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•Tertiary care hospital•Specialist orientation•Lack of basic skills to handle common health problems
Doctor at Primary/secondary level
Specialists•Urban hospitals•Migrate abroad
Medical College
•Knowledge to practice•Access to information•Referral support•Involvement in teaching & learning
Bridging the academic distance
OVERVIEWBack ground of CMC Mission Hospitals Linkage
E-Learning with Mission Hospitals so far
How E-Learning can be useful for Mission Hospitals
Integrating Primary/Secondary Education – An IDEA
!
4
Vellore
INDIA
200 secondary hospitals
20-200 bed hospitals
Rural and semi-urban areas of India
Broad based Services
2 years of service obligation after
graduation
BACK GROUND OF CMC – MISSION HOSPITALS LINKAGE
Jan Swasthya Sahyog, BilaspurAIIMS and CMC doctors –community health
projectChhattisgarh
Pregnant woman Transported across a stream Black water fever
Burnscontracture
Sickle cell crises
Krait bitewith paralysis
RESPONSE TO THESE CHALLENGES
Secondary Hospital Program (SHP)
Fellowship In Secondary Hospital Medicine
( FSHM)
Objectives Secondary hospital programme
To learnThe management of common health
problemsStudy a local health issue through project
workThe functioning of a secondary hospital
Develop a positive attitude towards care in rural locations.
7
Phases of the SHP
8
“Assam itself was a memory to savor, the ubiquitous bamboo, the all-to-real possibility of being shot despite having a military escort, travelling on top a vehicle rather than inside one, bathing in open air, forgetting the intrusions of cell phones and the internet, and the gracious hospitality of villagers who opened their home to us strangers..”
Student Quote
9
Clinical work
10
Medical Ward
OPD
Labor Room Operation Theatre
SHP Projects
Screening for hypothyroidism in a village
Preventive Community Diagnosis
11
12
“What shocked me was the hard work, perseverance and commitment of the people who work hand-in-hand as one of the team. I realized that the life and work in rural areas with the less privileged and no great facilities is ‘no less’ to the work done in a tertiary hospital”
Student Quote
ROLE MODEL TEACHERS
Secondary hospital programme
The SHP provides a distinctive learning
experience.
Sensitizes the student to cost-effective
community-based health care in remote
locations with their unique health issues
Provides role models and prepares the
student for rural work. 13
Use of Technology for SHP
Announcements and timetables
Student posting of videos/photo journey of
their visit
Feedback
Difficulties graduates face in service obligation
Transition problems from tertiary to secondary care- Broad based skills- Undifferentiated illness- Limited lab and specialty support- Cost-effective medicine
Lack of academic learningSocial isolationAdministrative problems
Integrated PG Diploma in Family Medicine
Distance course to support post-MBBS doctors working in
rural hospitals
Integrated Postgraduate diploma in Family Medicine
Objectives
1. Knowledge and skills in managing common
problems at a secondary level
2. Function well as a team member
3. Addressing a local health issue through
project work
4. Social and academic support
12 months0Months
CC-I CC-IIContactcourse
Distance course
18 modules
Project Work
Outline Projectplan
Interim Report
Course structureINTEGRATED PG DIPLOMA IN FAMILY MEDICINE
CC-IIIExaminations
FinalReport
UTILIZATION OF ANTE-NATAL CARE SERVICES AMONG PREGNANT WOMEN
EVANGELICAL HOSPITAL , KHARIARIMPROVING ANTIBIOTIC PRESCRIPTION PRACTICES
CSI HOSPITAL BANGALORE
BIOMEDICAL WASTE SEGREGATION AND DISPOSAL MANAGEMENT
BISHOP WALSH MEMORIAL HOSPITAL , THADAGAM
ESTABLISHING A DIABETIC CLINICTHE SALVATION ARMY HOSPITAL NAGERCOIL
PROJECT ON USE OF MOBILE PHONES TO SUPPORT STUDENTS
1. Adapting E-learning system for mobile device
2. Pilot testing3. Adapted
curriculum & content
4. Evaluating the delivery and support of the course using mobile device
E-Learning with Mission Hospitals so far
The Evolution
Methodology
Intial introduction to E-Learning
Needs Assessment
Infrastructure Support
Project development
Workshop
Evolution of CMC –Mission Hospitals E-Learning LinkageInformal
Voluntary visit by CMC FacultyVisiting faculty from Mission Hospitals for Skills
upgradationOberverships by Medical Students
Formal Obligation after Graduate & Post Graduate TrainingObligatory two weeks service for faculty Structured Program
SHP FSHM
E-Learning with Mission Hospitals
Chinchpada Raxaul Gudalur Manali ODC Herbetpur Chattarpur Padhar
Edu
cati
onal
C
ours
es
Med/PG x - x x x x AHS x x - x x x Nursing x x - x x - CW x x - - - Others - - - - - -
Com
p R
esou
rces
No of Comp
10 8 5 50 20
Com with Internet
5 5 Wi-Fi 4 15 5
Broad Band
x x x x x x
Dial-up - - - - - - USB - - - - - -
Mob
ile N
etw
ork
BSNL x x x x x x Airtel x - x - - x Aircel - - x - - - Reliance x - - - - - Tata - - - - - - Vodafone - - - - - - Others - - - - - -
Comp for edu 6 x x 4 10 x Specific Project Anesthesia
NEED ASSESSMENT SURVEY
Results of Need Assessment
Almost all the hospital have a medical education
programme running or in the process of starting
Everyone had sufficient hardware available with
internet facility
Everyone had broad band connectivity
Results of Need Assessment
Everyone have cellular / internet connectivity
Everyone has a computer available for
educational purpose.
All of them are keen to access E-learning
website
Most of them are keen to initiate E-learning
projects
IMPLICATIONS FOR ACTION
Feasible to provide E-learning website access
Need to identify potential partners and
initiate project
Need more communication and feedback if
we need to start a definite project
INFRASTRUCTURE SUPPORT
Grant to acquire hardware to establish E-Learning at the secondary hospital
E-learning workshop for secondary hospitals, January 2010
1. Sharing of CMC E-learning resources and approaches2. Training in using the E-learning website3. Discussion of secondary hospital needs4. Developing collaborative projects
WORKSHOP OUTCOME
Protocols & Clinical Care guideline
Image Library; Case Based Teaching
Modules &Videos
Communications and Technological
Support
Role of E-learning in Mission Hospitals
Access
Clinical Resources
Academic meetings
Guidelines
Networking
Distributed Open Educational Resources
Decentralization of Health care education
Decentralized clinical training
Use of IT in quality assured education across sites
1. Training of faculty 2. Podcast of lectures3. Delivery of integrated
training materials4. Log of cases5. E-forum6. On-line theory test
Electronic platform for distributed medical education
CMC :• E-learning resources• Digital library• Telemedicine support• Referral support
Mission hospitalProjects:Developing and sharing• Local educational resources• Clinical care guidelines
FUTURE
Selection of students from local communities
25% -50% of trainingTime at primary/Secondary level
Developed Secondarytraining sites
SupportedBy technology platform
Mentoring By teachers at Primary and secondarylevel
Solving problems at the Community level
Reciprocal flowOf knowledge
Integrating High School Education
To provide complimentary educational
resources to children of health care workers
in remote areas of need
This will improve the educational standards
of the children in rural areas and they can
potentially go on to become the next
generation of health care professionals.
THANK YOU FOR YOUR KIND ATTENTION
THANK YOU FOR YOUR
KIND ATTENTION
tomsamram@cmcvellore.ac.in