eHEALTH-July-2011-[20-26]-Revolutionising Pedagogy@ a Distance

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Revolutionising

Pedagogy@ a Distance

IGNOU, School of Health Sciences, educates students at the grass root level and provide in-service training for medical, nursing and paramedical courses through a multimedia approach

By Dr Biplab Jamatia

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GNOU has been constantly contributing significantly towards the education with the objective of augmenting educational avenues and for providing in-service training for medical, nursing, paramedical and allied personnel through the distance education mode. Today, it serves the educational aspirations of over 3.0 million students in India and 36 other countries through 21 schools of Studies and a network

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of 61 Regional Centers around 60 overseas centers. The School is a pioneer in developing competency-based programmes in various disciplines of Health Sciences. Innovative approaches in medical programmes include hands-on training, which is provided through diversified approaches of a network of colleges and districts-level hospitals.

To achieve this, the School has been collaborating, and exchanging ideas, with vari-

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ous national and international organisations like World Health Organisation (WHO), United Nations International Children’s Emergency Fund (UNICEF), Ministry of Health and Family Welfare (MoHFW), Voluntary Organisations like ‘ACTS Ministries’, GOI, National Board of Examination (NBE), Association of Rural Surgeons of India (ARSI), Trained Nurses Association of India (TNAI), Nursing Institutes in Seychelles and

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Total number of the Enrolled students of the various programmes SN 1 2 3 4 5 6 7 8 9 10

Name of the Programme

•

Launched Year Number of Enrolled Students

PGDMCH 1997 6828 PGDHHM 2001 4703 PGDGM 2004 1443 PGDCC 2006 994 PGCE 2008 223 PGCOI 2008 175 BSCHOT 2007 618 PGDACP 2009 85 CHCWM 2006 912 PGDDHM

Narayana Hrudayalaya and many other.

IGNOU has adopted a multimedia approach to enable students who seek such courses irrespective of age, region or formal qualifications. The objective of IGNOU is to democratize higher education by taking to the doorsteps of the learners and provide access to high quality education to all through a team of teachers called as Academic Counselors.

The School of Health Sciences was set up in the year 1991. The various functions of the school are planning, developing and launching of Degree, Diploma and Certificate Level Programme for various categories of health professional: health awareness courses for the general public and conducting research on health issues. The school adopts a diversified approach to educate students through a three-tier system i.e. medical colleges [ Programme Study Centres(PSCs)], District hospitals[ Skill Development Centres(SDCs)] and the work places of enrolled doctors, provide hands in training.

There are various programmes initiated

by School of Health Sciences to develop and build an infrastructure to revolutionize career opportunities through distance learning.

Post Graduate Diploma in Maternal and Child Health (PGDMCH) Post Graduate Diploma in Maternal a Child Health (PGDMCH) Programme is a oneyear programme of 36 credits (18 credits in theory and 18 credits in practical). This programme was launched in 1997 and has undergone two revision’s. The 2nd revised programme is being implemented since Jan-

• •

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manage the National Health Programmes especially in relation to MCH services; provide antenatal care including those of high risk pregnancy, conduct normal delivery, handle common emergency care related to pregnancy and its outcome and identify referral situations; manage common gynaecological morbidity and provide family planning services; provide newborn care, identify high risk babies, diagnose and manage common childhood morbidity including emergencies; and acquire knowledge on nutritional needs,

PROGRAMME STRUCTURE Course Code Course Title Course Credits Total Theory

Practical

Theory Practical Credits

MME-201 MMEL-201

Preventive MCH

6

6

12

MME-202 MMEL-202

Reproductive Health

6

6

12

MME-203 MMEL-203

Child Health

6

6

12

Total Credits

18

18

36

uary 2008. The number of PSCs established till date are 32.

This Programme is a comprehensive package of Community Medicine/PSM, Obstetrics and Gynaecology and Paediatrics so as to give an integrated knowledge on the MCH care. The Reproductive and Child Health (RCH) Programme, the Integrated Management of Neonatal and Childhood Illness (IMNCI) , Adolescent-Friendly Reproductive & Sexual Health (AFRSH) Service, and other approaches of Government of India to improve the various morbidity and mortality indicators related to MCH care forms the part of this package. The programme aims at updating the knowledge and skills of practicing doctors and those placed in a peripheral set up like Primary Health Centre/Community Health Centre. The package would also be beneficial for doctors at all levels engaged in the MCH care in different capacities.

OBJECTIVES The broad objectives of this programme are to: • imbibe comprehensive knowledge of ongoing Maternal and Child Health Programmes and be able to manage Health Care Services at different institutional levels; • tackle the disease outbreaks and effectively

assess growth and development of children and manage their respective problems.

