Learning competencies of Intern 2016 MBBS batch (June July 2021)in the department of Medicine

INTERNS ATTENDANCE POSTING FROM

DEPARTMENT OF GENERAL MEDICINE

BIMONTHLY FORMATIVE AND SUMMATIVE ASSESSMENT OF 2016 BATCH INTERNS 

This is an attendance as well as a blended, bimonthly formative and summative assessment of the learning competencies of 2016 batch interns posted in the department of Medicine from 01.06.2021 to 31.07.2021. The formative assessment is from each Intern logged competency around patients evaluated regularly from date of joining (left column) till date of current bimonthly summative assessment (right column), which is from the assignment posted for 26/06/20 and the assignment posted for  27/07/2021. The assignments have been linked to each student's online learning portfolio.

The formative assessment has been divided into non-verbal which assesses their competency in procedural domains including empathic communication and body language and verbal which assesses their ability to communicate their work through their day to day E logs.

Postings from 01.06.2021 to 31.07.2021

R. No.	Name	Formative Assessment	Marks	`Summative Assessment	Marks	Posting Days	Attend Days	CL’s	Absent
30	Bonike Pallavi	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/cikpH5PPaHQ Objective Verbal online portfolio pallavi191.blogspot.com		Summative Assessment June: http://pallavi191.blogspot.com/2021/07/june-assessment.html  July: http://pallavi191.blogspot.com/2021/07/july-assessment.html
31	Budde Roopa	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/t21gVeCrTKE Objective Verbal online portfolio https://roopabudde.blogspot.com/		Summative Assessment June: http://roopabudde.blogspot.com/2021/07/june-assessment.html  July: http://roopabudde.blogspot.com/2021/07/july-assessment.html

32	Budigam Madhumita	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/z4-6hDnyxpQ https://youtu.be/7ZWLojZFFcQ https://youtu.be/MFLZbfhjXtg https://youtu.be/SZzfhi1ug-w Objective Verbal online portfolio  https://budigammadhumithagm.blogspot.com/		Summative Assessment June: https://budigammadhumithagm.blogspot.com/2021/07/june-bimonthly-assessment.html  July: https://budigammadhumithagm.blogspot.com/2021/07/july-bimonthly-assessment.html
33	C. Pavan Kalyan	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://pavankalyanc.blogspot.com/		Summative Assessment June: https://pavankalyanc.blogspot.com/2021/07/i-was-given-following-assignment-to-and.html?m=1 July:  https://pavankalyanc.blogspot.com/2021/07/i-was-given-following-assignment-to-and.html?m=1
34	Chavva Tejashwini	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio		Summative Assessment June: NA July: NA	----
35	ChikatimallaRahul	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://rahulchclinicalcasediscussion.blogspot.com/		Summative Assessment June: NA July:   NA	---
36	Chirravuri VS Siddharth	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://siddharthcvs.blogspot.com/		Summative Assessment June: NA July:  NA

37	Chithaluri Rishik	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/ApL03lv4pwI Objective Verbal online portfolio  https://rishik37.blogspot.com/		Summative Assessment June: http://rishik37.blogspot.com/2021/07/bimonthly-blended-assignment-for-june.html  July:  http://rishik37.blogspot.com/2021/07/bimonthly-blended-assessment-for-july.html
38	Chithra	Formative Assessment from  Subjective Non Verbal offline presentation:  https://chitrasrinivas.blogspot.com/2021/07/non-verbal-competancy.html Objective Verbal online portfolio: https://chitrasrinivas.blogspot.com/2021/07/june-2020-internship-completion.html		Summative Assessment June: https://chitrasrinivas.blogspot.com/2021/07/june-2020-internship-completion.html July:  NA
39	Harika Chukka Rachel Chandra	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://39harikachukka.blogspot.com/		Summative Assessment June: NA July:  NA	-----
40	D. Kranthi	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://kranthireddy40.blogspot.com/		Summative Assessment June:  https://kranthireddy40.blogspot.com/2021/07/june-assessment.html   July: https://kranthireddy40.blogspot.com/2021/07/july-assessment.html
41	D. Sravani Reddy	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://sravanireddy41.blogspot.com/		Summative Assessment June: https://sravanireddy41.blogspot.com/2021/07/june-monthly-assessment.html July:  https://sravanireddy41.blogspot.com/2021/07/question-1-competency-tested-for-peer.html

42	Damarancha Keerhi Reddy	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/LxaHCmRp9lk https://youtu.be/yZ4DxBXzfRA Objective Verbal online portfolio https://keerthireddy42.blogspot.com/		Summative Assessment June: https://keerthireddy42.blogspot.com/2021/07/june.html  July: https://keerthireddy42.blogspot.com/2021/07/question-1-competency-tested-for-peer.html
43	Dasari Siddharth	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://siddarth43.blogspot.com/?m=1		Summative Assessment June: https://siddarth43.blogspot.com/2021/07/june-gm-assessment.html?m=1  July:  https://siddarth43.blogspot.com/2021/07/july-assessment-gm.html?m=1
44	Deekshitha Challa	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://deekshitha44medicinelogbook.blogspot.com/?m=1		Summative Assessment June: NA July: NA
45	Divya Mahapatra	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://decodemed.blogspot.com/		Summative Assessment June: https://decodemed.blogspot.com/2021/07/bimonthly-blended-assessment-june.html July:  https://decodemed.blogspot.com/2021/07/blog-post.html
46	Dontaraju Arun Kumar	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://arunrollno46.blogspot.com/		Summative Assessment June: NA July:  NA

