VIRTUAL TEACHING IN MEDICINE TELEMEDICINE What is Telemedicine? A - - PowerPoint PPT Presentation

VIRTUAL TEACHING IN MEDICINE

TELEMEDICINE

What is Telemedicine?

A SEVERELY OVERUSED AND MISUSED TERM!

“The delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information & communication technology for exchange of valid information for diagnosis, treatment & prevention of disease & injuries, research & evaluation, and for the continuing education of healthcare providers, all in the interest of advancing the health of individuals and their communities”. WHO (2002)

Components of Telemedicine

 Teleconsultation

Advice

 Telediagnosis

Pathology, Radiology

 Teletreatment

Advice

 Tele Surgery

Robotic surgery

 Telemonitoring

AIIMS to Andaman

 Telepresence  Tele Education



Tele Learning



Tele Teaching

Supply & Demand mismatch Maldistributed Logistics Affordability vs. Accessibility

Teachers less Facilities less Demand more

Problems in Med-Ed?

Problems in Med-Ed

• Shortage of resources
• compounded by difference in and

lack of uniformity in imparting or teaching/learning of medicine as compared to Engineering and some

• f the other technical disciplines
• Require 3D orientation
• Link systems of the body
• Explaining spatial concepts

Possible Solutions

• Increase the numbers of Teachers
• Increase resources and facilities
• Decrease the Demand!!
• Adopt assembly line approach to

Med-ed

• VIRTUAL TEACHING

VIRTUAL TEACHING

Tele Learning VERSUS Tele Teaching

NPTEL - Excellent distant teaching

model by IITs and IISc

AIIMS

The Virtual teaching Project

Creating the

Virtual Medical Classroom

A new paradigm for the impact of e-learning on medical teaching

REPORT ON A PILOT PROJECT SANCTIONED BY THE NKN

NKN

1st March, 2011 to 29th February, 2012

Investigators in the Pilot Project

• AIIMS, New Delhi

– Dr Manoj K Singh Pathology – Dr A K Dinda Pathology – Dr Rani Kumar Anatomy

• PGIMER, Chandigarh

– Dr Kusum Joshi, Pathology – Dr R K Vashishta, Pathology

• PGIMER, Kolkata

– Dr U Chatterjee, Pathology – Dr Suchandra Ray, Pathology

• NEIGRIHMS, Shillong

– Dr Santa Singh, OBGYN – Dr D K Brahma

• JIPMER, Puducheri

– Dr S K Verma, Pathology – Dr Debdatta Basu, Pathology

• IGMC, Bhopal

– Dr B P Dubey, FMT – Dr Simmi Dube, Medicine – Dr Ashish Gohiya, Orthopedics

• UCMS, Delhi

– Dr O P Kalra, Pediatrics – Dr S N Bhattacharya,Dermatology – Dr Arun Sharma, CCM

• CNBC, Delhi

– Dr R Gupta, Pathology – Dr Prasanjit Das, Pathology – Dr Nishant Verma, Microbiology – Dr Mamta Jajoo, Pediatrics

• LHMC, Delhi

– Dr Manjula Jain, Pathology – Dr Anita Nangia, Pathology

Academic Advisory Panel/The core group at

AIIMS consists of specialists from all specialties.

Anatomy R Kumar (AIIMS) T S Roy (AIIMS) R Dhingra (AIIMS) A Srivastava (KGMC) V Bharihoke (UCMS) Biochemistry S S Chauhan (AIIMS) K Luthra (AIIMS) Biostatistics R M Pande (AIIMS) Cardiosciences A K Bisoi (AIIMS) R Narang (AIIMS) Dermatology B K Khaitan (AIIMS) Medicine R Guleria (AIIMS) A B Dey (AIIMS) Naveet Wig (AIIMS) Microbiology L Dar (AIIMS) Neurosciences S S Kale (AIIMS) V Goyal (AIIMS) A Suri (AIIMS) OBGYN N Bhatla (AIIMS) J B Sharma (AIIMS) Pathology S DattaGupta (AIIMS) A K Dinda (AIIMS) Ruma Ray (AIIMS) K Joshi (PGI) R Gupta (CNBC) P Das (CNBC) Hematology R Saxena (AIIMS) Pediatrics V K Paul (AIIMS) A K Deorari (AIIMS) S Kabra (AIIMS) M Kabra (AIIMS) Pharmacology Y K Gupta (AIIMS) K H Reeta (AIIMS) Orthopedics P P Kotwal (AIIMS) S Rastogi (AIIMS) Physiology K K Deepak (AIIMS) N Mehta (AIIMS) R K Yadav (AIIMS) A Jaryal (AIIMS) Radiology S Thulkar (AIIMS) S Sharma (AIIMS) Gastroenterology G Makharia (AIIMS) Surgery A Srivastava (AIIMS) S Guleria (AIIMS) S Agarwala (AIIMS) Cancer P K Julka (AIIMS) Technical Advisors B D’Monte (AIIMS) B V Adkoli (AIIMS) P Khare (IGNOU) T K Jena (IGNOU)

The Project

• We have developed some initial virtual

teaching modules.

