Patients are interviewed by the learner and s/he also creates their HIPAA de-identified online-health-records that may contain their history and clinical images other than their investigations
Past patient experiences by Dr Jyoti Tripathi recorded online here: https://plus.google.com/109363683741842663030/posts
Here the learner is concerned with how things happen by attempting to see them from different perspectives and relying on one’s thoughts, feelings and judgement. (Reference 1)
Jyoti Tripathi Sir before meal sugar normal rh tha...bt after meal sugar 200 ke uper aati h .. aisa kyo ho rh h...
Rakesh Biswas Meal khane ke baad sabhi ki sugar badhti hai. Isliye kaide s ehar meal se pehle extra insulin ki zaroorat padhti hai jisePrakhar ne add bhi karwaya tha. Kya aajkal patient ko woh mill nahi raha?
Arun Chaudhary Sir ...per day me ..3 times milta h ...8 unit ..before brkfst .....8 unit before lunch .....and sir ..8 unit ..before dinner ....sir
Prakhar Gupta Sir before short meals bhi hai and they give it to him. But problem ye hai ki wo randomly snacks kar leta hai
Jyoti Tripathi Hb_5.8gm %
Jyoti Tripathi Sir Hb kam h...blood tranfusion krna h kya...
Jyoti Tripathi Sir patient...feel better...bt ab kya krenge....
Rakesh Biswas Step 1--Pehle unki vartaman sthiti ka mulyankan kijiye: Kyon hua hai yeh kidney problem? Aur kya janchon se yeh pata chal sakta hai. Kaun si chapter mein yeh padha ja sakta hai? Patient had features of glomerulonephritis in the urine RM with nephrotic range proteinuria and active sediment in the form of RBCs. So i guess you can begin finding the answer to step 1 by googling each of these individually and then share with us what you learn about it here before we can move on to step 2. Please others (Arun, Madhavi, Arjun, Arti, Niranjan attendance will be given only if you participate here daily.
Jyoti Tripathi Sir...why increased creatinine after dailysis....
Rakesh Biswas Google it and let us know. Prakhar already mentioned the answer once in the rounds 3 days back
Rakesh Biswas Hint: Any relation between total body water, dialysis and creatinine?
Here learning is achieved by rigorous thinking (reflecting), using a systematic approach to structure and frame the phenomena being experienced. Emphasis is placed on the definition and classification of abstract ideas and concepts, aiming at precise conceptual categories. (Reference 1)
Mechanisms of Blood sugar control
Approach to a patient of renal failure
The learner attempts to influence people and change situations as necessary. (Reference 1)
Taking patient histories (in patient’s voice) and taking clinical images and recording them in blogs
Using structured templates to record patient findings such as Mini-mental scores, depression scores, quality of life scores etc
Making an optimal assessment and plan for the patient
Jyoti Tripathi Pt complaining chest pain since night
Jyoti Tripathi N fever....bt abhi fever nh h.....
Rakesh Biswas Unka ECG hua hai? Idhar please share kijiye aur saath mein unka fever chart bhi. Objective data matlab yeh hain (aur unki cpmplaints subjective hain). Sahi interpretation ke liye dono ka hona zaroori hai.
Jyoti Tripathi Hmm sir ECG ho gyi h
Jyoti Tripathi Kl day me 500ml ke somthing urine huaa h...
Jyoti Tripathi Portclor syrup nh le rh h pt
Rakesh Biswas Pot klor syrup se bhi zaroori hai unka khana lena. Unse kahiye agar woh muh se nahi le rahe hain to RT daalna hoga.
Jyoti Tripathi Sir samjha to rh h..bt pt nh man rh h
Jyoti Tripathi Prakhar sir ne bhi pt dekha h....or pani n khane ka bola h...bt 1spoon pani lene ke bad mna kr diya
Writing an order for pharmacological therapy (only for those with a licence in that particular medical stream in which the prescription is being provided)
Assisting in data collection not only directly from the patient’s bedside but also from the patient’s radiology, labs and procedures and documenting it with images
Prakhar Gupta Jyoti unki dressing ho gayi?
Jyoti Tripathi Hnji sir....kr diya dressing
Performing physiotherapy (only for those with a licence)
These can be either based on the case or the number of learning points gained by the learner during the entire week.
Renal failure approach
Insulin therapy mechanisms and dose adjustment
1) Kohonen,V. 2009 Learning to learn through reflection – an experiential learning perspective. Full text downloaded on March 28th 2016 from http://archive.ecml.at/mtp2/Elp_tt/Results/DM_layout/00_10/05/Supplementary%20text%20E.pdf
Methodological differences that our 'constructivist' program has with traditional programs here in this link:http://images.slideplayer.com/10/2754034/slides/slide_20.jpg
Portfolios: Learning and Assessment in Medical Education Catherine Moltzan MD FRCPC: downloaded on March 28th 2016 from https://umanitoba.ca/faculties/health_sciences/medicine/education/pgme/media/Portfolio_Presentation_copy.pdf
Images of Portfolio Based learning: http://image.slidesharecdn.com/dublin2016-balancing-160323110905/95/dublin2016-balancing-2-638.jpg?cb=1458731715,
Sample ‘patient-information-communicator’ weekly-learning-portfolios recorded here:
Sample UDHC Case-study: http://userdrivenhealthcare.blogspot.in/2016/03/udhc-case-study-from-online-patient.html
Check-list for patient-safety near miss reporting (toward quality improvement):