Medicine department workflow:
(Designed as per NMC prompts from here:https://www.livemint.com/
Departmental Motto: Transparency and accountability through data capture and sharing for real time peer review and audit as regular departmental workflow toward furthering the cause of true evidence based medicine at the same time preserving patient confidentiality in social media.
Sharing below under the NMC and NAAC prompts, some cherry picked evidence from our departmental dashboard that archives links to thousands of student online learning portfolios containing even more number of archived hospital and community case report links here: http://
The rest of the volume in the above open access and other encrypted archives are under further thematic data analytic processing as part of our ongoing projects.
We shall be discussing our workflow using the main prompts listed below primarily from the NMC guideline linked above along with secondary mention of the same from NAAC terminology prompts :
1) Departmental Physical infrastructure
2) Departmental Faculty (and learning participants) for actual teaching and research who also undertake necessary student learning activities on a regular and continued basis
3) Departmental Clinical material : Availability of adequate clinical material in terms of number of patients of different specialties
4)Departmental teaching methodology adopted
5) Departmental Methods and modes of assessment, grading of the students
6) Departmental review of feedback from students
7) Departmental other parameters related to standards of medical education that may be added from time to time by the respective boards
Departmental Infrastructure
and Learning
Resources (NAAC prompt):
4.1 Physical Facilities (NAAC sub prompt)
A) Patient housing :
General and Special wards
(video also presented during an AIIMS Bhuvaneshwar guest lecture by one of our faculty...check link to departmental presentations below )
(Ward rounds)
ICU
Step down wards
B) Instrument housing :
Large lab based Patient investigation tools housed in central labs
Often shared in the case report links archived inside our student online portfolio dashboard here: http://
Departmental radiology diagnostic equipment housed in ward:
Faculty demonstrating ultrasound guided procedures during to medical students here: https://youtu.be/
Ventilators, Dialysis machines and other smaller pumps in ICU
https://youtu.be/5IdV6Q8ZfVA?
Departmental ultrasound usage (diagnostic non procedural) by faculty and students in action :
2) Departmental Faculty (and learning participants) for actual teaching and research who also undertake necessary student learning activities on a regular and continued basis (NMC prompt):
(NAAC sub prompt) 2.4 Teacher Profile and
Quality
Faculty:
Evidence of faculty teaching and research activities linked here in their online learning portfolio summaries available open access :
Online portfolio of our PG turned faculty:
Video online learning portfolios:
Other departmental senior faculty sample portfolios that are publicly accessible :
Video portfolio:
PGs : Yearwise online learning portfolios of all PGs accessible here: http://
PG
UGs: Yearwise online learning portfolios of all UGs accessible here: http://
Video online learning portfolios: https://youtube.
Evidence of PG learning sessions linked here:
Evidence of UG learning sessions linked here:
3) Departmental Clinical material : Availability of adequate clinical material in terms of number of patients of different specialties:
Evidence of 1000s of Clinical material created in UG PG learning portfolios in the departmental dashboard accessible here: http://
Variety of patients to fulfil all round training of students:
Variety of procedures:
Laboratory investigations:
In the case reports here: : http://medicinedepartment.
Radiological investigations:
Other relevant investigations:
Electrophysiology :
Our clinical material and clinical learning ecosystem is also captured and synthesized overall in this specially made clinical video case report here :
showcasing one of our clinical cases that received an honorarium from an US institute https://tu.edu/
https://youtu.be/xvE5b8Xk3vM?4) Departmental teaching methodology adopted (and it's assessment, NMC prompt):
1. Curricular
Aspects
1.1 *(U)Curriculum Design and
Development (NAAC prompt)
1.2 Academic Flexibility (NAAC prompt)
1.3 Curriculum Enrichment (NAAC ")
2. Teaching-
Learning and
Evaluation (NAAC prompt)
2.3 Teaching-Learning
Process (NAAC ")
Our teaching methodology leverages currently available blended learning modalities to create a case based blended learning ecosystem CBBLE first published here : https://pubmed.ncbi.nlm.nih.
And subsequently assessed through peer citations here : https://scholar.google.co.
Blended learning components:
9:00 AM to 11:00AM Offline inpatient experiential data capture and synchronous face to face discussion and follow up
Illustrative videos:
11:00 AM to 1:00 PM Offline outpatient experiential data capture and synchronous face to face discussion in the demo room
And subsequent community follow up and family adoption through online PaJR groups which are the online components of our blended learning ecosystem often described in the past as "user driven healthcare" which has it's own big fat text book here : https://www.amazon.in/User-
as well as had a journal with the same name since 2011 here: https://www.igi-global.