• Modules have been designed to promote, facilitate and encourage

the understanding of core concepts and the disease process

• We have tested these modules on the

NKN cable

• We have evaluated these modules using

detailed feedback questionnaires, filled by students and teachers

Types of modules

• 1. Videos of actual lectures
• 2. PowerPoint with Voice over
• 3. Videos of patient examination, practical

experiments

• 4. Case-studies - correlating pathological, clinical

and curative/management aspects

• 5. Animated modules 2-D animation
• 6. Animated modules 3-D animation
• 7. 3-D constructs / reconstruction
• 8. Hologram based

Actual Lecture

The purpose of the project was to demonstrate….

– High resolution & large sized

• Patient and specimen photographs,
• Photo-micrographs,
• Radiological images,
• Digital images/diagrams &
• Animated presentations

– All these can be transmitted and interchanged using the NKN cable. – Possibilities: Two way interaction between teachers, students and moderators/facilitators for didactic teaching, webinars / seminars, demonstrations / practical sessions and group discussions….and so on

VIRTUAL MEDICAL CLASSROOM

Workshop statistics

FEEDBACK RESULTS

• LIKE! (96.15%)

– Graphics – 2D & 3D animation – Videography – Content coverage and explanation

• BETTER THAN CONVENTIONAL!!!

IMPROVEMENT REQUIRED

• Technical difficulty(58%)

– voice comprehension – Asynchronous voice & image

• NO INTERACTION (86.6%)

– Explanation – Teacher Student Bonding

• SELF ASSESSMENT

– POLAR – INTERCESSIVE

Modules GMC AIIMS JIPMER LHMC CNBC UCMS PGI Shillong Total Hypersensitivity

22 39 8 44 10 80 35 238

Renal cell carcinoma

23 41 6 44 10 100 32 256

Acute leukaemia

13 9 44 10 21 34 131

Urine examination

19 32 10 44 10 31 146

Cardiopulmonary resuscitation(CPR)

24 21 10 44 10 7 30 146

Breast examination

33 9 10 26 23 101

Glomerulonephritis

19 10 7 10 13 15 78

Physiology of kidney

24 5 10 9 48

Total

107 207 64 220 80 256 200 1144

Like(Total-1144)

Picture/Video/animation 1100 96.15% Content/understanding/revision 898 78.5% Content/Explanation 389 34% Idea/New Technology 400 34.9%

Dislike(Total-1144)

No Interaction

757

86.6%

A/v problems 749

85.6%

Other Technical problems 515

58%

Content 121

13.8%

Suggestions

• Should be interactive session at the end/Assesment/Questions
• Use modified voice over
• Solve A/V and technical problems
• Add more animation and graphics
• Insert picture of a teaching Professor ???
• Add objective / summary
• include more clinical problems/Problem solving cases
• Prepare short lectures as long lectures are boring
• Add references at the end
• Self evaluation question/s at the end

• Cover more practical topics
• Should start from the basics for proper learning
• Lectures should be available on Net
• Presentation screen should be larger
• Good because lectures are developed by the specialist faculty
• Good bulk of high class learning will be available
• Use professional voiceover
• Teacher should be in video
• Use of original patient video in really good
• Use dual screen with teacher in one and module in another screen

Students’ response

• We thought more classes should be like this
• Compare to the conventional teaching it is easy to understand and

recollect

• Perfect module
• It should be a guiding tool
• Should be available in DVDs/internet
• There is no time wasted between the classes----good
• Good for students who missed the class
• We can interact with all connected medical colleges so that knowledge

can be shared

• More enjoyable/more interesting/student friendly

• We could concentrate more on the module, usually I lose my concentration

after some time in conventional teaching

• More effective that conventional;
• Place like AIIMS should prepare excellent cases like this
• Standardization of medical education
• Animation will itself clear lot of doubts
• This will definitely improve the teaching
• Moving slides are easy to concentrate
• More attractive than conventional teaching
• Requires less time to understand
• Has definitive edge over conventional teaching

• Not boring at all
• I always like to study in this way
• It is equivalent to bed side teaching
• Many distractions in conventional learning
• Uniform correct methods can be learnt
• Less motivation in the absence of teacher
• Moderator in the class
• Lack of human touch
• One way kind of teaching is boring
• Use simple and local language (hindi)
• Nothing else to dislike
• No face to face discussion

SUGGESTIONS

• Visualization will help in retaining for long time
• Very good and advanced technology
• This will definitely improve the teaching
• It should be available for even those who live in remote areas
• Better animation better understanding

Expected Outcomes

1.

