Trends in Medical education

Dr. Neelesh BhandariM.B.B.S (AFMC), M.D ( Path)P.G.P. in Human Rights

TV will be shut in 10 years, says BILL GATES

• "An interesting revolution is underway".said Microsoft founder Bill Gates.

• In the future there will be elimination oftext book or books altogether because we will have a very light screen, a tablet-like computer connected to the Internet that you will carry with you at all times.

• Medical education has a history of tinkering with the curriculum endlessly without realizing larger educational objectives.

• Medical Schools have yet to create a true learner- centered environment that makes active, self-directed learning under the close tutelage of interested faculty members .

A set of basic competencies and expectations from a competent medical graduate, for “the Physician of the 21st century”

Effective Communication.Basic clinical skills.Using science to guide Diagnosis, Management, Therapeutics & prevention.Lifelong Learning.Self-Awareness, Self –Care & Personal Growth.The social & Community Contexts of Health Care.Moral reasoning& Ethical judgment.Problem Solving.Professionalism & Role Recognition.

* Traditional lecture based approach, which is often teacher oriented

* Deprives the students of active learning with less clinical content

* Poor development of student skills

Inadequacies of the present Teaching Program

Problem

• Overload of information and expanding body of knowledge

• Subjects taught in isolation

Problem

• The following areas are inadequately covered:– Medical ethics– Behavioral skills– Communication skills– Management skills

Problem

• No provision for training medical students

for PG entrance tests.

• No training in using information technology

for gathering current scientific evidence.

Suggested additions by National Task force on Medical Education

“I never try to teach my students any thing.

I only try to create an environment where they can learn”

Albert Einstein

The Goal of Medical Education

• The ultimate aim of the MBBS program is not only to enable medical graduates acquire competencies related to knowledge, skill and attitude required of a medical graduate on completion of undergraduate medical education but also to provide sufficient opportunity to them to become familiar with the know how of medical informatics that would ultimately help them work efficiently.

Medical informatics• Health informatics or medical informatics is the intersection of

information science, medicine and health care.

• It deals with the resources, devices and methods required to optimize the acquisition, storage, retrieval and use of information in health and biomedicine.

• Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems.

• Subdomains of (bio)medical or health care informatics include: clinical informatics, nursing informatics, imaging informatics, consumer health informatics, public health informatics, dental informatics, clinical research informatics, bioinformatics, veterinary informatics, and pharmacy informatics.

SPICES Model of Medical Education

• Student-centred ---Teacher-centred• Problem-based---- Information-

oriented• Integrated -----Discipline-based• Community-based ----Hospital-

based• Elective ----Uniform• Systematic ---Apprenticeship

e-learning

• Also called CBT ( Computer based teaching )

• A general term that relates to all training that is delivered with the assistance of a computer

• Delivery:– CD, – Internet, – shared files on a network

e-learning

• Learning process facilitated by technology

• An additional arm to the teacher’s armamentarium

• e-Learning provides an environment that transforms teacher centric to learner centric learning .

Problems of Traditional teaching and benefits of e-learning

• E-learning has the potential to enhance both the students and instructors educational experience.

• Traditional didactic lectures often fall short in meeting the different learning styles of pupils.

• e-learning allows- students to access the lectures and other material when they are most attentive.

• In addition, students have the ability to review the material to the degree they feel necessary.

NTR university digital library

• To start with, the library is subscribing to 152 journals in 37 disciplines and 102 e-textbooks and yearbooks at a cost of Rs. 1.92 crores.

• He said that it was mainly a reference library for the fields of medical and allied sciences.

• Responding to the changing modes in the curriculum, the university had decided to focus on web-based resources and services.

• Staff and students of medical colleges affiliated to the university and staff of Government hospitals and other teaching hospitals in the State were eligible for regular membership in the library.

MEdRC EduTech

Medical Education Research Centre 

for Education Technologies 

MEdRC was set up in 1993 by Dr. Neeraj Raj, evolved into an ambitious project that aims at significantly enhancing the existing infrastructure and quality of medical and health education through digital channels using SmarTeach, a World-Class Teaching/ Learning software developed by MEdRC.

MEdRC Edutech

• A solution to medical education from the private sector.

• First of its kind in India

• Herculean task – About 7500 lectures from Anatomy to Medicine

AIMS of MEdRCAIMS of MEdRC

• To develop an exhaustive library of digitally To develop an exhaustive library of digitally archived e-Lectures by “Master Teachers” archived e-Lectures by “Master Teachers” encompassing the undergraduate and encompassing the undergraduate and continuing medical curriculum.continuing medical curriculum.

• To support and promote the expansion of To support and promote the expansion of lifelong learning at all levels of practicing lifelong learning at all levels of practicing healthcare professionals, particularly in the form healthcare professionals, particularly in the form of continuing professional development of continuing professional development

AIMS of MEdRC

• To develop interactive and hyper-linked

e-Learning modules that include animations and simulations of laboratory experiments and clinical case databases. 

Infrastructure

Infrastructure

UGMed

• The product shall be hosted on the SmarTeach Learning Management System (LMS) at a medical college. 

SmarTeach-LMS at MEdRC

Learning Management Systems (LMS) to support teaching and learning through the use of ICT (Information and Communication Technologies).

• The learner of the 21st

century faces many

challenges and demands

innovative approaches in

education.

What is an LMS

• Delivery of student assessments and course critiques and the collection of responses 

• Tracking of learner progress 

• Virtual classrooms 

• Collaboration between learners 

• Record of learners’ acquisition of knowledge, skills, and competencies.

Importance of LMS

UGMed Program 

• Targeted towards Undergraduate Medical students.

