This is a regular academic session impact assessment log for the post graduate residency training program comprising currently of residents of 2019 and 2020 batch.
The training program comprises of a regular hands on learning of clinical decision making during the bedside rounds from 10 AM to 1:00 PM as well as 2-4 sessions officially divided daily into:
Theory on Monday,
Seminar on Tuesday,
Journal club on Wednesday,
Tutorial on Thursday
Group discussion on Friday
Log Book audit on Saturday
These are blended learning sessions with both online and offline components and while the offline learning timings are as mentioned above, the online component of the learning continues 24x7.
The overall impact of each learning session is assessed under two main headings as impact on the student and impact on patient.
The detailed headings are :
Impact :
On learning ecosystem :
Cognitive competency levels touched in different levels of Blooms taxonomy BT (more here : https://sites.pitt.edu/~
Approach to disease localization (BT level 1 -3)
Resolving initial diagnostic uncertainty (BT level 1-4)
Therapeutic decision making toward evaluating patient requirements and outcome (BT level 1-5)
Developing and testing innovative diagnostic and therapeutic solutions ( BT level 1-6)
On patient care outcomes :
Was empathic trust built with patient and relatives?
Were the patient requirements identified adequately and a proper problem list made toward assessment?
Was standard of care provided with provision for care continuity ?
December 1st Wednesday :
journal club :
"Sun et al.13 performed a prospective study (level 2b evidence) on a cohort of 108 patients, in which 26 patients were treated with DX alone, 69 underwent burr-hole craniotomy and adjuvant corticosteroids, and 13 were treated with surgical drainage alone. In the corticosteroid group, 1 patient required surgical drainage, whereas in the surgical group hematoma recurrence was reported in 3 patients; no significant difference between the two groups was measured."
Dr Usha
Dr Rashmitha
Dr Durga krishna
And UGs
2nd December Thursday Tutorial :
Video :
Facial Nerve UMN LMN
Presented Dr Rashmitha
Attended by Dr Durga krishna Dr Usha and UGs
3/12/2021 Friday
Group discussion
Heart failure
4/12/2021
Saturday
Log Book assessment
Presentation of thesis logs by PGY3s just before getting their final signatures.
*Date : 06/12/21. Monday* ( Theory class)
Alcohol, comorbidities and multiorgan failure
Attended by Dr Dk
Dr Rashmitha
Dr Usha and 2018 UGs
7/12/2021 Tuesday seminar
COPD presentation by Dr surya internee
Attended by Dr Rashmitha
Dr Dk
Dr Usha and 2016 interns
Integrated seminar with Pulmology and Psychiatry
Around a patient with suspected drug interaction causing Giddiness
Attended by Dr Divya
Dr usha
Dr DK
Dr Rashmitha and Psychiatry and Pulmonology PGs and Faculty.
Date 8/12/1/21
Wednesday Journal club
Use of thyroglobulin as a tumor marker
Context : current admitted patient of thyroid carcinoma with humerus fracture who recently received radioactive Iodine 131. Case report link here :https://decodemed.blogspot.
9/12/2021
Thursday Tutorial
Management of hypercapnia and the role of volume control vs pressure control
Context :
Rs b/l decreased breath sounds+
P/a soft, non tender
Grbs 101 mg/dl
I/o 800/1000
pH -7.35----7.38----7.41----7.38
Pco2-131--110----117-----137
Po2---340---68.6--62.1---83.6
Hco3--70.5--64.4--74---80.2
St.hco3--61.9--56--66.2--72.3
O2 sat--99.4---92--90---95.2
A- Corpulmonale with type 3 pulmonary arterial hypertension
Severe respiratory acidosis
bronchial asthma
Denovo diabetes
10/12/2021
Friday Group discussion
Video link : https://youtu.be/IJrK2A3pqPg
Etiology of renal failure
Patient context :
Discussion on ACEI vs Hydralazine:
To define better the efficacy of vasodilator therapy in the treatment of chronic congestive heart failure, we compared the effects of hydralazine and isosorbide dinitrate with those of enalapril
References used :
11/12/2021
Saturday log book evaluation :
Log books evaluated for
Dr Rashmita and Dr Divya
Observations :
No log of answers to the online assignments from June 2021 to November 2021!
