Introduction: There is a striking deficiency in medical learning
competencies attained by medical faculty and students that are hardly
ever reflected on or brought to notice in the course of caring for their
patients. A biochemist may not know how the HbA1c values that s/he
regularly facilitates in his lab is actually utilized by the clinician
and patient and the clinician may not realize how the HbA1c values are
actually generated in the lab. The
undergraduate students need to be trained to become a primary basic doctor who
can take care of a rapidly growing patient population but in our current curriculum they end up
being taught specialized subjects like biochemistry, pharmacology even before
they get to see a patient and get to realize why they need to learn what they
are learning, how this knowledge may be applied by them to meet their patient
requirements and if their training can allow them to answer queries that arise
naturally and not as a result of an outdated curriculum that compels them
toward non-contextual rote memorization.This
affects current day healthcare practice where a large proportion of health
professionals are in danger of becoming apathetic to patient requirements. To
resolve the above mentioned problems in current medical education and
healthcare, Medical council of India MCI has recently proposed 'early clinical exposure (see this recent debate here:https://groups.google.
Methods: We shall utilize a mixed methods quasi-experimental study design. In the course of a learning session for 1 year,a team of faculty and students (n=25) will be exposed to regular 'patient encounters' in the inpatient and outpatient wards of LNMC &RC. The group shall also comprise of students from the 1st year MBBS toward effecting early clinical exposure.This team shall capture patient-data at the 'point of care' (in the form of images of clinical findings as well as radiology data) and then subsequently bring them to our 'computer aided learning' CAL lab for further processing.The patients selected will have a sufficient level of clinical complexity likely to generate maximum learning outcomes in terms of patient centered learning questions (detailed here:http://www.pcori.org/
Subsequently the prepared 'patient centered online health record' PCOHR link is shared on to our online social-media based processing forum that has a current global membership of 1000+ members, many of who actively participate in solving patient problems posted to the forum. All this patient centered 'data collection and processing' activity shall be subsequently documented in 'patient centered online health records' PCOHRs such as these http://www.udhc.co.in/INPUT/
Results/Expected Outcomes: This mixed methods study design will document results through qualitative thematic analysis of student-faculty learning insights, qualitative insights on patient-health-outcomes and quantitative estimates in terms of the number of validated participatory learning inputs contributed by each student and faculty and quantitative estimates of patient health in terms of QoL. The results of the impact evaluation of our PCOHR educational intervention strategy will be validated as per currently known paradigms(http://en.wikipedia.
Discussion and Implications for Practice: The 'patient-centered learning' process will further involve learning feedback provided to the patient's primary caregiver by our 'computer aided learning' CAL team and then noting the results in comparison to a 'control group' of patients whose providers receive no CAL feedback. Our hypothesis toward the expected outcome of this project is that the CAL team as well as their patients will have respectively better learning as well as QoL outcomes than the control group-team. CAL performed and scaled in an appropriate patient centered manner can go a long way toward improving health professional learning as well as improving patient outcomes and the combination of the two will be instrumental in augmenting national capacity building and transforming healthcare.
Other ongoing similar programs in our Institute:
Blended learning electives:http://journals.bmj.
Past Experience:
http://www.ncbi.nlm.nih.gov/
http://scholar.google.com/
References/Bibliography:
http://www.ncbi.nlm.nih.gov/
http://www.ajmc.com/
Clinical complexity and teaching learning competencies:http://www.
Quasi Experimental studies and identifying causation between intervention and effect:
http://www.ncbi.nlm.nih.gov/
https://www.academia.edu/
Methods: We shall utilize a mixed methods quasi-experimental study design. In the course of a learning session for 1 year,a team of faculty and students (n=25) will be exposed to regular 'patient encounters' in the inpatient and outpatient wards of LNMC &RC. The group shall also comprise of students from the 1st year MBBS toward effecting early clinical exposure.This team shall capture patient-data at the 'point of care' (in the form of images of clinical findings as well as radiology data) and then subsequently bring them to our 'computer aided learning' CAL lab for further processing.The patients selected will have a sufficient level of clinical complexity likely to generate maximum learning outcomes in terms of patient centered learning questions (detailed here:http://www.pcori.org/
Subsequently the prepared 'patient centered online health record' PCOHR link is shared on to our online social-media based processing forum that has a current global membership of 1000+ members, many of who actively participate in solving patient problems posted to the forum. All this patient centered 'data collection and processing' activity shall be subsequently documented in 'patient centered online health records' PCOHRs such as these http://www.udhc.co.in/INPUT/
Results/Expected Outcomes: This mixed methods study design will document results through qualitative thematic analysis of student-faculty learning insights, qualitative insights on patient-health-outcomes and quantitative estimates in terms of the number of validated participatory learning inputs contributed by each student and faculty and quantitative estimates of patient health in terms of QoL. The results of the impact evaluation of our PCOHR educational intervention strategy will be validated as per currently known paradigms(http://en.wikipedia.
Discussion and Implications for Practice: The 'patient-centered learning' process will further involve learning feedback provided to the patient's primary caregiver by our 'computer aided learning' CAL team and then noting the results in comparison to a 'control group' of patients whose providers receive no CAL feedback. Our hypothesis toward the expected outcome of this project is that the CAL team as well as their patients will have respectively better learning as well as QoL outcomes than the control group-team. CAL performed and scaled in an appropriate patient centered manner can go a long way toward improving health professional learning as well as improving patient outcomes and the combination of the two will be instrumental in augmenting national capacity building and transforming healthcare.
SWOT Analysis:
Strengths: Promising solution to current felt need that can bridge gaps in healthcare learning competencies as well as address patient outcome complexities.
Weaknesses:
Quasi-experimental and complex study design and consequent potential of
study sample selection bias. (Workarounds:ensure transparent and
accountable online documentation of entire process that is naturally
subject to external peer review in real time)
Opportunities:Potential to scale into a sustainable model of practice based learning toward
improving patient outcomes
improving patient outcomes
Threats:
Participant motivation leading to study attrition, patient privacy and
confidentiality (Workarounds: regular motivational meets with
participants of both groups with real-time transparent documentation of
the interaction that transpires between all the stakeholders)
Blended learning electives:http://journals.bmj.
Past Experience:
http://www.ncbi.nlm.nih.gov/
http://scholar.google.com/
References/Bibliography:
Clinical Complexity:
http://www.ncbi.nlm.nih.gov/
http://www.ajmc.com/
Clinical complexity and teaching learning competencies:http://www.
http://www.ncbi.nlm.nih.gov/
https://www.academia.edu/
No comments:
Post a Comment