Post Graduate Diploma in Hospital and Health Management (PGDHHM) Post Graduate Diploma in Hospital and Health Management (PGDHHM) Programme comprises 32 credits (18 credits in theory and 14 credits in practical) including project work. This programme aims at improving the managerial skills of practicing Doctors, Health Professionals and Allied Health Care Professionals working in health care professions for providing effective and efficient hospital and health care services.

This programme was launched in January 2001. The number of Programme Study Centres activated at present are 23.

OBJECTIVES The broad objectives of this programme are to: • acquire theoretical knowledge and develop practical skills to apply scientific approach to management of people, materials, finance, communication and for organizing work and managing resources; • learn modern management techniques

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spotlight PROGRAMME STRUCTURE Course Code Course Title Course Credits Total

Theory Practical Credits

PGDHHM-001

Introduction to Management-I

3

2

5

PGDHHM-002

Introduction to Management-II

3

2

5

PGDHHM-003

Organization and Management of Hospital

3

2

5

PGDHHM-004

Clinical, Diagnostic and Therapeutic Services

3

2

5

PGDHHM-005

Support and Utility Services and Risk Management

3

2

5

PGDHHM-006

Health System Management Project work

3 -

2 2

5 2

Total Credits

18

14

32

•

•

like inventory control; economic order quantity (EOQ), operational research and organizational development, management information system etc. learn methods of problem solving and decision making and plan in advance to face the problems of hospital management; and assess the clinical and non-clinical needs of patient care, and understand the administrative and technical requirements of physicians and paramedical personnel.

ELIGIBILITY The eligibility for the different categories of the target group is: • Medical/Dental graduates from a Medical/Dental institute of India or other countries recognised • By Medical Council of India (MCI) or Dental Council of India (DCI).

• Graduates in Indian System of Medicine, Homeopathy, Nursing and Pharmacy recognised by the Respective Councils with three years of hospital experience.

•

•

Candidates holding MBA degree or PG Diploma in Financial, Material or Personnel Management With five years of hospital experience.

PROGRAMME STRUCTURE Course Code Course Title Course Credits Total

Fundamental Environment and Health, Health Care Waste Management Regulations

4

-

4

BHM-002

Health Care Waste Management; Concepts, Technologies and Training

6

-

6

BHM-003

Project

-

4

4

Total Credits

10

4

14

Post Graduate Diploma in Geriatric Medicine (PGDGM) Post Graduate Diploma in Geriatric Medicine (PGDGM) Programme is a one-year Diploma Programme of 32 credits (14 cred-

Course Code Course Title Course

Credits

Practical

Theory

MME-004

Basic Geriatrics

6

-

MME-005

Clinical Geriatrics

8

-

MMEL-004

Basic Geriatrics

-

6

MMEL-005

Clinical Geriatrics

-

12

Total Credits

14

18

22

Theory Practical Credits

BHM-001

PROGRAMME STRUCTURE

its in theory and 18 credits in practical). This programme was launched in January, 2004.

The number of Programme Study Centres activated at present are 17. This programme will equip the practicing doctors with knowledge and skills in the field of Geriatric Medicine and enable them to deal with the special problems faced by the elderly.

With increased expectancy of life over the years, the proportion of elderly population is fast increasing. Aging is inevitable and irreversible. The epidemiology and the clinical features of diseases vary in this age group and drug dosages and interactions also differ. Geriatric management requires not only medical interventions but also special economic and environmental interventions.

This programme aims at not only enhancing the knowledge but also multiskilling the doctors so as that they can provide primary level care to the elderly.

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OBJECTIVES The broad objectives of this programme are to: • upgrade the knowledge and skills for providing comprehensive health care to elderly; • inculcate the inter-disciplinary approach for diagnosing and management of geriatric health problems; and • improve the clinical, social and communication skills by providing hands on training in Medical colleges and district hospitals.

Post Graduate Diploma in Clinical Cardiology (PGDCC) India, with over a billion population requires a few thousand cardiologists to be trained.

spotlight Contrary to this, today we produce only around hundred cardiologists with DM/ DNB qualifications. Unless we address this issue of training a large number of cardiologists, especially for treating heart patients in an average district town/semi-urban area, the situation will not change much. To address this issue School of Health Sciences is developing a 2-year programme for MBBS doctors in collaboration with Narayana Hrudayalaya, Bangalore. This is a 72 credits programme comprising of 30 credits in theory and 42 credits in practical. In this programme the young medical graduates will be intensively trained for two years through an extremely well structured programme. It will be implemented through leading cardiac institutions in the country. The programme was launched in January, 2006. The number of Programme Study Centres activated at present are 61.