The May 2021 answer was read out and many inadequacies were found the learning points of which will be summarized by the evaluated PGs.
The PGY3s were also asked if they would prefer to have a timed hand written question paper for them to answer followed by their uploading their hand written answers toward global peer review feedback (as well as allow them to practice writing theory answer papers as is the current norm for their final university assessments) and there has been no positive response to this option as well till now.
It was observed that very few PGs had shared their thesis work logs in the manner below (although instructed to do so since the beginning of their thesis) as illustrated here :
12th December, Sunday
Date 13/12/21 ,Monday - 10-11 AM class
Case presentation by thanmayee
2-4 pm Theory
Discussed about Benign heriditary chorea
"BHC is caused by mutations in the NKX2-1 gene (also known as the TITF1 gene). It is passed through families in an autosomal dominant fashion."
Attended by Dr Dk pgy2
Dr Rashmitha pgy3
Dr Usha pgy3
*Date 14/12/21, Tuesday*
11- 1class:
Case presentation by Shivani 3rd year MBBS student.
Case presentation by Final year mbbs student in 11-1 Class
2-4 pm class Seminar
Dosage titration of tetrabenazine plasma concentration
The starting dose should be 12.5 mg/day once in the morning. After one week, the dose should be increased to 12.5 mg twice daily; it should then be titrated up slowly by 12.5 mg at weekly intervals to identify the lowest and best tolerated effective dose. If a dose of 37.5 to 50 mg/day is needed, it should be given in three divided doses. Each dose should not exceed 25 mg. Patients who seem to require doses greater than 50 mg/day should undergo genotyping for CYP 2D6. Doses above 100 mg/day are not recommended for any patient.
Attended by Dr Dk pgy2
Dr Rashmitha pgy3
Dr Usha pgy3
*Date 15/12/21, Wednesday- Journal club*
Case presentation by final year MBBS student.
*Elog link:*
2-4pm journal club
Hypopituitary Females Have a High Incidence of Cardiovascular Morbidity and an Increased Prevalence of Cardiovascular Risk Factors
Attended by Dr DK pgy1
Dr Rashmitha pgy3
Dr usha pgy3
*Date 16/12/21, Thursday
Case presentation by final year MBBS student.
*Elog link :*
2-4 pm class Tutorial (ITP)
Mechanism of Action of Tetrabenazine
Currently we are giving her only tetrabenazine ,which is a VMAT (vesicle mono amine transport inhibitor) ,i.e it prevents dopamine release. For this she isnt getting symptomatic relief . So we can add additionally D2 (dopamine receptor blockers) ,like atypical antipsychotics( olanzepine,risperidone etc) .Can reduce the frequency of attacks and also
might help with the psychiatric issues she is facing .
Attended by Dr DK pgy1
Dr Rashmitha pgy3
Dr Usha pgy3
*Date 17/12/21, Friday -* 2-4 pm , Group discussion.
Differential Diagnosis of chronic vomitings and Diagnostic modalities available for chronic pancreatitis.
Case presentation by Intern
Elog link:
Attended by Dr DK pgy1
Dr Rashmitha pgy3
Dr sushmitha pgy3
27/2/2021 Monday seminar
2-4 pm class
Treatment options for CBD stricture
Attended by Dr Dk pgy1
Dr sushmiths pgy3
Dr Rashmitha pgy3
28/12/2021 Tuesday Theory class
2-4 pm class
Nephrotic syndrome
Attended by Dr Dk pgy1
Dr sushmiths pgy3
Dr Rashmitha pgy3
29/12/2021 Journal club
Dr Huda : case presentation about Dialysis Dysequilibrium syndrome
Attended by Dr Dk pgy1
Dr sushmiths pgy3
Dr Rashmitha pgy3
30/12/2021 Tutorial
Case discussed on Mitral stenosis and murmurs
Attended by
Dr Dk pgy2
Dr Rashmitha pgy3
Dr k vaishnavi pgy3
Dr sushmitha pgy3
Dr Nikitha pgy3
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