Medical Electives in ‘Patient information communication management’

Methodology:

100% practical hands on learning which will be documented and stored in paper as well as archived online for formative assessment at the end of the course (also see section on 'assessment' and 'course-content' below and Telehealth center workflow plan)

Objectives of the Course:

Train course participants to effectively utilize Information and Communications Technologies ICT toward applying information driven clinical problem solving for improving patient health outcomes in the community.

Become efficient tele-health practitioners by collecting patient information through telephone and email and further processing of the data by gathering and adding evidence based solutions from medical consultants using store and forward techniques with e-mail, phone as well as face to face meetings.

Become efficient health journalists by researching and writing up case studies around interesting clinical problems as well as write health reviews to spread health awareness in local languages.

Duration: Assessment driven

Assessment of Course participants:

A system of formative Assessment will evaluate student generated data/learning points arising from their experiences during the course of their online learning interactions with virtual patients and faculty.This means there will be multiple weekly assessments and validation/corrections of the candidate's learning through a dialogue between the facilitator and the student all of which will be recorded on the web site. At the end of the course all these formative assessment data shall be qualitatively
analyzed for an overall assessment. There will be no formal exam/summative assessment at any point of the course


Course Content and learning outcomes:

At the end of the course students will be able to obtain

1. An overview of clinical problem solving
(The student will learn to prepare a patient problem list, identify an anatomical and
etiological diagnosis and as one of the stakeholders in the patient’s care facilitate a
positive relationship between the patient and his/her primary-secondary-tertiary health
professionals through efficient and optimal knowledge sharing between all these
stakeholders)

2. Master Clinical history taking and examination

(The student will learn to assist and facilitate the process of examining the patient’s
narrative and other information obtained through physical examination with and
without the help of modern technological tools such as radiological imaging and
laboratory parameters reflecting the patient’s internal chemistry)

3. Master the Essentials of anatomy, radiology, physiology and biochemistry
(This is necessary to reach an anatomical, functional and molecular diagnosis for a
given clinical problem at hand. Students will be taught to discover these essentials
while practicing online clinical problem solving beginning with the case at hand and
traveling right down to basic anatomy, physiology and biochemistry in context of case-based
information collected from clinical, radiological and laboratory data.)

Students will learn an approach to solve problems around diseases of:

Ø Cardiovascular system (Cardiology)
Ø Respiratory system (Pulmonology)
Ø Renal and genitourinary system (Nephrology, Urology)
Ø Hematological system (Hematology, Immunology)
Ø Nervous system (Neurology)
Ø Gastrointestinal system (Gastroenterolgy)
Ø Reproductive system (Men’s and Women’s health)
Ø Skin and Integumentary system
Ø Cognitive system (Psychology, Psychiatry)
Ø Musculoskeletal system (Rheumatology, Orthopedics)
4. Master Essentials of pathology and microbiology
(Necessary to reach an etiological diagnosis and students will be taught to discover these in
the context of solving their patient’s problems)
5. Master Essentials of Pharmacology, EBM and Net-searching
(Necessary to formulate a solution and treatment plan and students will be taught to discover these in the context of solving their patient’s problems)

Course Faculty: Will comprise of Medical Consultants and Professors

Onsite: 9-4 PM and virtual 24x7

 Project Goal: Finding the best way to train a Community health worker well equipped to handle a variety of patient requirements

Eligibility criteria for project participation: Dreams Big (beyond the Nobel), Good computer and language skills (lives online 24X7 and has own portable device and data card connection), Entrepreneurial mindset

WHY and WHAT?

The answer comes from a parable that's very common in the public health community. This is a parable of three friends. Imagine that you're one of these three friends who come to a river. It's a beautiful scene, but it's shattered by the cries of a child, and actually several children, in need of rescue in the water. So you do hopefully what everybody would do. You jump right in along with your friends. The first friend says, I'm going to rescue those who are about to drown, those at most risk of falling over the waterfall. The second friend says, I'm going to build a raft. I'm going to make sure that fewer people need to end up at the waterfall's edge. Let's usher more people to safety by building this raft, coordinating those branches together. Over time, they're successful, but not really, as much as they want to be. More people slip through, and they finally look up and they see that their third friend is nowhere to be seen. They finally spot her. She's in the water. She's swimming away from them upstream, rescuing children as she goes, and they shout to her, "Where are you going? There are children here to save." And she says back, "I'm going to find out who or what is throwing these children in the water." From Rishi Manchanda’s TED talk: http://www.ted.com/talks/rishi_manchanda_what_makes_us_get_sick_look_upstream/transcript?language=en#t-520480

An ideal community health worker may need all the three attributes described in the parable above?

Current day modern medicine and all our medical education is mostly Hospital Based and focused on Rescue and this is one of the characteristics we can expect in most of our community health workers but again training them to the desired levels can be challenging though not impossible especially with the help of technology one can see this being ushered in through 'home-healthcare?

