Based on the history and investigations, what is your provisional diagnosis for this child?
Student: The provisional diagnosis is Thalassemia Major.
Thalassemia is an inherited blood disorder caused by reduced or absent amounts of hemoglobin. The key features that point to Thalassemia Major in this case are:
- Recurrent pallor and need for frequent blood transfusions since birth indicating severe anemia.
- Hepatosplenomegaly which is commonly seen in Thalassemia Major due to extramedullary hematopoiesis.
- Microcytic hypochromic anemia on blood smear examination.
- Hemoglobin electrophoresis showing
Integration in Competency based medical educationKhan Amir Maroof
Presented by Dr Amir Maroof Khan and Dr Dinesh Kumar in IAPSM Preconference workshop held on 16th March 2021 - online. Focused on Community Medicine.
Workshop convener: Dr Pankaj Shah
Assessment in CBME Competency Based Medical Education Dr Girish .B CISP 2 MCIDr Girish B
Assessment in CBME Competency Based Medical Education by Dr Girish .B, Associate Professor, Department of Community Medicine, Chamarajanagar Institute of Medical Sciences (CIMS), Chamarajanagar, Karnataka
Integration in Competency based medical educationKhan Amir Maroof
Presented by Dr Amir Maroof Khan and Dr Dinesh Kumar in IAPSM Preconference workshop held on 16th March 2021 - online. Focused on Community Medicine.
Workshop convener: Dr Pankaj Shah
Assessment in CBME Competency Based Medical Education Dr Girish .B CISP 2 MCIDr Girish B
Assessment in CBME Competency Based Medical Education by Dr Girish .B, Associate Professor, Department of Community Medicine, Chamarajanagar Institute of Medical Sciences (CIMS), Chamarajanagar, Karnataka
To choose the most appropriate T-L Method for objectives & competencies
To discuss efficiency and effectiveness of various TLM
To discuss advantages and limitations of various TLM
To discuss factors in selection of T-L Method in different domains and levels of learning to match objectives and competencies
It is quiet difficult to have the concept for right and appropriate teaching methods aligning with competency & objective. This PPT may be helpful to have the basic concepts of it.
Systems approach,Principles of Adult learning & Learning process in Medical E...anitasreekanth
MEU WORKSHOP:Changing trends in the societal attitude calls for change in the medical education curriculum in India so that an INDIAN MEDICAL GRADUATE is of global significance
This is my latest PPT on the Principles of student assessment in medical education which is illustrated with suitable pictures, diagrams for understanding better..
To choose the most appropriate T-L Method for objectives & competencies
To discuss efficiency and effectiveness of various TLM
To discuss advantages and limitations of various TLM
To discuss factors in selection of T-L Method in different domains and levels of learning to match objectives and competencies
It is quiet difficult to have the concept for right and appropriate teaching methods aligning with competency & objective. This PPT may be helpful to have the basic concepts of it.
Systems approach,Principles of Adult learning & Learning process in Medical E...anitasreekanth
MEU WORKSHOP:Changing trends in the societal attitude calls for change in the medical education curriculum in India so that an INDIAN MEDICAL GRADUATE is of global significance
This is my latest PPT on the Principles of student assessment in medical education which is illustrated with suitable pictures, diagrams for understanding better..
The benchmark assesses the following competency4.2 Communicate .docxarnoldmeredith47041
The benchmark assesses the following competency:
4.2 Communicate therapeutically with patients.
The RN to BSN program meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.
Note: The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.
Select one of the following as the focus for the teaching plan:
1. Primary Prevention/Health Promotion
2. Secondary Prevention/Screenings for a Vulnerable Population
3. Bioterrorism/Disaster
4. Environmental Issues
Use the "Community Teaching Work Plan Proposal" resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.
1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
2. Request feedback (strengths and opportunities for improvement) from the provider.
3. Complete the "Community Teaching Experience" form with the provider. You will submit this form in Topic 5.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion
RUBRICS: The teaching plan is based on an approved topic. The epidemiological rational is well-supported and relevance to the topic is demonstrated.
All assignment criteria are thoroughly completed. Rational and detail is provided throughout.
The teaching plan is communicated with an activity that uses clear active listening techniques to connect with the audience. A clear description of how the attention of the audience was captured and how the presentation was concluded is presented. The teaching plan thoroughly describes nonverbal techniques that were employed, such as eye contact, appropriate dress for the setting, facial expressions, and voice intonation.
Proposal is well-organized and logical. Ideas progress and relate to each other. Paragraph and transition construction guide the reader.
Writer is clearly in command of standard, written, academic English. All format elements are correct.
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
For initial post talk about the charts compositions: the chart size, .
