Quality Improvement Cycle 1 of Teaching Programme - Case Based Blended Learning Ecosystem

 

Quality Improvement Cycle 1

Quoting the stated objectives here –

The stated objectives of the teaching programme are –

1. To improve history taking with a focus on patient-centered problems.
2. To perform a targeted clinical exam with video demonstration of relevant clinical signs.
3. To perform a critical and clinically sound analysis of the history and physical exam and generate a list of differential diagnoses.
4. To perform interpretation of laboratory data and demonstrate an understanding of test characteristics by performing a review of literature.
5. To demonstrate procedural competencies on video.

The programme was devised to enable online asynchronous learning, during the COVID-19 pandemic, designed for –

1. Undergraduate students
2. Interns
3. Postgraduate students
4. Global network of students on our WhatsApp groups

 

Case 1 - https://ruchithareddy007.blogspot.com/2020/06/e-log-of-p-ruchithareddy.html

Objectives met – 1, 2, 3, 4 and 5

Targeted Audience – 2, 3, 4

Case 2 - https://ruchithareddy007.blogspot.com/2020/06/e-log.html

Objectives met – 1, 2, 3 and 4

Targeted Audience – 2, 3, 4

Case 3 - https://geethika110.blogspot.com/2020/06/medicine-case.html

Objectives met – 1, 2, 3 and 4

Targeted Audience – 2, 3, 4

Case 4 - https://mounika96.blogspot.com/2020/05/medicine-case-presentation.html

Objectives met – 1, 3 and 4

Targeted Audience – 2, 3, 4

Case 5 - https://geethika110.blogspot.com/2020/06/a-20-year-old-water-supplier-who-is.html

Objectives met – 2, 3, 4 and 5

Objectives failed – 1

Targeted Audience – 2, 3, 4

Case 6 - https://preethi1432.blogspot.com/2020/07/blog2.html

Objectives met – 1, 2, 3 and 4

Targeted Audience – 1, 2, 3, 4

Case 7 - https://nishithatummala006.blogspot.com/2020/08/nishithas-elog.html

Objectives met – 1, 2, 3, 4 and 5

Targeted Audience – 1, 2, 3, 4

Case 8 - https://ynniharika.blogspot.com/2020/07/a-20-year-old-man-presented-with-chief.html

Objectives met – 1, 2, 3 and 4

Exhibit 1 - Demonstration of Review of Literature and application of the appraisal to patient care –

July 202 Log Book – Publicly available; Open access – Archived from our WhatsApp conversations

https://adityasamitinjay.blogspot.com/2021/08/selected-monthly-electronic-logs.html  

Topics covered – OSAHS, Pulmonary Edema, Sydenham Chorea, Doxycycline Deficiency State, ASO Titres in Rheumatic Fevers, Lady Windermere Syndrome, Antiepileptic therapy in Ischemic Stroke, Efficacy of aspirin for secondary prophylaxis of stroke, Hypertensive Encephalopathy & SIADH in GBS.

Targeted Audience – 1, 2, 3 and 4

Case 9 - https://nishithatummala006.blogspot.com/2020/08/nishithas-elog.html

Objectives met – 1, 2, 3, 4 and 5

Targeted audience – 1, 2, 3 and 4

Exhibit 2 – Demonstration of Review of Literature and application of the appraisal to patient care –

August 2020 Log Book – Publicly available; Open access – Archived from our WhatsApp conversations

https://adityasamitinjay.blogspot.com/2021/08/selected-monthly-electronic-logs.html

Topics covered – Histological variants of Nephrotic syndrome, Review of Literature on Nephrotic syndrome causing a hypercoagulable state and Acute Pulmonary Embolism, detecting pulmonary edema on USG, Review of Literature on How to Dose Lasix in patients with Nephrotic Syndrome and Review of Literature on Unexplained Peripheral Neuropathy

Targeted Audience – 1, 2, 3 and 4

Exhibit 3 – Demonstration of Procedural competencies as part of ICU duties

https://sreeramsripadi.blogspot.com/2020/08/history.html - Lumbar Puncture

Targeted Audience – 1, 2, 3 and 4

Case 10 - https://ynniharika.blogspot.com/2020/08/35-year-old-male-patient-who-is-daily.html

Objectives met – 3 and 4

Objectives failed – 1 and 2

Targeted audience – 1, 2, 3 and 4

Case 11 - https://ynniharika.blogspot.com/2020/09/16-year-old-female-with-headache.html

Objectives met – None

Objectives failed – 1, 2, 3 and 4

Targeted audience – 2, 3 and 4

Case 12 - https://nishithatummala006.blogspot.com/2020/09/a-55-yr-old-with-chronic-inflammatory.html

Objectives met – 1, 2 and 3

Objectives failed – 4

Targeted audience – 2, 3 and 4

Case 13 - https://zuberiasanya.blogspot.com/2020/09/this-is-online-e-log-book-to-discuss.html

Objectives met – 1, 2, 3 and 4

Targeted audience – 2, 3 and 4

Case 14 - https://zuberiasanya.blogspot.com/2020/09/hello-everyone.html

Objectives met – 1, 2, 3 and 4

Targeted audience – 1, 2, 3 and 4

Exhibit 4 - Demonstration of Review of Literature and application of the appraisal to patient care –

September 2020 Log Book – Publicly available; Open access – Archived from our WhatsApp conversations

https://adityasamitinjay.blogspot.com/2021/08/selected-monthly-electronic-logs.html

Topics covered – Interpretation of NCS, Corticosteroids for CIDP, ACEI/ARBs vs CCBs for Diabetic Nephropathy, Seronegative spondyloarthropathies, Multifocal atrial tachycardia.

Targeted audience – 1, 2, 3 and 4

 

Self-Reflections –

 

The Good - The programme was largely successful in implementing and enabling continuous data logging. Although in its infancy, key stakeholders and players showed an active interest and enthusiasm to set the programme up and running. The programme is still being successfully run by our professor, Dr. Rakesh Biswas. Also, we have done impeccably well in properly deidentifying patients and meticulously videoing our procedures and clinical exams.

The Bad – While most interns and undergraduates showed interest, a few did not and may have taken some shortcuts in just getting done with the objectives. Thus, although the programme was dutifully obliged to, I have considered some objectives as failed in certain cases as they were not up to the required standard.

The Ugly – Embraced enthusiastically by me and my professor, some colleagues may have given up and willfully ignored the programme. Their indifference may have precipitated the same in the interns and juniors and could have sabotaged some of our objectives.

 

Dr. Aditya Samitinjay Gade