Rescuer Attributes/Myer’s Brigg’s Typologies: Sensory reflexes, Feeling

Raft building in healthcare has been delegated to administrators, policy makers and politicians but raft building needs to begin in the community and the CHW is well positioned to initiate it again with the help of technology that has the power to connect him/her with decision makers?

Raft Builder Attributes/Myer’s Brigg’s Typologies: Extroverted, Sensory, Thinker, and Judgmental.

Upstream swimmers in Healthcare are very few and are generally thought to be taken up by people labelled health activists but this is a role often left to patient’s relatives or even patients themselves. The role of a CHW here is perhaps paramount?

Upstream swimmers Attributes/Myer’s Brigg’s Typologies: Intuition, Thinking, Feeling, Perception

I have used Myer Brigg's typologies and anyone wishing to figure out their own typology can just click on this link:http://www.humanmetrics.com/cgi-win/JTypes2.asp#questionnaire 

There are 72 yes/no questions but once you answer them it may be fun to diagnose your own typology and see what kind of community health work you are suited for?

Global Health Case Reports Template

We have begun developing the Global health case reports campaign on a war footing in collaboration with the BMJ Case Report Editorial board who have been gracious enough to peer review our pre-publication drafts and we are looking forward to more Global Medical Elective students joining  our program with us here http://promotions.bmj.com/jnl/bmj-case-reports-student-electives/
in Bhopal.

Pasted below is a Global Health Case Reports Template (also downloadable from the BMJ Case Reports web site if you google for it) to guide our prospective authors:

TITLE OF CASE Do not include “a case report”

150 WORD SUMMARY Focus the summary on the case or the Global Health problem that you want to discuss. You may wish to give an indication of the severity of the case or the scale of the problem

CASE PRESENTATION Explain the relevant features of the case in sufficient detail so that someone in another country would have a good understanding of who you are describing. Go back to the history of the problem, and forward to the outcomes that have resulted

GLOBAL HEALTH PROBLEM LIST Just list the problems raised in the case. These will be discussed more precisely in the section below

GLOBAL HEALTH PROBLEM ANALYSIS The problem analysis directly addresses each problem in your case that needs attention to achieve a better health outcome for the patient. This should be a well-researched and balanced account. Find and appraise all the relevant medical, epidemiological and socio-political literature. Explaining missing epidemiological data is important in the appraisal of the literature. Make sure you discuss all the relevant aspects of the case, including important anthropological, cultural and community issues

LEARNING POINTS/TAKE HOME MESSAGES 3 to 5 bullet points – this is a required field and should be directly relevant to the Global Health issues being discussed

REFERENCES Vancouver style

FIGURE/VIDEO CAPTIONS Figures should NOT be embedded in this document

PATIENT’S PERSPECTIVE Optional but strongly encouraged

Copyright Statement

I, [INSERT YOUR NAME IN FULL], The Corresponding Author, has the right to assign on behalf of all authors and does assign on behalf of all authors, a full assignment of all intellectual property rights for all content within the submitted case report (other than as agreed with the BMJ Publishing Group Ltd) (“BMJ”)) in any media known now or created in the future, and permits this case report  (if accepted) to be published on BMJ Case Reports and to be fully exploited within the remit of the assignment as set out in the assignment which has been read. http://casereports.bmj.com/site/misc/copyright.pdf. Date:

PLEASE SAVE YOUR TEMPLATE WITH THE FOLLOWING FORMAT: Corresponding author’s last name and date of submission, eg, Smith_March_2014.doc ·         This template is for case reports with a focus on Global Health; you will need to submit your completed template online http://mc.manuscriptcentral.com/bmjcasereports o    You will be asked for more detailed information on submission where you can also upload images, multimedia files, etc o    Further details are available in the Instructions for Authors PATIENT CONSENT ·         You must have signed informed consent from patients (or relatives/guardians) before submitting to BMJ Case Reports. Please anonymise the patient’s details as much as possible, eg, specific ages, ethnicity, occupations. For living patients this is a legal requirement under the UK’s Data Protection legislation; we will not send your article for review without explicit consent from the patient or guardian. If the patient is deceased the Data Protection Act does not apply but authors must seek permission from the next of kin. If you cannot get signed consent from the next of kin, the head of your medical team/hospital or legal team must take responsibility that exhaustive attempts have been made to contact the family and that the paper has been sufficiently anonymised not to cause harm to the family. You will need to upload a signed document to this effect. o   Further information is available online o   Consent forms are available in several languages PUBLICATION ETHICS ·           BMJ takes publication ethics very seriously and abides by the best practice guidance of the Committee on Publication Ethics. BMJ is a member of CrossCheck by CrossRef and iThenticate which is a plagiarism screening service that verifies the originality of content submitted before publication. iThenticate checks submissions against millions of published articles, and billions of web content. Authors, researchers and freelancers can also use iThenticate to screen their work before submission by visiting www.ithenticate.com Every article is screened on submission and any that is deemed to overlap more than trivially with other publications will be rejected automatically with no right of appeal