BEPAA-Integrated Health Sciences (IHS) STEM Curriculum Tools Access DEMONSTRA...RBG Communiversity
Screen Capture and Scree Shots
I have placed a snapshot sequence after the explanation that has more visibility.
http://www.imhotepvirtualmedsch.com/drimhotep-tv.php
Running Head PERSONAL NURSING PHILOSOPHY 1PERSONAL NURSING P.docxglendar3
Running Head: PERSONAL NURSING PHILOSOPHY 1
PERSONAL NURSING PHILOSOPHY 2
Personal nursing philosophy
Student name
Professor
Course
Date of submission
This paper focuses more on nursing paradigms that are comprised of four key elements. These factors include persons/clients, health, environment, and nursing, where each is subjected to own theoretical connotation and has an essential role in enhancing and promoting healthcare. In this regard, the paper outlines and contrast approaches and is in line with these four approaches in efforts to attain modern health care. Various theories in this regard try to give a vivid description of the environment and critical role in healthcare. All the stakeholders are therefore supposed to collectively work together as one of attaining a competitive advantage, healthcare and create a conducive work plan that total defense potential alignment of healthcare. This theory creates a personal definition that applies to the scenario in an exemplifying the applicability in the nursing processes (Warren W. Tryon, 2019).
In my analysis and interpretation, Person metaparadigm focuses more on recipient care and the patient. This facet extends and encompasses factors such as culture, personal spiritual aspects, family friends, and the associate economic status. This fact has been proved by a research hat outlined that the current world view of nursing has existentialism and humanism transcendence, which are based on their own interpretation and perception. The nature of intensive care that is acceded to a patient in some cases is based on the personal attribute and predetermined forces that surround one self. The third part is always crucial in attaining healthcare through could and proviso of essential secondary services that help in the healing processes. This is a closely associated environment metaparadigm; it deals with both external and external factors that relate to competent and reliable patient care. Some of the factors that are defined in this phase include interacting with patients, which changes the cognitive perspective of the subject. Visitors, as well as surrounding, are vital factors that can be used to determine and offer the best services to a patient (Saul McLeod,, 2015).
Am sure that nurse and the integrated practices of theories have established s scope and level of abstraction that has developed a proper framework through the nursing situation. Through capacity building a convinced that nurse intervention is the road map of attaining all phenomena and goals of universal healthcare. In this case, the use of cognitive theory appliance is predominating, arguing that intellectual structure and processes must be followed. The nurse must, therefore, attain a high degree of competency through the use of one's thought, interpretation of the environment, and correct assumption. In my opinion, this is the most critical aspect that requires professional input to attain effective, effi.
Running Head PERSONAL NURSING PHILOSOPHY 1PERSONAL NURSING P.docxtodd581
Running Head: PERSONAL NURSING PHILOSOPHY 1
PERSONAL NURSING PHILOSOPHY 2
Personal nursing philosophy
Student name
Professor
Course
Date of submission
This paper focuses more on nursing paradigms that are comprised of four key elements. These factors include persons/clients, health, environment, and nursing, where each is subjected to own theoretical connotation and has an essential role in enhancing and promoting healthcare. In this regard, the paper outlines and contrast approaches and is in line with these four approaches in efforts to attain modern health care. Various theories in this regard try to give a vivid description of the environment and critical role in healthcare. All the stakeholders are therefore supposed to collectively work together as one of attaining a competitive advantage, healthcare and create a conducive work plan that total defense potential alignment of healthcare. This theory creates a personal definition that applies to the scenario in an exemplifying the applicability in the nursing processes (Warren W. Tryon, 2019).
In my analysis and interpretation, Person metaparadigm focuses more on recipient care and the patient. This facet extends and encompasses factors such as culture, personal spiritual aspects, family friends, and the associate economic status. This fact has been proved by a research hat outlined that the current world view of nursing has existentialism and humanism transcendence, which are based on their own interpretation and perception. The nature of intensive care that is acceded to a patient in some cases is based on the personal attribute and predetermined forces that surround one self. The third part is always crucial in attaining healthcare through could and proviso of essential secondary services that help in the healing processes. This is a closely associated environment metaparadigm; it deals with both external and external factors that relate to competent and reliable patient care. Some of the factors that are defined in this phase include interacting with patients, which changes the cognitive perspective of the subject. Visitors, as well as surrounding, are vital factors that can be used to determine and offer the best services to a patient (Saul McLeod,, 2015).
Am sure that nurse and the integrated practices of theories have established s scope and level of abstraction that has developed a proper framework through the nursing situation. Through capacity building a convinced that nurse intervention is the road map of attaining all phenomena and goals of universal healthcare. In this case, the use of cognitive theory appliance is predominating, arguing that intellectual structure and processes must be followed. The nurse must, therefore, attain a high degree of competency through the use of one's thought, interpretation of the environment, and correct assumption. In my opinion, this is the most critical aspect that requires professional input to attain effective, effi.