47	Edam Sai Nikhitha	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://nikithaedam48.blogspot.com/		Summative Assessment June: NA July: NA
48	Ellanathakunta Sreeja	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/4c38s4glLuA Objective Verbal online portfolio  https://sreejaellanthakuntarollno49.blogspot.com/?m=1		Summative Assessment June: http://sreejaellanthakuntarollno49.blogspot.com/2021/07/june-assesment-medical-log-book-of-roll.html  July:  http://sreejaellanthakuntarollno49.blogspot.com/2021/07/july-assesment-questions-are-around.html
49	Firdous Sameera	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/6GR6ysmkIpM  Objective Verbal online portfolio https://firdoussameera50.blogspot.com/		Summative Assessment June: https://firdoussameera50.blogspot.com/2021/07/june-assessment.html  July: https://firdoussameera50.blogspot.com/2021/07/july-assessment.html
50	G. Preethi	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/YGHGwJF5kR0 Objective Verbal online portfolio https://goudigamapreethi3036.blogspot.com/		Summative Assessment June: https://goudigamapreethi3036.blogspot.com/2021/07/june-assessment.html  July:  https://goudigamapreethi3036.blogspot.com/2021/07/july-assessment.html

 

51	G. Swaroopa	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://rollno52.blogspot.com/		Summative Assessment June: https://rollno52.blogspot.com/2021/07/monthly-summative-assessment.html  July: https://rollno52.blogspot.com/2021/07/monthly-summative-assessment-july.html
52	Gaddam Suhas Yadav	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio  https://gaddamsuhas53.blogspot.com/?m=1		Summative Assessment June: https://gaddamsuhas53.blogspot.com/2021/07/this-blog-is-assessment-and-questions.html July: https://gaddamsuhas53.blogspot.com/2021/07/this-blog-is-assessment-for-questions.html
53	Gaddamedi Krupa Latha	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://krupalatha54.blogspot.com/		Summative Assessment June: http://krupalatha54.blogspot.com/2021/07/june-assessment_30.html  July: http://krupalatha54.blogspot.com/2021/07/july-assessment.html
54	Gadde Sai Varun	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio		Summative Assessment June: July:	----
55	Gajjela Ritheesh Babu	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio		Summative Assessment June: July:	----

56	Garikapati Nuthna Sriya	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://sriyagarikapati.blogspot.com/?m=1		Summative Assessment June: http://sriyagarikapati.blogspot.com/2021/07/question-1-pulmonology-review.html July: http://sriyagarikapati.blogspot.com/2021/07/medicine-department-paper-for-july-2021.html
57	Geddada Kusuma	Formative Assessment from  Subjective Non Verbal offline presentation:  https://youtu.be/9trbKPsLO5c Objective Verbal online portfolio https://kusumageddada58.blogspot.com/		Summative Assessment June: https://kusumageddada58.blogspot.com/2021/07/june-assesment.html July: https://kusumageddada58.blogspot.com/2021/07/july-assesment.html
58	Goriparthi Sai Vittal	Formative Assessment from  Subjective Non Verbal offline presentation:  Objective Verbal online portfolio https://saivittal60.blogspot.com/?m=1		Summative Assessment June: http://saivittal60.blogspot.com/2021/07/this-is-link-of-questions-asked.html July: http://saivittal60.blogspot.com/2021/07/medicine-department-paper-for-july-2021.html

Rational minimalism and parachute interventions

Are we conditioned to think that we are better off (presumably both doctor and patient) for having acted positively 'materially,' rather than just sat on it helplessly because it's so much more better to remain engaged in the role of someone who is in charge and is a doer? 

 As an actively practicing hospitalist, physician, professor of Medicine in a low resource rural setting , I face these nodes very often when I do have to provide (very often it's my team of residents and on call attendings who make these decisions) overtreatment. 

 Can recently recall a young boy with multisystem inflammatory response syndrome with hemolysis, liver failure, covid antibodies and coma who received antimalarials (cerebral malaria is very common here), hepatic coma regime and even n acetyl cysteine because residents pulled out a paper that showed a small trial displaying dubious benefit in non paracetamol related liver failure but the course of treatment and the boy's sudden remarkable recovery from coma even convinced our residents (especially when we later reflected on it in a central clinical meeting) that the recovery couldn't be correlated to any of our interventions. 

 Yet we are also convinced that because we continued to offer one new drug after the other, it kept his parents hope and faith alive in us and made them stick with our hospital (also the coma lasted just a few days and didn't drag) , else very often patients in India have the option of leaving for another hospital if they can afford the fee for service the other hospital with a better name commands (the system is slightly different here and not yet insurance driven). 