PaJR publications and ongoing OPD projects to create persistent clinical encounters :
2:00 PM to 4:00 PM offline (and
beyond that blended 24x7 online)
Overall weekly logs of academic activities: https://
Journal clubs: Hands on learning around critical appraisal of research and evidence based medicine
The following illustration is from our case based
blended learning ecosystem, the online component
of which happens in social media groups such as
whatsapp.
Online asynchronous : http://medicinedepartment.
Offline synchronous :
https://youtu.be/LXy4FM6NBXA?
Seminars:
Dr Aditya Covid :
https://youtu.be/unW70mGlh1Y?
Prof Meltzer Behchets disease :
https://youtu.be/IX3Mz2Y1teE?
Prof Sturmberg :
https://youtu.be/2lBlfz9dNvc?
Flipped classroom discussions:
https://youtu.be/VjF9eGfOaSk?
Case discussions:
https://youtu.be/QhjiomY-S74?
Dr Manasa :
Group discussions:
Dr Aditya :
Dr Nikita:
Didactic clinical methods:
Respiratory movement (and cognitive clinical bias) :
Reflexes:
Joint position sense :
UG Peer to peer learning:
https://youtu.be/ra710Bb2dwc?
https://youtu.be/XrY8f8m_3oQ?
Thesis review :
Dr Rashmita :
Procedural competences:
UG ascitic tap :
Anahita 3rd semester (under PG Dr Sai Charan's supervision) : https://youtu.be/
Hyndavi 9th semester (under PG Dr K Vaishnavi's supervision)
PG various procedures :
IJV, LP, Pericardiocentesis, Renal biopsy
Knee joint aspiration : https://youtube.com/shorts/
5) Departmental Methods and modes of assessment, grading of the students (NMC prompt):
2.5 Evaluation Process and
Reforms
2.6 Student Performance and
Learning Outcomes (NAAC prompt)
Medicine department 360 degree formative and summative assessment and grading at end of UG/PG other than the traditional university driven summative assessment approaches : http://medicinedepartment.
This month's single observer and patient driven blended learning Mini-Clinical Evaluation Exercise (mini-cex) sample:
Quantitative evaluation : 65/100
No extension (pass)
Qualitative evaluation : Takes initiative, trainable, Hardworking, sincere
Can focus on asking more questions and sharing and communicating more
Quantitative evaluation : 50/100
No extension (pass)
Qualitative evaluation : Trainable
Can focus on asking more questions and sharing and communicating more as well as maintaining continuity and consistency of work done
Quantitative evaluation : 40/100
Extension 20 days
Qualitative evaluation : Needs more extension to see if she's trainable
Can focus on asking more questions and sharing and communicating more as well as maintaining continuity and consistency of work done
4) went on USMLE leave midway
Extension : 30 days
5) Did not report at all
Extension 60 days
More of this month's single observer mini-CEX linked here:
Comprehensive assessment in terms of Bloom's taxonomy and the specified rubric questions around the student's written sample from his/her online learning portfolio here:
**1. Bloom's Taxonomy driven Evaluation:**
- **Level 1 Knowledge (Remembering):** The intern successfully gathers basic patient information such as history, presenting complaints, personal and family history, and examination findings. This demonstrates knowledge application at the remembering level.
- **Level 2 Comprehension (Understanding):** The intern understands the patient's condition by correlating the symptoms, physical findings, and laboratory results. This level of comprehension is evident in the diagnosis section.
- **Level 3 Application (Applying):** The intern applies medical knowledge by ordering relevant investigations like serology, RBS, B.urea, S.Cr, and ECG, and interprets these results to make a diagnosis. They also prescribe medications and treatment, which reflects the application of medical interventions.
- ** Level 4 Analysis (Analyzing):** The report lacks in-depth analysis of the patient's condition. While a diagnosis is provided, there is limited discussion of the underlying pathophysiology or potential differential diagnoses. An in-depth analysis would involve considering various possibilities and critically evaluating them.
**Level 5 Evaluation (Evaluating):** The report does not include an evaluation of the effectiveness of the treatment plan, the potential complications, or the overall management strategy. This is an important aspect that could improve the report's quality.