• The entire MBBS curriculum as per the MCI prescribed syllabus has been broken in to component subjects, chapters and topics.

• Each topic constitutes a module of learning consisting of several granular learning objects such as digital lectures, slides, animations of concepts, textual notes, glossaries, questions relevant to the topic, book and journal references, etc .

Content divided into three categories

1. Must learn

2.Useful to learn

3.Interesting / Nice to learn

UGMed

• Each module is developed and delivered by a Teacher of Excellence who provides all inputs to the content.

• Gets peer reviewed by a subject expert

• Subsequently gets enriched with addition of multimedia elements such as graphics, illustrations and animations.

UGMed Program

• Integrated database which enables the student to navigate through the knowledge across the subjects thus ensuring total cross integration

Learner centered - benefits

• Anytime learning • Any where learning• Any number of times learning• Customized to level of assimilation• Individual or group learning• Interactivity based learning – active learning• Enables group discussion across geographical

barriers.• Adaptability and flexibility of the system

Solution

• Lectures on HR issues for doctors exclusively covers these issues

• Effective staff management• Effective team work• Goal setting for doctors• Balancing life• Docs – know thy emotions• Effective presentations for docs• Leadership skills for docs• Manpower management for docs• Personality development for docs• Motivation skills for docs• Stress management for docs• The successful doctor• Time management for docs• ……etc. etc.

A Note on Animation

2D– Allow the students

to visualize complex concepts and structural designs - enhance understanding and sharpening their doctoring skills.

A note on animations 3D Animations transport students into a

three-dimensional journey through the dynamic microscopic world of a cell

3D Animations transport students into a three-dimensional journey through the dynamic microscopic world of a cell

–visually pleasing and –scientifically meaningful.

Take undergrads beyond textbooks and vividly illustrates the mechanisms.

Problem

• No provision for training medical students for PG entrance tests.

• PG MED – SmarTest

the digital approach to entrance exams.

Solution

PG Medical Entrance Exam Preparation CourseTargeted towards final year students, house-surgeons and junior doctors who are preparing for various Post Graduate Medical Entrance Examinations. 

Duration: 300 hours 

Also included:

• Case discussions and case oriented approach• Videos in clinical medicine• Clinical methods• Emergencies and their management• Evidence based medicine• Ethics, • HR issues• Computers for doctors• Learning modules• Questions bank – Large essay, short notes and

MCQs

What is EBM..

• The conscientious, explicit and judicious use of current best evidence in making clinical decisions about the care of individual patients

• Can be categorized into

1. Evidence based Guidelines ( for institutions)

2. Evidence based individual decision making

Advantages to Students• Learn any topic through video lessons prepared by

India’s best teachers including many authors of the books you normally read!

• You can learn at the e-Library or access through owned Laptop for 5 years

• Self paced learning – Pause, View/Review, Skip/Rewind, Bookmark

• Add your own notes, Share notes, e-Mail and Chat

• Weaker students can take as tutorial several times

• Self assessments for students- Know your own strengths and weaknesses- Know where to devote more attention

Advantages to Medical Colleges

• Establish an Electronic Library with Servers, LAN, 25-50 PC’s, Software 

• Wi-Fi enabled Campus - Hotspots created in academic building, library, hostels, etc. 

• Deploy the SmarTeach Medical Learning Management System- All students get registered- Enhanced communication between    departments- Allows all academic activities to be tracked- Electronic records allow real time      management analysis

Advantages to College Management

• Get college technologically on par with campuses around the world 

• One of the ways to counter shortage of teachers 

• Existing teachers empowered with excellent and standardized teaching material & tools 

• Tracking of academic student data from 1st year to final year across all subjects

Advantages to Faculty

• Empowered to teach using modern

audiovisual aids such as a Laptop and LCD

projection system in the class

• Get training in use of I.T. for Teaching from

Intel, Microsoft and MEdRC

• Able to create question papers for

assessment using our bank of over 1,00,000

questions and MCQ’s

• Standardized teaching material available to you

with readymade and customizable lesson plans,

library of slides, illustrations, 2D and 3D animations

and case databases for teaching

• Access data on individual student / group progress

Advantages to Faculty..(contd.)

Demos• Baby Delivery• Brainstem• Human Heart• Spino Thalamic Tracts• Blood glucose levels• Induction of PEPCK• Glucose Alanine Cycle• Gluconeogenesis• Coris Cycle• Activation of Glycogen Phosphorylase• Glycogen Breakdown• Cellular Respiration• Citric Acid Cycle• Inhibitors of Citric Acid Cycle• Mechanism of PDH• Mercuric Poisoning

Demos

• Oxidative Phosphorylation

• PDH Complex

• Pyruvate Dehydrogenase Complex

• Regulation of Metabolite flow from Pyruvate through the TCA cycle

• Role of TCA Cycle in Anebolism

• Urea Cycle

• Central Dogma

• DNA Replication

• Lac Operon

• Prions

• Peripheal Nerves

• Changes in the Nerve Fiber: Stages of Regeneration

• Reflex Types

• Formation of Myelin Sheath

Student Feedback

• 1000 student survey

• In summary:

– 95% favor computer assisted learning facilitated by faculty

Is computer assisted learning facilitated by faculty required?

Survey Result

95%

2%

3%

1

2

3

Our Vision of a Virtual Medical

Education Network

Collaboration

• In its effort to create the most desired medical education network, it seeks to collaborate with various partners – universities, professional bodies, pharmaceutical companies, technology companies and broadband Internet service providers

Pharma. Companies

ISPTech

Companies

ProfessionalBodies

University

Medical Education Network

And Thanks for your time.