The Photosynthesis is energetic processes where light photons from the sun generate in photosynthetic organisms and the student will understand and comprehend the importance of both the light and dark reactions of photosynthetic organisms for the energetic balance in all ecosystems.
Each student is required to complete and turn in the evolution oAlyciaGold776
Each student is required to complete and turn in the evolution of the course prior to sitting for the final exam. This is a portfolio requirement that must be completed at the end of each course. You will not be allowed to sit for the final without having completed the evolution for this course.
Rubric
NURS_307 - Nursing Evolution Rubric
NURS_307 - Nursing Evolution Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeReflects on current theory and clinical class with concepts and theories using the Program Learning Outcomes and BSN Essentials listed in the syllabus
3.3 pts
Meets Expectations
1. Reflects on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Synthesizes theories and concepts from liberal education to build an understanding of the human experience. 3. Uses skills of inquiry and analysis to address practice issues 4. Applies knowledge of social and cultural factors in the care of populations encountered in this course.
2.51 pts
Approaches Expectations
1. Limited reflection on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Limited synthesis of theories and concepts from liberal education to build an understanding of the human experience 3. Use limited skills of inquiry and analysis to address practice issues 4. Applies limited knowledge of social and cultural factors in the care of populations encountered in this course.
1.65 pts
Does Not Meet Expectations
1.No reflection on current theory class and clinical and how courses support each other 2. Does not synthesize theories and concepts from liberal education to build an understanding of the human experience 3. Does not use skills of inquiry and analysis to address practice issues 4. Does not apply knowledge of social and cultural factors in the care of populations encountered in this course.
3.3 pts
This criterion is linked to a Learning OutcomeDevelops an effective communication style for interacting with current patients, families, and the interdisciplinary health team when providing holistic, patient centered nursing care to populations encountered in this course.
3.4 pts
Meets Expectations
1. Reflects on providing holistic patient care to populations encountered in this course. 2. Describes inter-collaborative involvement (i.e. Interprofessional rounds; consultations and interaction with PT/OT; Respiratory Therapy, Pharmacist consultation---describe their role/ contribution.)
2.58 pts
Approaches Expectations
1. A limited reflection on providing holistic patient care to populations encountered in this course. 2. Describes limited inter-collaborative involvement
1.7 pts
Does Not Meet Expectations
1. No reflection on providing holistic patient care to populations encountered in this course. 2. Does not describes inter-collaborative involvement
3.4 pts
This criterion is ...
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
1. Alignment and Integration
Dr. Prabhakar Patil
Professor
Department of Pharmacology
Dr. Prasanna.N
Assistant Professor
Department of Pathology
2.
3. Traditional curriculum in MBBS:-
1st Phase:-
Anatomy , Physiology , Biochemistry
2nd Phase :
Pathology , Pharmacology , Microbiology, Forensic Medicine
3 rd Phase
Medicine, Surgery & Orthopedics , Gynecology and obstetrics,
Pediatrics, Community Medicine, ENT, Ophthalmology
Internship
4. Confused Doctor :-
It was Myocardial Infarction. Everyone around me was acting
very fast to save patients life. But I was totally in confusion. I
started feeling the same pain and anxiety of the patient in front
of me.
Seniors started shouting at me. That made me more
embarrassing. My eyes welled up with tears
Then I started thinking
Whatever I learnt . I was not able to apply it
5. Whether that was my fault?
Or
My teachers fault?
No . Not at all.
Then what was the reason for my failure in practical aspects?
We got education in Silos model:-
Model of Compartmentalized education
6. Things were not taught to us as whole disease
The concepts though taught were fragmented
7. e.g. Myocardial Infarction
1) Anatomy :- Origin, course, branches of coronary arteries
Anatomical basis of Ischemic heart disease
2) Physiology:- The functional anatomy of heart including chambers, sounds and pacemaker
tissue and conducting system. Introduction to ECG:- Normal and abnormal
patterns
3) Biochemistry:- Biochemical tests done in MI
4) Pathology :- Pathogenesis of MI
5) Pharmacology :- Classification ,Mechanism of action, PK/PD, doses and side effects of drugs
used in MI
6) PSM :- Modifiable and non modifiable risk factors of MI
5) Internal Medicine:- Pathogenesis, causes, differential diagnosis, investigations and treatment.
10. What are the advantages of Integrating?
1) Can avoid redundancy
2) Promote contextual learning
3) Promote meaningful and relevant learning
4) Student will be able to correlate between basic and clinical
science
5) Things learned are better retained
6) It promotes faculty communication
11. How integration can be done?
Try to cover the whole organ system(CVS/RS/Endocrine/CNS),or
a particular disease (Anemia, Myocardial infarction ) within
certain time period.
