Tuesday, June 22, 2021

Working prototype of a scholarly integration of medical education and research framework

 Scholarship of integration connecting community  patient health care requirements to student learning outcomes toward peer review assessment: 


Illustration from recent real time student teacher patient learning workflow :


Two starting nodes that are at the center of this learning and caring ecosystem :



1) Patient at home in the community connected to teaching hospital



 through 



2) a chain of health professionals starting with medical students at home in their community as well as their teaching hospitals and their faculty coordinator 



A patient in touch with a community connected hospital in Narketpally, Telangana (2000 kms from her place of residence in Bengal, gets in touch with theTelehealth physician and coordinator of the hospital at Narketpally through a whatsapp text query seeking help for her son and this patient is referred to a medical student currently locked down at a distance of 1000 kms from the same patient. 

The medical student proceeds to gather the history from the patient and prepares a brief case report with the patient requirements and shares it with the global CBBLE network from which the patient requirements are further shared in various other Global fora by other interested health professionals both in learning more about the problem presented as well as helping the patient. 

The first example is copied below as it happened:

Box 1:

The telehealth physician faculty coordinator receives a text message from one of his long distance patients who had even made a 2000 kms journey in the past to be evaluated for her spondyloarthrpathy symptoms and this time she needed consultation for her son and below are the deidentified verbatim text messages in Hindi (to provide a feel of the real manner in which this really evolved):



"[5/13, 6:00 PM] Pt Spondyloarthrpathy 30f: Hum ... (location) se


[5/13, 6:00 PM] Pt Spondyloarthrpathy 30f:


 Mera bacha 8 saal ka hai



[5/13, 6:01 PM] Pt Spondyloarthrpathy 30f:


 Sir wo bar bar toilet karta hai



[5/13, 6:03 PM] Pt Spondyloarthrpathy 30f: Test Karwaya koi infaction nhi hai.



[5/13, 6:04 PM] Pt Spondyloarthrpathy 30f: Sir kya problem ho Santa hai



[5/13, 6:05 PM] Pt Spondyloarthrpathy 30f: Par isko constipation ka program hai


The faculty coordinator replied one hour later:

"Humare doctor aapko phone karenge detail mein jaan ne ke liye"


The faculty Coordinator immediately posts this requirement below onto the global CBBLE whatsapp group (a global group of medical students and faculty health professionals with 200 members) :

"

[5/13, 7:21 PM] FC: Anyone here who would like to take a telephonic history from the mother of an 8 year old child with frequent urination and then share the deidentified details here for analysis?

[5/13, 7:22 PM] FC: Mother's language is Hindi


Within minutes there were a few interested medical students texting the faculty coordinator FC in pm and he chose the earliest person and within one and a half hours that student had telephoned the mother and made a summary of the patient's problem representation which was again circulated by the FC into the global CBBLE as well as other healthprofessionals groups such as one even among his batch mates who entered national medical college, Kolkata in 1987 and the subsequent inputs into the patient problem have all been captured by the same student in her E log book here: drsaranyaroshni.blogspot.com/2021/05/an-eight-year-old-with-frequent.html?m=1

The same student was instrumental in arranging a telecounselling with one of the Psychiatry department faculty members from her Medical College in Narketpally from 2000 kms away and the patients health outcomes currently appear to be evolving to everyone's satisfaction. 

In the next module we shall see how this patient data was utilized in a monthly summative assessment module for the same batch of students to test their competencies in patient care related to clinical problem solving through empathic patient data capture and continuity of communication. 


Please click on the link below to get back to the first layer of the chapter:



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