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ongoing Common Cardiovascular Diseases and be able to manage Health Care Services at different institutional levels; provide cardiac emergency at various places i.e. smaller town, district town; provide services related to the Electrocardiography, Stress Test, Holter Monitoring, Echocardiography, Cardiac Radiology and related non-invasive services, including diabetes mellitus; provide non-invasive peadiatric cardiology including peadiatric cardiac emergencies; acquire knowledge of the risk factors of the cardiovascular diseases; and provide preventive cardiology and cardiac rehabilitation services to the community.

OBJECTIVES

Certificate in Health Care Waste Management of South-East Asian Countries (CHCWM)

The broad objectives of this programme are to: • imbibe comprehensive knowledge of

The concern for bio-medical waste management has been felt globally with the rise in

PROGRAMME STRUCTURE Course Name of the Course Credits of Credits of Code Theory Courses Practical Courses MCC-001 Fundamentals of

Cardiovascular System-I

4

–

MCC-002 Fundamentals of

Cardiovascular System-II

4

–

MCC-003 Common Cardiovascular

Diseases-I

6

–

MCC-004 Common Cardiovascular

Diseases-II

4

–

MCC-005 Common Cardiovascular

Diseases-III

4

–

MCC-006 Cardiovascular

Epidemiology

4

–

MCC-007 Cardiovascular Related

Disorders

4

–

MCCL-001 Cardiovascular Evaluation-I

–

8

MCCL-002 Cardiovascular Evaluation-II

–

6

MCCL-003 Management of Common

Cardiovascular Diseases

–

10

MCCL-004 Management of

Congenital Heart Diseases

–

4

MCCL-005 Preventive Cardiology

–

8

MCCL-006 Intensive Coronary Care

–

6

30

42

Total

deadly infections such as AIDSand Hepatitis B and indiscriminate disposal of health care waste. The main bottleneck to sound health carewastemanagement practices is lack of training and appropriate skills to manage waste by different health carefunctionaries.

To cater to the needs of health care functionaries and impart good waste management practices, a six-month, 14credits Certificate Programme in Health Care Waste Management has been developed in collaboration with WHO-SEARO. The programme has been deveoped for the South East Countries Partner Institutions (Programme study centre) have already been established in Bangladesh and Nepal. A few more centres in other South East Asian Countries are in the offing.

OBJECTIVES The broad objectives of this programme are to: • sensitize the learner about health care waste and its impact on our health and environment; • acquaint the learner about the existing legislation, knowledge and practices regarding infection • control and health care waste management practices in the countries of South- East Asia Region; and • equip the learner with skills to manage health care waste effectively and safely.

ELIGIBILITY Doctors, Nurses, Paramedics, Health Managers and others with a minimum of 10+ 2 qualification.

B.Sc. (Hons.) in Optometry and Ophthalmic Techniques (BSCHOT) B.SC.(Hons.) in Optometry and Ophthalmic Techniques (BSCHOT) is a four-year degree programme and is aimed to develop a multipurpose ophthalmic manpower in the country. This programme comprises of 128 credits (52 credits theory and 76 credits practical). This programme was launched in July, 2007. The number of Programme Study Centres activated at present are 19.

OBJECTIVES The Programme has been launched with broad objective of training the students in optometry various ophthalmic procedures.

After going through this programme the

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spotlight PROGRAMME STRUCTURE

OBJECTIVES

Course Code Course Title Theory/Practical Credits MDT 001

Fundamental of Endodonitcs

The broad objectives of this programme are to: • enhance the knowledge and skills in the field of oral implantology.

• be able to assess, diagnose and manage the cases requiring dental implants.

Theory

4

MDT 002 MDT Clinical Endodontics I

Theory

4

003 MDTL 001 Clinical Endodontics II

Theory

6

MDTL 002

Practicals of Fundamentals of Endodontics

Practical

6

Post Graduate Diploma in Acupuncture (PGDACP)

Practicals of Clincal Endodontics

Practical

10

Acupuncture is a traditional method of therapy which is very well recognized world over and well accepted by the people as it does not have any side effects. This method has been found to be useful in all types of diseases specially the chronic diseases.

Moreover the cost of the treatment is less as compared to the other systems of medicine.

Post Graduate Diploma in Acupuncture is the first medical programme which is being offered online. The programme is the one year duration and it aims to help graduates of different systems of medicine to learn a new therapy and utilize it for patient benefit in treating acute and chronic diseases.

students shall be able to: • assist eye specialists in big eye hospitals, eye care health units, etc., as refractionists, orthoptists, theatre assistants and refractionists; • get themselves self employed as opticians, optometrists and refractionists; • estimate errors of refraction and be able to prescribe glasses; • maintain ophthalmic appliances and instruments; and • assess ocular motility disorders and prescribe adequate treatment including eyeball exercises.