This can be done by
1) Aligning the topics(Subjects of same phase)
2) Integrating them (Subjects of different phase)
3) Link the concepts in alignment and integration by using linker
12. 1) Alignment of the organ systems/topics as much possible –
(Temporal coordination)
• It means that as much as possible organ systems/ topics in
different subjects in the same phase that have similar
threads will be grouped together in the timetable
• Used for the majority of the curriculum (80% )allowing
similar systems or topics in different subjects to be learnt
separately but during the same time frame.
• This is the principal method to be followed while creating
the phase-wise timetable.
13.
14. How alignment can done?
1)We can align organ systems
2) We can align Topics
3) We can align both
15. Examples of Alignment :
1) Organ system:- Cardiovascular system in anatomy, physiology and
biochemistry can be scheduled simultaneously in the timetable (Organ
system based Time table for CVS)
17. 3) Organ systems plus topics
Aligned timetable using organ system(CVS) and topic(MI)
18. 2) Integrate the topics to the limited extent. :-
Topics in different subjects in the same phase or different
phases that have similar threads will be grouped together in the
timetable
Concepts in a topic / organ system that are similar,
overlapping or redundant are merged into a single teaching
session in which subject based demarcations are removed
19. Directions of integration:
A) Horizontal : Two or more disciplines of any phase of MBBS
curriculum (preclinical, para-clinical or clinical)
• The purpose of horizontal integration (within a phase) is to
remove redundancy and provide interconnectedness
20. B) Vertical : Two or more disciplines of two or more phases of
MBBS curriculum.
The purpose of vertical integration
• In the earlier phases: It used is to emphasize on the applied
aspect of the basic science
• In the later phases: It is to used to give more information
clinically oriented concepts
22. The 11 steps on the integration ladder described by
Professor Ronald M Harden
Professor Ronald M Harden, Centre for Medical
Education Dundee university ,UK
24. Liver function in physiology
and bilirubin metabolism in
biochemistry can be planned
jointly in one single session
Mainly used for
Horizontal Integration
25. Used for vertical
integration
Most of the part of Subjects are taught
by using methods like temporal
coordination (Covering large part of the
syllabus)
In the same time frame you add a
session which brings together concepts
common to each of the subjects
26. Mainly used for
vertical integration
The teacher identifies concepts and skills from other
subjects and incorporate them while teaching his own
subject
27. How exactly should we integrate? What are the steps involved?
Step 1: Identify a list of topics or organ systems that will be
accommodated in the timetable as aligned and integrated topics
(AITo).
E.g.:-
Topics :- Anemia, Diabetes, Thyroid Diseases,
Nutrition, Febrile Illness , Tuberculosis, Malaria, Diarrhea
Ischemic Heart Disease ,Polycystic Ovarian Syndrome, Jaundice
Organ system :- Cardiovascular System, Gastro-intestinal system,
Endocrine system
28. Here we are taking example of Meningitis
In which subjects Meningitis can be taught?
Pathology(Phase 2)
Microbiology (Phase 2)
Internal Medicine(Phase 3)
29. Step 2:
• Use the subject-wise competency document book developed
by the MCI for noting down required competencies in each
subject to teach that particular topic
• Transfer the competences into a template
• Arrange these competencies according to phase and subject
30. Step 3: For each competency, derive learning objectives.
Subject Pathology Microbiology Internal
Medicine
Competencies 2 1 3
Objectives 5 3 7
31.
32. Step 3:
Derive learning sessions to teach these objective
a.Put together a bunch of objectives that can be accomplished in the
allotted time and require a similar method of instruction and create a
learning session
b.While creating a learning session Review the objectives /
competencies in each phase for particular topic so that Redundancy
can be reduced
C. Put together a bunch of learning sessions for alignment and
integration that covers a particular objectives from different subjects
Subject Pathology Microbiology Internal Medicine
Competencies 2 1 3
Objectives 5 3 7
Objectives those can aligned
and integrated
3(2) 2(1) (2)
Learning methods(Instruction ) Lecture ,Practical Small group discussion Case study
33.
34. Objectives which can be aligned and integrated
3(2)
2(1)
5(2)
Derive assessment methods for each objective.
Subject Pathology Microbiology Internal Medicine
Competencies 2 1 3
Objectives 5 3 7
Objectives those can aligned
and integrated
3(2) 2(1) (2)
Learning methods Lecture ,Practical Small group discussion Case study
Assessment method Structured essay
Viva
Skill assessment
Structured essay
Viva
Skill assessment
Structured essay
Viva
Skill assessment
35.
36. Step 4: Create a adding a linker to each AITo so that we can
introduce it into time table
A linker is a session that will be helpful in connecting the
concepts(helps the student to Correlate) in different subjects
while learning about a particular topic or organ system
The linker is most commonly a case.