 So is it eventually as deep as faith based medicine that lurks in the shadows of our profession? 

 "Is it not possible to offer hope -- and more importantly, relieve suffering -- in ways that do not assume the only alternative to abandoning a patient is to give them something that you know is useless or likely to be so?" (SB)

A solution to the problem statement shared above is "rational minimalism" as opposed to the previous examples of "rational maximalism" that were shared as a part of our current medical industrial complex training and upbringing. 

One way to implement rational minimalism is to first identify the "parachute" intervention (the one that hasn't been tested in an RCT and yet every physician knows they can't do without, for covid recently, it was oxygen) and then decide about the other interventions keeping wishes of all the stakeholders around the patient in mind rather than aim at covering all therapeutic targets with rational but marginal efficacies, all the while remembering that it's the trillion cells in the body that would be responsible for 80% of it's healing with time rather than the chemicals or molecules we deliver. 

In all this process the role of the doctor is very much like the man in this video 

https://youtu.be/klhOM2hxhRM,

who strapped a 100 year old US citizen onto his shoulders and jumped out of the plane along with him till he landed safely.

Rational minimalism may drastically summarize the three goals of medical care into one, which is to "be with the patient" till he lands safely. It would rely on strong and well designed complex empathy straps to hold the patient, doctor (and the family) together all through the plunge in regular best case scenarios.

 

Medicine paper for July 2021 bimonthly blended assessment

 

18/07/2021 9:00 PM

Answer all questions:                                                      

Max Marks: 100 (5 questions in total and 20 marks for each  answer) 

Submit by:   25/07/2021               

Below is an online formal question paper to be answered online using all available resources at your online disposal over a period of days and E logged in a manner demonstrated by one of the past examinees in the link here:https://caseopinionsbyrollno156.blogspot.com/2020/10/medicine-blended-assignment-october.html?m=1

And the above answer paper link was in response to one of the past online assignments linked here:  medicinedepartment.blogspot.com/2020/09/medicine-paper-for-october-2020-first.html?m=1

Feel free to be creative and not necessarily be restricted by the above format. Please be original and refrain from plagiarism. Please note that every logged answer paper should contain the link to this current "assignment/question paper" page and the patient context for each answer. Also share the detailed online links to every quote or reference cited in your answer. 

Questions plan and context:

All questions are around student driven patient centered case reports prepared by our students (including 2019 batch students in 3rd semester) over last one month. For the same students taking this exam, separate marks will be provided for their contribution to the questions. 

Question 1: Competency tested for Peer to peer review and assessment : 

Please go through one student's entire answer paper from this link, the one who is closest to your own roll number :

http://medicinedepartment.blogspot.com/2021/07/2019-batch-medicine-department-online.html?m=1

and share your peer review of each answer with your qualitative insights into what was good or bad about the answer. 

Question 2-4: 

Patient centered data around the theme of renal failure patients with AKI, CKD and acute on CKD, 

captured by students from 2016 and 2019 batch in the links below:

Patients with low back ache and renal failure :

AKI :

https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1 (Instructions to case reporter : Please remove the identifiers properly here. Also add his history of sudden low back ache after lifting weights. PG and interns you haven't guided this case report properly at all)

Acute on CKD :

http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html

CKD :

https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1

Past E log similar to last case :

casereports.bmj.com/content/2009/bcr.03.2009.1726

Patient with coma and renal failure  :

https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1

Patients with acute on CKD :

https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1

https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html?m=1

https://krupalatha54.blogspot.com/2021/06/this-is-online-e-log-book-to-discuss.html?m=1

Patients with AKI :

https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1

https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1

http://chavvaclassworkdecjan.blogspot.com/2021/06/pancreatitis-in-chronic-alcoholic-with.html?m=1

Q2) Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case. 

Q3) (Testing peer review competency of the examinees) :

Please go through the cases in the links shared above and provide your critical appraisal of the captured data in terms of completeness, correctness and ability to provide useful leads to analyze the diagnostic and therapeutic uncertainties around the cases shared.

Q4: Testing scholarship competency of the examinees ( ability to read comprehend, analyze, reflect upon and discuss captured patient centered data as in their 'original' answers to the assignment for May 2021):

Please analyze the above linked patient data by first preparing a problem list for each patient (based on the shared data) and then discuss the diagnostic and therapeutic uncertainty around solving those problems. Also include the review of literature around sensitivity and specificity of the diagnostic interventions mentioned and same around efficacy of the therapeutic interventions mentioned for each patient. 

Q 5) Testing scholarship competency in  

logging reflective observations on your concrete experiences of this last month : (10 marks) 

Reflective logging  of one's own experiences is a vital tool toward competency development in medical education and research. 

A sample answer to this last assignment around sharing your experience log of the month can be seen in one student's  answer to Q10 in the  May 2021 assignment in the link below:

https://drsaranyaroshni.blogspot.com/2021/05/assignment-patient-centred-learning.html?m=1

Please reflect on and share  your telemedical learning experiences from the  hospital as well as community  patients over the last month particularly while you were E logging their case report while even in the hospital or perhaps when locked down at home.