• 1. Extensiv

Extensive e use of the NKN use of the NKN for real-time exchange of high

volume images, videos & teaching modules. Patient and specimen photos, photo- micrographs, Radiology images, digital diagrams and animated presentations

• 2. AIIMS experts can collaborate to construct these high volume

teaching modules

• 3. CORPUS OF MATERIAL

Comprehensive list/syllabus of VTMs adequate to cover the entire MBBS course including correlative & interactive Structure-Function case studies

*(The Virtual MBBS curriculum)

YES YES YES YES YES YES..

..

Bu But t will ill tak take time e time

Visit of Secretary

VIRTUAL TEACHING IN MEDICINE

WHAT NEXT?

MODULES LIKES - AUG

NEGATIVES

• AUG

LIKES - MAR

NEGATIVES

• MAR

RATIO : LIKES & DISLIKES AUG MAR

BREAST EXAMINATION 532 (72.4%) 203 (27.6%) 141 (69.1%) 63 (30.9%) 2.62 2.23 URINE EXAMINATION 537 (64.5%) 296 (35.5%) 74 (56.9%) 56 (43.1%) 1.81 1.32

HYPERSENSITIVITY

844 (67.2%) 411 (32.8%) 246 (62.4%) 148 (37.6%) 2.05 1.66 CPR 221 (56.9%) 167 (43.1%) 189 (64%) 106 (36%) 1.32 1.78 RCC 143 (65.8%) 74 (34.2%) 46 (65.7%) 24 (34.3%) 1.93 1.91

Virtual Teaching Platform

We hope the VTP can become a vibrant,

viable, feasible, valid and reliable alternative to traditional teaching, and add value. eventually, because of its flexibility and limitlessness, it may replace traditional methods of teaching AT A NATIONAL LEVEL

THE VIRTUAL MEDICAL SCHOOL

POSSIBLE FUTURE OUTCOMES

• 1. NATIONAL MEDICAL EDUCATION

PORTAL

• 2. NPTETMED
• 3. The VIRTUAL SKILLS LABORATORY
• 4. SKILLS TRAINING FOR ANMs, Nurses,

Technicians

• 5. Continue teaching at present level

NPTETMED NPTETMED

• A COLLABORATIVE PROJECT

– Ministry of Health & FW, GOI – All India Institute of Medical Sciences, Delhi – NIC, DIT – Other Medical Colleges/faculties – MCI

NATIONAL PROGRAM for TECHNOLOGY ENHANCED TEACHING in MEDICINE NPTETMED

NPTETMED

• Cf NPTEL of IITs and IISc

NATIONAL PROGRAM for TECHNOLOGY ENHANCED TEACHING in MEDICINE (NPTETMED)

While this program is initially tuned to UG teaching, it can easily be geared to many other applications. These can include  PG teaching (as various courses)  PG teaching (sporadic/issue based)  Conferences  CME programs  Refresher courses for practitioners  Credit hours for MCI/State Councils AND AND

• Nur

Nursing sing

• Den

Denta tal

• Pharma

Pharmacy cy

One Suggested Alternative

• A judiciously crafted blend of Distance

teaching & Teleconferencing, with strategically placed moderators at the user end.

• Delivering a mix of Lectures, case-studies,

videos with voiceover for practical exercises, specimen demonstration, instrument classes, patient examination, clinical procedures etc. ??? REQUIREMENTS

Modus operandi

• An adequate group of competent faculty
• Embedded in an adequately equipped medical

college/s (for laboratories, experiments, clinical/patient material)

• An adequate teleconferencing solution (hardware &

software) between the medical colleges

• Suitably trained & oriented subject moderators at

the user end, who can

• help explain concepts to the students
• rganize & co-ordinate the teaching
• rganize the evaluation process
• continuously provide feedback to strengthen the

program.

• An empowered, technically competent authority/

committee to run this project WITH

• TIGHT programming and delivery AND
• NETWORKING SOLUTIONS AT ALL LEVELS

CREATION TRANSMISSION

DIGESTION

ASSIMILATION UNDERSTANDING COMPREHENSION ASSESSMENT UTILIZATION

CO-ORDINATION

The VIRTUAL SKILLS LAB

• SKILLS
• In the Health Sciences, a very significant component

is acquisition of skills, aesthetic and manual, as well as the correlation (at times 3 Dimensional) of manual skills with theoretical knowledge. and there is a greater emphasis on active Teaching, involving skill demonstration, skill practice and an integration of theoretical knowledge with the skill.

• These skills are varied; they include venepuncture for

diagnosis, putting a plaster bandage, suturing cuts, conducting deliveries (deciding when an episiotomy is required) and so on.

SKILLS MODULE

Suturing Class

LOW LEVEL CONTINUING TEACHING

• CREATE WEBSITE
• INSTALL SUITABLE LMS
• IDENTIFY TARGET AUDIENCES
• DEVELOP SUITABLE COURSE

CURRICULUM CME, REFRESHERS, PRACTICAL MODULES ETC

• CREATE MODULES
• TEACH!!!

THANK YOU