Linker can be creatively written and used in each phase (often
the same case) to allow students to correlate what they have
learnt and apply into understanding disease process, diagnosis
and care.
37. When you use the case discussion at different time points in
integration students will be able to link concepts appropriately
In addition, encourage the student to go for collaborative and
self-directed learning
38. Step 5: Ensure that while making table adequate time should be
given to AITos (Aligned and Integrated topics) ,Non aligned
topics and assessment methods
39. Which things we must take into consideration according to
GMR 2019 while doing integration:-
• Integration should not to exceed 20% of the total curriculum
• The integration session most preferred will be a case based
discussion so that student will learn concepts as well as their
connection with other subjects
40. • Prime importance should be given to achieve phase - based
objectives
• The integrative elements from lower phases are used only
to provide adequate recall of applied concepts and
understand their clinical application in higher phases
• Objective writing and session planning must be done with
teachers of all subjects involved in the aligned and
integrated topic (AITo) and their inputs taken for the
integrated session
41. • It must be emphasized that integration does not necessarily
require multiple teachers(the concepts should be integrated. It
is not necessary to integrate teachers) in each class. Experts
from each phase and subject may be involved in the lesson
planning but not it in its delivery unless necessary
• Topics that cannot be aligned and integrated(Non- aligned
topics) must be provided adequate time in the curriculum
throughout the year
42. • Assessment will continue to be subject based. However,
efforts must be made to ensure that phase appropriate
correlates are tested to determine if the learner has
internalized and integrated the concept and its application
(This is nothing but integrated assessment)
47. Step 2 ALIGN IT same Phase ( 2 ) – and sequence it
(Pathology and Microbiology )
No. Competencies
Pathology
PA 13.1 Describe haematopoiesis and extra medullary haematopoiesis
PA 13.3 Define and classify and anemia
PA 13.4 Enumerate and describe the investigations of anemia
PA 13.5 Identify and describe the peripheral blood picture in anemia
PA 14.1 Describe iron metabolism
PA 14.2 Decribe the etiology investigations and differential diagnosis of microcytic hypochromic anemia
PA 14.3 Identify and describe the the peripheral and smear in hypochromic anmeia
PA 15.1 Describe the metabolism of Vitamin B12 and the etiology and pathogeneisis of B12 deficiency
PA 15.2 Describe the laboratory investigations of macrocytic anemia
PA 15.3 Identify and describe the peripheral blood picture of macrocytic anemia
PA 15.4 Enumerate the differences and describe the etiology and distinguishing features of megaloblastic and non megaloblastic anemia
Microbiology
MI 4 List the common microbial agents causing anaemia. Describe the morphology, mode of infection and discuss the pathogenesis, clinical
course, diagnosis and prevention of the common microbial agents causing Anaemia.
Pharmacology
PH 1.35 Description of drugs used in haematological disorders and discuss mechanism/s of action, types, doses, side effects, indications and
contraindications, like 1. Drugs used in anemias2. Colony Stimulating factors
PA 16.1 Define and classify hemolytic anemia
PA 16.2 Describe the pathogeneis and clinical features and hematologic indices of hemolytic anemia
PA 16.3 Describe the pathogenesis features, hematologic indices and peripheral blood picture of sickle cell anemia and thallasemia
PA 16.4 Describe the etiology pathogenesis, hematologic indices and peripheral blood picture of Acquired hemolytic anemia
PA16.5 Describe the peripheral blood picture in different hemolytic anaemias.
PA 17.1 Enumerate the etiology, pathogenesis and findings in aplastic anemia
PA17.2 Enumerate the indications and describe the findings in bone marrow aspiration and biopsy
56. Step 3 b
Bunch objectives and
create learning sessions
Subject 1 Subject 2
Obj
Anemia
Phase 1
Obj Obj
Obj Obj
Obj Obj
Obj Obj
Obj
Obj
Obj Obj
Obj Obj
Phase 2
Obj Obj
Obj Obj
Subject 4 Subject 5 Subject 6
Obj
Obj Obj
Phase 3
Obj
Obj
Obj Obj
Subject 7 Subject 8
Integration - Correlation
Choose objectives from a different phase can be used to link the
concepts in various sessions
Correlation
LinkerCase
PA 14.I DESCRIBE THE IRON METABOLISM
PA 14.2 DISCUSS THE AETIOLOGY,
INVESTIGATIONS AND DIFFERENTIAL
DIAGNOSIS OF HYPOCHROMIC MICROCYTIC
ANAEMIA
A) Discuss absorption , transport , storage,
functions and degradation of iron
B) Discuss etio-pathogenesis , clinical features,
diagnosis of iron deficiency anaemia
PY 2.5 DESCRIBE RBC FORMATION
(ERYTHROPOIESIS) AND FUNCTIONS
• Describe the formation and regulation of
erythropoiesis
PE 13.1 DISCUSS RDA , DIETARY SOURCES
AND ROLE OF IRON IN HEALTH AND
DISEASE
A) Discuss the RDA and dietary sources of iron
B) Discuss role of iron in Health and disease
A child with
iron
deficiency
Anaemia
Principle Integration
CORRELATION
57.
