BMJ Elective: A new experience leading a newer perspective....The Patient-centered learning.
Science is always changing, and whatever we learn today is soon washed away by a deluge of newer evidence. Currently, medical education is largely limited to the lecture halls, books, and clinics in many parts of the world. We may need to revisit the aspects of traditional medical education system that may need to change or fix and build different mechanisms that will help student critically think, provide an experience and exposure to various patients within a very short time, equip with a platform around which student can learn topics and prepare for the exams, a process keeps one involved, the facts learned to stay longer than those learned directly from the book, and provide the knowledge about latest research or management of a particular case, and by closely working with patients one can learn to build better doctor-patient relationship and thus build confidence in clinical decision through proper clinical reasoning. I am sharing my experience of a BMJ Elective wherein I have experienced medical education in a different way.
BMJ elective was one of the best experience I have had which stimulated and changed my thought process from traditional medical learning system to a new blended offline-online learning system offered through BMJ Case reports under the supervision of Professor Rakesh Biswas (deputy editor for BMJ Case reports). I am sharing my experience below which is a bit lengthy and I really apologies in advance for that.
It was a patient-centered learning where through face-face interactions with the patients in the ward and outpatient department I was collecting data (bedside clinical evaluation as well as imaging and labs) followed by sharing the de-identified raw data to web-based medical record (blog after taking consent), processing the clinical data through an online discussion in various web-based network of medical professionals providing clinical output (patients management) to our primary beneficiaries of medical education, the patients, chiefly by the supervising doctor to tailor them to match available resources and I experience and reflect upon the consequences and causation of health disadvantage and share them with our team in the form of written text in our online forum. We were using three online platforms- WhatsApp, Tabula rasa (Facebook) and Email wherein doctors from various specialties like internal medicine, cardiology, endocrinology, pulmonology, critical care medicine, orthopedics, oncology, hematology, radiology, pathology, microbiology, pharmacology, epidemiology etc. were involved in discussion while giving real time feedback. I also used to make home visit for the patients previously admitted or came to our OPD and was evaluating their history and clinical improvement while guiding them in various home procedures they were advised e.g. medicine compliance, blood glucose monitoring, diet plan, temperature record in graphs (which would tell the pattern of fever) etc., educate them about their diseases and updating their case records so that any further management plan can be applied after more discussion.
I was formatively assessed as well as supervised through our online community where all our cases are discussed regularly (and an online learning-portfolio for the student can be generated from the student's learning interactions). I was encouraged to share searches on the recent evidences from UpToDate and PubMed, reflections and thoughts around each case with a larger community so that my inputs can actually benefit the patient in terms of generating interest and quality care from all those involved with the patient (offline and online). During the elective, I also involved 50-60 medical students from the same institution to go through the same experience and with involvement of all the stakeholders the patient was getting integrated evidence-based management and much better care even at a low resource setting. The primary objective for which I had started this elective was initially to make case reports for BMJ and through this excellent learning experience I did make one case report which is under review and three case reports are in the pipeline for submission to BMJ case reports. Another global case report which I am working on to raise an issue of unnecessary coronary interventions across the globe.
While the shortage of doctors is of prime concern in a health system, a large force of health system, the medical students have not utilized adequately in patient care.If we think that the way I was involved in the patient care could also be done by all the medical students then how greatly patient care could be improved and during the process medical student can become much more knowledgeably updated, skillful and competitive in their career.
A system I expect where the mental presence will be given priority over the physical presence.
Comments
Post a Comment