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
Problems in Med-Ed? Supply & Demand mismatch Maldistributed Logistics Affordability vs. Accessibility Teachers less Facilities less Demand more
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 of 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 1 st March, 2011 to 29th February, 2012
Investigators in the Pilot Project • • AIIMS, New Delhi IGMC, Bhopal – – Dr Manoj K Singh Pathology Dr B P Dubey, FMT – – Dr A K Dinda Pathology Dr Simmi Dube, Medicine – – Dr Rani Kumar Anatomy Dr Ashish Gohiya, Orthopedics • • PGIMER, Chandigarh UCMS, Delhi – – Dr Kusum Joshi, Pathology Dr O P Kalra, Pediatrics – – Dr R K Vashishta, Pathology Dr S N Bhattacharya,Dermatology – Dr Arun Sharma, CCM • PGIMER, Kolkata • – CNBC, Delhi Dr U Chatterjee, Pathology – – Dr Suchandra Ray, Pathology Dr R Gupta, Pathology – Dr Prasanjit Das, Pathology • – Dr Nishant Verma, Microbiology NEIGRIHMS, Shillong – – Dr Mamta Jajoo, Pediatrics Dr Santa Singh, OBGYN – Dr D K Brahma • LHMC, Delhi – • JIPMER, Puducheri Dr Manjula Jain, Pathology – – Dr Anita Nangia, Pathology Dr S K Verma, Pathology – Dr Debdatta Basu, Pathology
Academic Advisory Panel/ The core group at AIIMS consists of specialists from all specialties. Anatomy Neurosciences Physiology S S Kale (AIIMS) K K Deepak (AIIMS) R Kumar (AIIMS) V Goyal (AIIMS) N Mehta (AIIMS) T S Roy (AIIMS) A Suri (AIIMS) R K Yadav (AIIMS) R Dhingra (AIIMS) A Jaryal (AIIMS) A Srivastava (KGMC) OBGYN V Bharihoke (UCMS) N Bhatla (AIIMS) Radiology J B Sharma (AIIMS) S Thulkar (AIIMS) S Sharma (AIIMS) Biochemistry Pathology S S Chauhan (AIIMS) S DattaGupta (AIIMS) Gastroenterology K Luthra (AIIMS) A K Dinda (AIIMS) G Makharia (AIIMS) Ruma Ray (AIIMS) K Joshi (PGI) Surgery Biostatistics R Gupta (CNBC) A Srivastava (AIIMS) R M Pande (AIIMS) P Das (CNBC) S Guleria (AIIMS) S Agarwala (AIIMS) Cardiosciences Hematology A K Bisoi (AIIMS) R Saxena (AIIMS) Cancer P K Julka (AIIMS) R Narang (AIIMS) Pediatrics V K Paul (AIIMS) Technical Advisors Dermatology B D’Monte A K Deorari (AIIMS) (AIIMS) B K Khaitan (AIIMS) S Kabra (AIIMS) B V Adkoli (AIIMS) M Kabra (AIIMS) P Khare (IGNOU) T K Jena (IGNOU) Medicine Pharmacology R Guleria (AIIMS) Y K Gupta (AIIMS) A B Dey (AIIMS) K H Reeta (AIIMS) Naveet Wig (AIIMS) Orthopedics P P Kotwal (AIIMS) Microbiology S Rastogi (AIIMS) L Dar (AIIMS)
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 0 35 238 23 41 6 44 10 100 0 32 256 Renal cell carcinoma Acute leukaemia 0 13 9 44 10 21 0 34 131 19 32 10 44 10 0 0 31 146 Urine examination 24 21 10 44 10 7 0 30 146 Cardiopulmonary resuscitation(CPR) Breast examination 0 33 9 0 10 26 0 23 101 Glomerulonephritis 19 10 7 0 10 13 0 15 78 0 24 5 0 10 9 0 0 Physiology of 48 kidney 107 207 64 220 80 256 0 200 1144 Total
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) 757 No Interaction 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
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