58.
59.
60. • Step 4 c : The objective writing and session planning should be done by
teachers of all subjects in the AIT - Anemia
• Step 4 d : The concept and not necessarily teachers should be integrated
61.
62. .
Anemia
Session
s
Anemia
Session
Anemia Anemia Anemia
IAnemia Anemia
Step 5 b ANEMIA By reviewing objective / competencies across phases redundant
ones and those with a common thread can be identified for Vertical integration
Aligned and integrated Anemia sessions
Anemia
Session
s
Anemia
Anemia Anemia
IAnemia Anemia
Anaemi
a
Anemia Anemia
IAnemia Anemia
Phase 1
Phase 2 Phase 3
63. .
Anemia
Session
s
Anemia
Session
Anemia Anemia Anemia
IAnemia Anemia
Step 5 b ANEMIA Consider Adding a Linker ( Aligned and Integrated )
Aligned and integrated Anemia sessions
Vertically
Common
thread
Linker is usually a
case
Anemia
Session
s
Anemia
Anemia Anemia
IAnemia Anemia
Anaemi
a
Anemia Anemia
IAnemia Anemia
Phase 1
Phase 2
Phase 3
64. Look at the vertically aligned document of “ Anaemia”
What are the common problems that the IMG will have to solve,
as a first contact physician in the community with respect to the disease
(Anemia) ?
Anemia in children , Pregnant women , elderly , Poly trauma
To what degree of complexity can they solve the problem ?
Recognition , evaluation , management and referral
Create cases
1. An infant with repeated blood transfusion , anemia and jaundice
2. A pregnant women with iron deficiency anemia
3. An elderly alcoholic with GI bleed
4. A patient with POLY TRAUMA and acute blood loss ,
pre Operative , Post operative management
Cases should address objectives from the various phases from “
Anemia” topic
How to create linker ?
What cases to link ?
68. When ever we complete a topic or session we can assess the student by
giving them formative assessment.
What is the purpose of formative assessment?
To help the student as well as teacher to know how the student is
progressing and what remedial actions can be taken
When the formative assessments are conducted?
Through out the academic year
Summative assessments :-
They are conducted at the end of academic year
What is the purpose :-
69. • In traditional assessment system we were not integrating
assessments .
• But now MCI tells us to use integration in assessments also .
• It tells us that more integration should be there in formative
assessment
• Advantage of Integrated assessment: It provide an
creative learning platform to the students so that whatever
he learns can be linked to real life i.e., what will he/she
experience in their practice.
70. Examples of Integrated Assessments
Reflection
FORMATIVE
ASSESSMENTS
Structured
Essays
Short
answers
Integrated
OSPE
/OSCE
Case
resolutions
Assignments
Integrated
MCQ
71. Case
resolutions
FORMATIVE
ASSESSMENTS
Small Group Discussion
A 3 year old toddler presents with recurrent pallor , jaundice and requiring recurrent blood
transfusion since birth . The blood group of the child is O positive . The child clinically has
an hepato-splenomegaly ………Lab values ……..
Lead questions
1. What's happening in this child ?
2. What normal physiology that is deranged ?
3. What is the physiological deviations leading to the abnormal clinical findings ?
4. What is the normal parameters and why it has deviated in this child ?
5. What is the physiological basis of blood transfusion ?
6. How does blood transfusion help to restore normal physiology in this child ?
PY 2.5 Describe RBC formation (erythropoiesis & its regulation) and its functions
PA 13.I Describe hematopoiesis and extra medullary hematopoiesis
• Objectives :
• Describe erythropoiesis and regulation
• Explain the functions of rbc
• Discuss significance of medullary and extramedullary erythropoiesis
Formative assessment Format of Small group discussion
Examples of Integrated Assessments
74. Formative Assessment
Integrated
MCQ
PA 14.1 Describe iron metabolism
PA 15.1 Describe metabolism of Vitamin B12 and the etio- pathogenesis of B12
deficiency
PY 2.11 Estimate RBC count and interpret normal Group B
PY2.11 Estimate Hb, RBC indices and interpret
Objective :
a) Classify anaemia based on red blood cell morphology
b) Interpret RBC indices
c) Interpret peripheral smear
Aligned to multiple lectures and Practical session
75. Formative Assessment
Describe the components of blood . Outline the normal erythropoiesis and its
regulation . Enumerate disorders of abnormal erythropoiesis .