ELIGIBILITY The candidates should have passed 10+2 examination of CBSE or equivalent with English, Physics, Chemistry, and Biology with at least 45% marks.

Post Graduate Certificate in Endodontics (PGCE) Programme is a one-year Certificate Programme of 30 credits (14 credits

OBJECTIVES The broad objectives of this programme are to: • enhance the knowledge and skills in the field of conservative dentistry.

• be able to assess, diagnose and manage the cases which require specialized interventions in the field of conservative dentistry.

Post Graduate Certificate in Oral Implantology (PGCOI) Programme of 30credits (14 credits theory

PROGRAMME STRUCTURE Course I

Basic Theory of TCM

Course II

TCM Diagnosis

Course III

Accupuncture and Meridians

Course IV

Accupuncture and Moxibustion Treatment

Course V

Scalp an Ear Accupuncture

Course VI

Treatment of common disease by Accupuncture

PROGRAMME STRUCTURE Course Code Course Title Theory/Practical Credits MDT 004

Fundamentals of Oral Implantology

Theory

8

MDT 005

Advanced Surgical, Implantology

Theory

6

MDTL 004

Practicals of Oral Implantology-I

Practical

8

MDTL 005

Practicals of Oral Implantology-II

Practical

8

theory and 16 credits practical) developed

by IGNOU in collaboration with Dental Council of India (DCI). This programme has been launched from July, 2008. Fifteen Programme Study Centres are activated.

This programme will equip the practicing doctors with enhanced knowledge and skills in the field of Conservative Dentistry.

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and 16 credits practical) developed by IGNOU in collaboration with Dental Council of India (DCI). This programme has been launched from July, 2008. Twelve Programme Study Centres are activated. This programme will equip the practicing doctors with enhanced knowledge and skills in the field of Oral lmplantology.

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There are many more initiatives and new courses are to be launched from next session onwards. Students in the peripheral areas look forward for such this flexible mode of education which has further helped them to prepare and appear in exams as per their convenience. Such an approach to educate students through technology and other multimedia modes of teaching has brought people closer.

As a world leader in Distance education, IGNOU has further set an example to be one of the most prestigious institutions to provide medical courses through high end academicians and professors. In January, 2010, it was listed 12th in the webmetric ranking of Indian Universities, based on the caliber of its presence on the internet.

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Skill Training Process in Medical Programmes of IGNOU

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ndira Gandhi National Open University (IGNOU) offers post Graduate Diploma in various medical specialties. The theory material is developed in a self instructional style and the practical training is provided through contact sessions conducted in tertiary and secondary health institutions through a three-tier hands-on-training model which not only provides flexibility in pace and place of learning but also ensures that after completion of the training process, a student can actually practice the skills with confidence in his own work environment. In addition, this three-tier system has integrated the pedagogy of skill learning and has ensured that the benefit of both, group learning and one to one learning is given to the students.

The Model The model describes the implementation of practical component in three steps at three levels. The tertiary level infrastructure (Medical College) where the academicians

could be involved as counselors conveys the second step of learning process. Second, the involvement of secondary level health infrastructure (District Hospital) where the subject specialists could help the students in repeatedly performing the skills and thus guide them practicing the skill that are taught in tertiary level. Third, the student performs his job at the primary level health setup. This could also be a clinic/health set up run by the student himself where the student tries to practice the learned skills without any supervision. In IGNOU parlance, these three levels are called as prorgramme study centre (PSC), Skill Development Centre (SDC) and Work Place (WP) respectively.

For administrative purpose, the programme study centers are linked up with the Regional Centres (RCs) which are a part of the IGNOU establishments. The PSC becomes the nucleus of programme implementation process. The Programme In-charge (PIC) is stationed at the PSC. He/she is normally a permanent faculty of the medical colleges with additional responsibilities of being the

PIC. He will primarily be monitoring the learning process of all students enrolled in his institution with the help of other counselors. The students will be required to come here to attend the contact sessions in theory and practical. The end assessment examination would also be held here. Every student has an opinion to select his nearest SDC. The number of SDCs is not fixed. There could be as many SDCs as the number of students.

SDC is selected as per the guidelines where students are allowed to practice the skills under supervision. At work place, the students will practice the skills without supervision so that enough number of patients are examined by them before appearing in the termend examination for certification.

