•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