• CMC hospital
• hospitals
CMC Vellore
Network of 200 rural secondary
hospitals across India
1909 – First batch of nursing...
Addressing public health problems
through distance learning
Lessons from a postgraduate course in
HIV clinical care
The Fe...
HIV care scenario in India - late 1990’s
• Emerging HIV epidemic
• Lack of care services
-Primary and secondary level
-Rur...
Collaboration between
Medical School & Distance Education University
Christian Medical College
National level training
ins...
EDUCATIONAL APPROACH
SELECTION TRAINING HIV CARE
SERVICES
PROJECT
IMPLEMENTATION
TRAINING- SERVICE DEVELOPMENTTRAINING- SE...
Focused objectives
1. Independent practice
2. Context specific learning
3. Service development
• Improve doctors
knowledge...
INTEGRATED COURSE DESIGN
Distance Course
MONTHS 0 5 12
Project phase
Contact courses CC-I CC-II CC-III
MODULES
IMPLEMENTAT...
Course development
• Course team
• Faculty training
• Development of course
materials
• Systems
• Quality assurance
Facult...
Critical factors in course design
• Selection
• Contact courses
• Integrated learning
texts
• Project work
• Student suppo...
Project work
• Towards development of
HIV care services
- Out patient care
- Inpatient services
- Counseling
- Lab testing...
Examples of project work
ART CLINIC COMMUNITY CARE STAFF TRAINING
HOSPITAL BASED CARE PALLIATIVE CARE SUPPORT GROUP
0
10
20
30
40
50
60
70
80
90
100
Mean score
(%)
Distance
course
Project Theory Practicals
COURSE ASSESSMENTS
PASS
MARK
Dev...
1 year evaluation-
Service development
0
10
20
30
40
50
60
70
80
90
100
H
IV
testing
C
ounseling
O
ut-patientcareIn-patien...
3 year External evaluation
• 70% of graduates were working in their original
hospitals
• Graduates were competent in HIV c...
DLC
CMC
Christian
Medical
College,
Vellore
Maulana
Azad
Medical
College,
New Delhi
School
of Tropical
Medicine,
Kolkotta
D...
Critical factors in up scaling
process
• Selection of centres
• 6 month faculty
development
programme
• Upgrading institut...
Regional training centres
FHM class, Kolkotta Project presentation Computer session
Clinical examination OSCE examination ...
33
46
15
29
4
3 1
17
16
12
4
2
1
3
2
1
4
2
5
1
1
12
33
Graduates -Sector
Government
Hospital
48%
Voluntary
sector
47.6%
Pr...
Conclusions
• The Fellowship in HIV Medicine has succeeded in:
- Developing a sizable cadre of HIV physicians
- Ensuring q...
CONCLUSION
Critical factors to addressing public health problems
through DL
• Partnership with DL resource centre
• Carefu...
Further developments at CMC
Distance education department
Courses
• PG Diploma in Family
medicine
• Course for MBBS doctor...
Proposal for School of Distance Learning in Medicine
CMC-OU collaboration
Proposed DL courses
• Distributed undergraduate
...
Acknowledgements
HIV /STI Research Intervention, Population Council
funded by the European Union
Resource Centre for Sexua...
Graduation Fellowship in HIV Medicine 2002
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Distance Learning for Health Workshop: Programmes of Training for Health Managers and Medical Educators - Anand zachariah

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  • Distance Learning for Health Workshop: Programmes of Training for Health Managers and Medical Educators - Anand zachariah