Structured
Essays
PY 2.1 Describe the composition and functions of blood and its
components
PY 2.5 Describe RBC formation (erythropoiesis & its regulation) and its
functions
PA 13.I Describe hematopoiesis and extra medullary hematopoiesis
• Describe erythropoiesis and regulation
• Explain the functions of RBC
• Discuss significance of medullary and extramedullary erythropoiesis
Multiple lectures and Practical session
An 2 year old child presents with pallor , jaundice and recurrent
transfusion requirements since 6 months of life. The child has a growth
retardation and hepatosplenomegaly . Discuss the patho -physiological
basis of this condition and explain its relation it to the clinical condition .
OR
76. Write a short note on :
Laboratory diagnosis of enteric fever
Short
answers
MI3.3 Describe the enteric fever pathogens and discuss the evolution
of the clinical course and the laboratory diagnosis of the diseases
caused by them
MI3.4 Identify the different modalities for diagnosis of enteric fever.
Choose the appropriate test related to the duration of illness
IM4.3 Discuss and describe the common causes, pathophysiology
and manifestations and diagnosis of fever in various regions in India
including bacterial, parasitic and viral causes (e.g. Dengue,
Chikungunya, Typhus)
Objectives
1. Discuss the laboratory diagnosis of enteric fever
2. Explain the significance of the tests relating it to the duration of the
illness
Multiple lectures and Practical session
FORMATIVE ASSESSMENT
77. This is the peripheral smear of 2 year old child with PICA
and a Hemoglobin of 6 gm%
a) Describe the RBC in the peripheral smear.
b) Which other RBC indices are will you order as next step
in the evaluation ?
Integrated
OSPE
PY 2.11 Estimate RBC count and interpret normal Group B
PY2.11 Estimate Hb , RBC indices and interpret
PA13.5 Perform, Identify and describe the peripheral blood
picture in anemia
PA14.3 Identify and describe the peripheral smear in
microcytic anemia
PE13.2 Describe the causes, diagnosis and management of
Fe deficiency
Multiple lectures , Practical session and clinical rotations
FORMATIVE ASSESSMENT
78. A 25 year old pregnant lady has come for routine antenatal check up .
Perform general examination for the patient.
Check list
Introduces himself to patient
Explains the procedure
Ensures patient privacy
Performs general examination looking for Pallor , Lymphadenopathy ,
Jaundice , edema , Cyanosis and clubbing
Integrated
OSCE
PA 14.1 Describe the pahtogenesis and clinical features of iron deficiency anaemia
IM 9.4 Demonstrate general examination of a patient in bed side clinics / out patient
clinic / community clinics
9.4.1 Spot / recognize Pallor in the given picture / patient in bed side clinics
9.4.2 Demonstrate Pallor in bed side clinics as a part of general examination
Multiple TL sessions Lectures / Clinical / Practical session
FORMATIVE ASSESSMENT
79.
80. Sample Time table for AIT Anemia – Phase 2
Linker here is a case of a child with anemia, blood transfusion , helminthic infestation and iron deficiency anemia
Linker gives better integration in student mind if all learning experiences including lectures , practical sessions can provide a discussion correlation with the case ( Correlation, Harden )
Feed
back
CASE
RESOL
UTION
1-3
PM
Skill
assessm
ent OSPE
Skill
assessme
nt OSCE
81.
82. Reference:-
1)https://www.slideshare.net/swanandpathak/integrated-teaching by
Dr Swanand Pathak
2) Shilpa Khullar Integrated teaching in medical education in india Int. J
Basic Appl. Physiol.,5(1),2016
; 6-14
3)https://www.slideshare.net/Poligar/integrated-assessment-in-
medical-education
4)Hedef D. El-Yassin Integrated assessment in medical education J
Contemp Med Sci, Vol. 1, No. 4, Autumn 2015: 36–38
5)Ronald M Harden The integration ladder: a tool for curriculum
planning and evaluation MEDICAL EDUCATION 2000;34:551–557
6)CISP module 4 for alignment and integration published by MCI 2019
Editor's Notes
We all products of traditional teaching. In traditional curriculum we came across all these subjects in different phases. Followed by this there was compulsory internship. I also went through this process and joined as medical officer in a hospital. I was very happy that I became a doctor. I started working with great enthusiasm.
The first case came was myocardial infarction. Everyone around me was acting very fast to save patients life. But I was totally in confusion. . I started feeling the same pain and anxiety of the patient in front of me.
Seniors started shouting at me. That made me more embarrassing. My eyes welled up with tears
Here what was expected from me as a doctor. I should be able to handle most of the things independently. Then I started thinking (what wrong has happened to me?) and the answer to this was whatever I learnt for last five and half years. I was not able to apply it in practical situations.