Implementation Process of Practical Component Every course has a practical component. The skills that the students need to learn under each course are listed in their programme guide. The skill training is divided into three parts i.e. training at PSC, training at SDC and

Steps of Learning Implementation Process The Model

Text Reading

Self Instructional Material

Distance Education Setup

Demonstration with Discussion

Programme Study Centre

Tertiary Health Setup

Practice Under Supervision

Practice for Self Confidence

Skill Development Centre

Work Place

Secondary Health Setup

Primary Health Setup

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The regional health sciences advisory committee (RHSAC) streamlines the implementation of practical component at all levels to promote the health programmes in states by ensuring proper hands on training at peripheral level training at Work place. The students have to maintain record for each case as mentioned in their practical manual. For all the three places, the time division against each skill is also mentioned in the practical manual.

At the PSC, students are demonstrated each skill. To ensure that they have understood the steps involved in each of the skills demonstrated, they should also practice the skills on at least one of the sample cases. If they get opportunity, they are allowed to practice the same skill on more number of patients at PSC. However, if they do not get more chances, they practice the same procedure at their allotted SDC.At the SDC, the students practice all the skills taught to them at the PSC. To guide them, there are counsellors at SDC. Depending upon the programme students has to perform the activities himself under the supervision of the counselor.

Guidelines are given to ensure that the minimum of patients/activities are practiced at SDC. Similarly, a student has so do unsupervised activities at the work place. These activities are recorded in the logbook.

Log Book Maintenance The students are supplied with logbooks. This helps to ensure that the skill training is implemented in a standardized manner throughout the country. The logbooks are countersigned

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by the counselors of medical college/SDC so that the learning defects of the students are identified in time and reinforcement of training could be provided. The programmes where logbooks are not supplied, major headings/formats for recording the activities/case records are provided in the practical manuals. Students are required to write down the details of procedures. They have to maintain record for all the cases they perform at SDC and the work Place.

In some programmes, logbooks carry a weightage of 10% marks in the final evaluation. This further enhances the regularity of maintenance of logbooks by students.

Teleconference In the teleconferencing sessions, subject experts are invited to deal on various subject areas as marked for that session. While dealing with the theory component, principles/concepts dealt in different units are highlighted and the questions arose by the students are replied with the help of examples so that they could link them to practical activities. In the practical component, important clinical examination procedures are dealt with and attempts are made to deal with rare patients and where possible, show them live or get video clips. Discussions are also generated with the help of models or with the video clips of five to ten minutes on certain procedures. Attempts are also be made to make model case presentation, case discussion and simulate clinical rounds/ seminars. Most of the presentations follow the format of panel discussion or lecture demonstrations. Attempts are made to link the practical spells with the teleconference dates wherever feasible. This increases the participation of students. Some of the teleconference sessions are also recorded so that students missing important sessions could go through these cassettes.

Evaluation of Students Students undergo evaluation both in theory and practical component. In theory, the internal assessment is done through tutor marked assignments having weightage of 25 to 30%. In term-end examination, the weightage is 70%. In practical examination, the internal assessment varies from 30 to 50%. It is essential to pass in the internal component so as to become eligible

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for term-end examination. The term-end examination includes long case, short case, spots and viva-voce. 50% of the examiners are external examiners. This helps to maintain standard of the examination process.

The framing of the examination questions, checking of the answer sheets are done by a panel of examiners of respective specialties. Thus, at all levels of evaluation of a student professional quality is given prime importance.

Monitoring To ensure proper implementation of the programme monitoring is done at three levels. Feedback from the peripheral setups (Skill development centres) is collected by the regional consultant who in turn sends bimonthly reports to programme coordinator. Feedback at state level is taken in the Regioanl Health Sciences Advisory Committee (RHSAC) meeting held one to twice a year. At the school level, feedback is collected directly from the students and counselors through performa that are incorporated in the programme guide. Time to time feedback is also collected in structured performa from the Programme In-charge, Regional consultant, Regional centres. In addition, feedback is also collected in every 4-5 years while revising and updating the programmes. The regional health sciences advisory committee (RHSAC) is formed in every state which has the members from state health departments, Medical College having the PSC, Regional centre of IGNOU and the School of Health Sciences. As all the persons involved in the programme implementation meet together, the hurdles in implementation process are identified and the remedial measures are taken. This committee thus helps to streamline the implementation of practical component at all levels. The Regional Consultant is usually a retired medical person having a personal rapport at state level. This helps to promote the health programmes in states and win the confidence of professional colleagues as well as the state Governments. Health being a state subjects the regional consultantâ&#x20AC;&#x2122;s personal efforts makes significant impact on popularising the programmes. The regional consultant by physical supervision to SDCs in the state ensures proper hands on training at peripheral level.