- **Level 6 Synthesis (Creating):** The intern does not demonstrate synthesis in the report. They do not connect the patient's condition to broader medical concepts or research. Synthesis would involve exploring how this case fits into the larger context of COPD, acute cor pulmonale, and other related conditions.
**2. Rubric Evaluation:**
Rubric formulated here :
- **General Knowledge Learning Points:** The report provides basic information about the patient's condition, such as symptoms, examination findings, and lab results. However, it lacks insights into the broader implications or epidemiology of COPD or acute cor pulmonale. It also doesn't reference external sources or guidelines for further context.
- **Discovery-Driven Learning Questions:** The report mentions the patient's history and symptoms but does not delve into specific questions related to the internal or external medicine aspects of the case. It could benefit from exploring questions like the cause of the acute exacerbation, the role of smoking cessation, or the relationship between COPD and heart failure.
- **Clinical Complexity:** The report briefly touches on the patient's clinical complexity, mentioning comorbidities like diabetes and hypertension. However, a deeper analysis of the biological, psychological, and social aspects of the patient's condition is lacking.
- **Thematic Analysis:** The report does not conduct a thematic analysis of the patient's case or identify overarching themes that could provide insights or guidance for future management.
- **Impact on Patient Outcomes:** The report does not discuss the potential positive or negative impacts of the diagnosis and treatment on the patient's short-term and long-term outcomes.
- **Competence of the Intern:**
- (i) **Competence in Data Capture:** The intern successfully captures the patient's data, including history, examination findings, and lab results.
- (ii) **Competence in Asking Questions:** The report lacks in-depth questioning and exploration of the case. It does not effectively sort themes for thematic analysis.
- (iii) **Competence in Finding Answers:** The intern makes a diagnosis and prescribes treatment but does not engage in in-depth analysis or exploration of new knowledge.
- (iv) **Competence in Communication:** The report could improve in communicating the case's learning points effectively, particularly in relation to how the findings could influence patient outcomes and future research.
In summary, while the medical report demonstrates competence at the knowledge and comprehension levels of Bloom's taxonomy, it falls short in terms of analysis, synthesis, and evaluation. Additionally, it lacks depth in addressing the rubric's questions related to clinical complexity, thematic analysis, and the impact on patient outcomes. Enhancing critical thinking and providing more comprehensive insights would improve the report's quality."
More log book assessment and student work audit prompts practiced in the department here : http://medicinedepartment.
PGs weekly log assessment :
6) Departmental review of feedback from students (NMC prompt) :
2.7 Student satisfaction Survey (NAAC prompt)
Analysis of anonymized student feedback regarding Medicine department
Summary : This is a single observer review and analysis of student feedback regarding teaching delivery and formative assessment of medicine department received from a batch of students finishing their degree and on their way to finish the final hurdle of the university. The validity of this anonymized feedback appeared high as students had fearlessly opened their heart outs and well addressed our negatives as we had ensured that we were properly blinded to their identity.
The entire feedback in images of their hand written notes can be accessed here: https://
The feedback has been analyzed and problem statements identified as well as solutions planned.
7) Departmental other parameters related to standards of medical education that may be added from time to time by the respective boards ( NMC prompt):
3. Research,
Innovations
and Extension
3.1 Promotion of Research and
Facilities
3.2 Resource Mobilization for
Research
3.3 Innovation Ecosystem 30 10 NA 10
3.4 Research Publications (NAAC prompt)
Departmental Publications :
2023 (KNRUHS format)
Older 2021-17 (NAAC dsir format)
Departmental Presentations:
2023-22:
Older 2021-17
Ongoing thesis projects:
Ongoing projects:
https://medicinedepartment.
Ethical clearances :
Outreach :
PaJR family adoption pan India :
District residency program : http://deepikaraga97.blogspot.com/2023/07/residency-dairies.html
World heart day : https://youtu.be/JJaUNOW8nNQ?feature=shared
SO WHAT??
S
trengths
Cherry picked and shared above
W
eaknesses
Hint: A system is only as competent and efficient as it's individual components and participants
On a scale of 1-10 rating would be...
O
pportunities
NAAC prompts: 3.5 Consultancy
3.6 Extension Activities
3.7 Collaboration
7. Institutional
Values and
Best Practices and
Social Responsibilities
7.3 Institutional Distinctiveness
T
hreats
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