through tools such as libraries, online journals, or medical dictionaries or hot topics that might interest you, this site delivers quickly and with reliability. A big bonus of the site is that it also provides content in Spanish.
InteliHealth www.intelihealth.com
t's important for a portal to "have it all." This one is a good example. Whether it's drug information, a medical dictionary, or a rundown on a long list of diseases and conditions, Intelihealth is your gateway to top-notch information. It doesn't hurt to have Harvard Medical School's consumer health information tied to the site.
National Institutes of Health www.nih.gov
Contain the leading collection of health research institutes in the world. Whether the topic is allergy and infectious disease or cancer, this is your gateway to health information. You'll find the latest in research and well-written fact sheets and brochures that reach out to inform all.
WebMD www.webmd.com
One of the most heavily marketed portals on the Net, this site stands up to most of the hype. It's nicely divided for different audiences, ranging from patients and doctors to physician assistants to health teachers. It has a robust television service that allows you to watch broadcasts on different health topics.
Thank You