Sunday, January 27, 2019

Utilizing web based log books of post graduate residents to create online patient records and online resident learning portfolios

This is a lecture discussion session beginning on a Sunday with this social media post to a closed group of online post graduate residents and faculty about an upcoming session on Tuesday.

First post: 5:00 PM to 5:30 PM

"Welcome to this Tuesday session that promotes using "web based log books" to not only help current PGs manage their paper based log books in a genuine manner but also enables them and the entire medical college to utilize these as a learning and decision making tool around our patients.

We hope that this will enable a large number of our faculty man power in clinical physiology, clinical anatomy, clinical microbiology, clinical pathology, clinical pharmacology and Community Medicine to actually regularly review and help us with useful ideas around our patients.

This Tuesday session is a blended learning exercise and we begin this "flipped" classroom by sharing some basic knowledge around "web based log books" and online learning portfolios as done in other parts of the globe and India.


You may notice some "medical education" buzz words here, such as "flipped classroom, blended learning, portfolio based learning etc and I have been slightly liberal with these terminologies as everyone in this group (including the PGs) are medical educators.

I have included in this online group everyone possible in the faculty (at least those whose numbers I have and those who may not leave midway) and the Principal, Medical Superintendent, Vice principal and most HOds are here other than the post graduate residents.

Two resources around web based log books shared below. Keeping all this to the bare minimum to avoid information overload

Indian article on Portfolio based learning 

Western article on portfolio based learning

Will await all of your queries, thoughts and inputs on the above

Deafening silence till 8:45PM when the online instructor for the online component of this blended learning session (yours truly)  decides to share his second post

Second post (8:45 PM to 10:45 PM)

To take you to the point where you may be able to appreciate how and why web log books can be used as a valuable learning tool that can positively impact patient outcomes in this hospital I shall try to begin this journey from our current existing paper based log books. Shared below are some images of its key pages each of which I shall discuss separately again below regarding their importance and how web-logbooks can improve on them.

Figure 1


Figure 1 shows the first important page that you see in your log book and it appears to be all about yourself as a PG. What would you like to write about yourself has been suggested although I am not sure if that actually tells us a lot about what you have already attained in your previous years of graduation in terms of your learning. It just tells us that you have cleared some memory based exams to reach your current position.

Figure 2



Figure 2 shows the next page in your log book which is about evaluation of your clinical work day wise. Now considering that you will be working everyday as a PG 365 days a year, I guess the number of pages are grossly inadequate? 🤔😬


Now there are three more type of slots in your log book meant to assess the kind of presentations you have made in terms of 'Journal review,' seminar and case presentation. Perhaps in our regular Tuesday sessions, from now on, we can incorporate the elements of 'journal review' along with the case presentation and discussion seminar that you have already been doing around the cases that you have been presenting here.'

So now that you know the university log book requirements well, we just need to come to the most important part of our session and that is how would expanding this paper based log book workflow into a web based log book (and online learning portfolio) be useful for you or the institution. Before I move ahead I would need your valuable inputs on what would be your thoughts on the above.

There's one response from one of the Professors in this online group next day at 10:45 AM:

"Micro lesson of medical education will be of very effective ?"

My brief response at 11:40 AM:

👍

Again continuing with the online posts

Third post at 11:40 AM:

Continuing the one way lecture (aka talking to myself) I now share a few links below to a few web based log books ( aka Online learning portfolios) done by current PGs in the Indian Medical education system.

[ 11:42 AM] Here's an online log book from a PG in RIMs Ranchi, India where you can notice the first page of the bio data although not the other pages like day to day work or case presentations or seminars or journal reviews although you can see a lot of his seminar based publications in the past done in his UG and early PG years


Online learning portfolio on research gate 

[11:42 AM] Here's an online log book (web based portfolio) from a PG in AIIMS Delhi and again you will notice that it contains much less than what is recommended in the paper based format.


Online learning portfolio in LinkedIn 





[11:42 AM] Here's another more dynamic and impactful online learning portfolio from another PG in AIIMS Delhi


Online learning portfolio in quora

Here you will notice that he has included a case presentation and even a useful seminar answer to someone's query (which shows that his seminar can actually have a wider impact among global users and readers of his portfolio.

He has off course included a lot of other content, which shall we just say is not a part of his syllabus and that brings us to the important point that Online portfolio based learning is not just bound by the narrow confines of a university syllabus which is again one of the reasons some universities who are way behind in creating academic impact will have little to do with it.

(11:42 AM)So why are we trying to be any different and why are we striving hard to move beyond our university requirements?

Simply because as PGs when we chose our profession we had a dream of making an impact and reaching out to a wider audience.


11:42 AM] This impact can only happen if all of us who are part of the medical college hospital based learning ecosystem strive to improve together. In the beginning straddling two different tools could appear daunting rather than a value addition but we must realize that this is not to burden ourselves additionally but to actually lessen our burden. Any day and in any way if you feel burdensome you can feel free to make an anonymous post and share and we shall try to address that issue without being judgemental. The online learning portfolio ecosystem affords us the luxury of both anonymity as well as transparency.

[11:42 AM]: Here's another online portfolio from one of our own Institute PGs

http://derangedmedicine.com/about/


That promises to be about some of the stuff that is also prescribed in his paper based log book. He has used his online learning portfolio well till now and also published a few of that content in journal formats.


[11:42 AM]: Here's another online portfolio from another PG from our institution who has made it an anonymous portfolio and we are perfectly fine with that as every individual has a right to express him/herself in his/her own manner.

https://virtualmedicocases.blogspot.com/?m=1


The most important thing that differentiates a portfolio from a paper based log book is that the portfolio brings out the personality of the individual and the point here is that one can guage and admire an author's personality just through his/her reflective writings even if one is unable to identify the author.

Some book authors are able to write under pseudonyms and yet successfully make a global impact.


[11:42 AM]: Another learning portfolio from our PG with case presentations and her thesis plan. This portfolio is not anonymous although there is no bio page yet.

http://keerthiereddy.blogspot.com/?m=1


[11:42 AM]: Another learning portfolio from our PG which is all about her thesis and details about her thesis cases. This can be very useful to obtain learning inputs on your thesis on a case by case basis.

http://allabouthyponatremia.blogspot.com/?m=1

We continued this in further online samples of E logs from our institution as well as another institution with arguably one of the best post graduate training programs in the country with dedicated offline faculty and a number of global faculty who respond to the E logs by the post graduate residents by helping out to solve the problems presented in the E logs with experiential and critically appraised evidence.

Also coming up in the next post is a video about what actually transpired in the actual offline component of this blended learning flipped classroom.

Meanwhile here are a few videos of classroom sessions with our post graduates doing Journal reviews, case presentations and seminars as prescribed in their log book curriculum:

Case presentation

Journal review  1

Journal review 2

Elective presentation in CMC Vellore