    1. 1. • CMC hospital • hospitals CMC Vellore Network of 200 rural secondary hospitals across India 1909 – First batch of nursing students 2200 bed teaching hospital Dr. Ida S Scudder Christian Medical College Schools of Medicine Allied Health Science & Nursing
    2. 2. Addressing public health problems through distance learning Lessons from a postgraduate course in HIV clinical care The Fellowship in HIV Medicine
    3. 3. HIV care scenario in India - late 1990’s • Emerging HIV epidemic • Lack of care services -Primary and secondary level -Rural areas • Lack of trained personnel -Doctors involved in care unable to leave work place • Lack of training programmes
    4. 4. Collaboration between Medical School & Distance Education University Christian Medical College National level training institution in Medicine Resource centre for HIV Medicine • Clinical care • Laboratory testing • Counseling Open University Centre for Education in Medicine • Training and capacity building • Assistance in course development • Guidance and support in implementation
    5. 5. EDUCATIONAL APPROACH SELECTION TRAINING HIV CARE SERVICES PROJECT IMPLEMENTATION TRAINING- SERVICE DEVELOPMENTTRAINING- SERVICE DEVELOPMENT APPROACHAPPROACH Interested doctors Contact & Distance courses OP, IP, HIV testing Counseling, Staff education, ART HIV CARE PROBLEM 2.3 million cases Lack of care facilities Stigma
    6. 6. Focused objectives 1. Independent practice 2. Context specific learning 3. Service development • Improve doctors knowledge and skills for - Independent care of HIV patients - at secondary level • Develop HIV services at students institutions - Basic components - Quality- assured - Accessible
    7. 7. INTEGRATED COURSE DESIGN Distance Course MONTHS 0 5 12 Project phase Contact courses CC-I CC-II CC-III MODULES IMPLEMENTATIONPLANNING TRAINING SERVICE DEVELOPMENT CC-IV LAB TECHNICIAN & COUNSELLOR TRAININGTEAM TRAINING NETWORKING
    8. 8. Course development • Course team • Faculty training • Development of course materials • Systems • Quality assurance Faculty training workshop Course team Based on OU best practices
    9. 9. Critical factors in course design • Selection • Contact courses • Integrated learning texts • Project work • Student support • Assessments • Student and hospital • Progressive skill development • Case based and contextual materials • Staged and guided project work • Mentoring • Knowledge, skills and project work
    10. 10. Project work • Towards development of HIV care services - Out patient care - Inpatient services - Counseling - Lab testing - ART - Infection control - Staff education Project work- critical factors 1. Need based 2. Administrative support 3. Staged project work 4. Project guide CMC & local guide 5. Seed grant 6. Site visits 7. Monitoring
    11. 11. Examples of project work ART CLINIC COMMUNITY CARE STAFF TRAINING HOSPITAL BASED CARE PALLIATIVE CARE SUPPORT GROUP
    12. 12. 0 10 20 30 40 50 60 70 80 90 100 Mean score (%) Distance course Project Theory Practicals COURSE ASSESSMENTS PASS MARK Development of knowledge and skills for Independent practice
    13. 13. 1 year evaluation- Service development 0 10 20 30 40 50 60 70 80 90 100 H IV testing C ounseling O ut-patientcareIn-patientcareStaffeducation Pre-course Post-course • 75% of institutions had basic components of HIV care • Increase service utilisation • Improved quality of services % AVAILABILITY OF BASIC SERVICES
    14. 14. 3 year External evaluation • 70% of graduates were working in their original hospitals • Graduates were competent in HIV care Greater responsibilities given to graduates • Quality of HIV services had improved - Staff had been trained - Policies and guidelines were being used - Linkages to the community enhanced - Climate of HIV care had improved
    15. 15. DLC CMC Christian Medical College, Vellore Maulana Azad Medical College, New Delhi School of Tropical Medicine, Kolkotta Distance learning centre •Coordination •Material development •Quality assurance Regional Training centres UP-SCALING- OU model
    16. 16. Critical factors in up scaling process • Selection of centres • 6 month faculty development programme • Upgrading institutional infrastructure • Setting up systems
    17. 17. Regional training centres FHM class, Kolkotta Project presentation Computer session Clinical examination OSCE examination Informal sessions
    18. 18. 33 46 15 29 4 3 1 17 16 12 4 2 1 3 2 1 4 2 5 1 1 12 33 Graduates -Sector Government Hospital 48% Voluntary sector 47.6% Private 4.4% Distribution of FHM Graduates 2002-2009 Total number of graduates- 237 Drop out rate- 4.6% Vellore Delhi Kolkotta
    19. 19. Conclusions • The Fellowship in HIV Medicine has succeeded in: - Developing a sizable cadre of HIV physicians - Ensuring quality assured and comprehensive HIV services at the community level • Such a well developed DL course can be rapidly and efficiently replicated. • It is possible to address emerging or unmet health care needs through distance learning.
    20. 20. CONCLUSION Critical factors to addressing public health problems through DL • Partnership with DL resource centre • Careful design and development • Motivation and expertise of faculty • Selection of motivated students • Need based project work • Basing the DL course in centres where clinical expertise and experience is available
    21. 21. Further developments at CMC Distance education department Courses • PG Diploma in Family medicine • Course for MBBS doctors working in rural hospitals • Fellowship in Diabetes care • Primary health worker training
    22. 22. Proposal for School of Distance Learning in Medicine CMC-OU collaboration Proposed DL courses • Distributed undergraduate medical training • General practice • Priority health areas • Health worker training • Specialty disciplines
    23. 23. Acknowledgements HIV /STI Research Intervention, Population Council funded by the European Union Resource Centre for Sexual Health and HIV/AIDS funded by DFID Maulana Azad Medical College, New Delhi School of Tropical Medicine, Kolkotta Open University Centre for Education in Medicine
    24. 24. Graduation Fellowship in HIV Medicine 2002

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