I learnt each subject as a compartment which is not connected with the other compartment(Other subject) regarding therotical and practical aspects. In the United States of America, silos in education was used. In this one teacher per room, every subject its own class or time frame, and every child his or her own desk! Compartmentalized, organized, safe.
Students attend a lecture on anatomy on CVS, and then move on to a lecture in physiology where they will attend lecture on Endocrinology and in biochemistry carbohydrate metabolism.
Things were not taught to us as whole disease.Every teacher taught me myocardial infarction in his compartment compartments. Similar concepts were taught but in different time frames. So it was not possible to internalize a particular topic as whole.
Whether my teacher taught me MI.Yes definitely . They all were great teachers They taught MI in bits and pieces. Every teacher was the expert in his subject. He used to deliver loads of knowledge to me. One more problem we faced teacher were trying to make us experts in their subjects delivering unnecessary loads of knowledge to us(We can call it as redundant. Which means exceeding whatever is necessary). There was lot of repetition which made learning boring.
The new curriculum proposed by MCI
Teach the concept as whole in integrated manner by breaking the barriers between to subjects.
Redundancy:- Which means exceeding whatever is necessary
Contextual learning:- is a method of instruction that enables students to apply their knowledge and skills to real-life situations
These are some ways by which we can arrange our syllabus so that student will be able to learn and able to implement his knowledge and skill in his day to day practice.
Teaching related systems or topics from different subjects in the same phase
This temporal coordination is called as alignment in the guidelines given by MCI for new curriculum.
Here you can see example of temporal coordination between all subjects of phase 2.
So this is the time table of one week having six hours per day teaching
Example given is CVS shown in green colour. If you take example of Monday All three subjects of first year can go for aligned teaching related to some part of CVS(Here you can see first four classes). But last two classes are Non aligned topics (Topics other than CVS )they are from physiology and community medicine. That means we have to give some time to non aligned topics in the time table.
Examples of Non aligned topics:-Anatomy :- Upper limb, lower limb , Physiology:- Exercise physiology, Aviation physiology, Biochemistry:- Chemistry of Carbohydrates and lipids Pharmacology:- Adverse drug reactions, Drug development.
Same thing can be followed for whole week
Similarly while teaching infectious disease you can align Pathology, Microbiology and Pharmacology.
In this time table you can see rectangles with blue and red outline. These are examples of integrated session.I will discuss this later.
Similarly you align a particular topic. Here the example is of Myocardial infarction.
Similarly you can also align a topic while teaching organ system. Here example is Myocardial infarction and Cardiovascular system.
After alignment second method is integration. It is done in limited extent.Topics in different subjects in the same phase or different phases that have similar threads will be grouped together in the timetable
Concepts in a topic / organ system that are similar, overlapping or redundant are merged into a single teaching session in which subject based demarcations are removed
. In this method we break the barriers between subjects.
To answer this question Professor Ronald M Harden proposed 11 step integration ladder. In this ladder the teaching starts as isolated teaching (Silos teaching/ Compartmentalized teaching) by each subject. But the further steps of ladder leads to integration. The success of integration depends on communication and joint planning between teachers from different subjects
From these 11 steps MCI has suggested only three steps to be used in teaching.
So let us see these methods in details.
Similarly Case of Myocardial Infarction can be used to recap the concepts in subjects like Biochemistry and Pathology while teaching Internal Medicine.
Now I want the participants to tell which subjects can be aligned or integrated to teach one of the topic.
Again the question to you is which subjects can be aligned or integrated while teaching meningitis.
Here as I am going to tell you example of creating time table of II phase I will try to include subjects from 2nd year. Then align them according to need. Then I will think which subjects can be integrated to these subjects within phase and outside the phase.
As we are making timetable of Phase II, in this table you can see digits shown in red colour tells us
About objectives that can be aligned. The digits shown in bracket tells us about the objectives that can be integrated.
e.g. In this example we can see a case which create a link between concepts of pathology, microbiology and internal medicine
So we will see some examples integrated assessment after dr prassana will give you example of making time table for particular topic in detail.
There are two types of assessments :- Formative and summative.
In traditional assessment system we were not integrating assessments .But now MCI tells us to use integrated assessments. It tells us that more integration should be there in formative assessment.
this is the example of case resolution which can be used to assess objectives in physiology and pathology related to topic anemia. It can be conducted as small group discussion in practical sessions.
This is the example of reflective writing which can be used to assess objectives in physiology and pathology related to anemia .
Here student is expected to reflect on experience taken in a particular situation (Experience is Visit to blood bank). This assessment can be conducted as reflective writing as a question in theory.
In this example of integrated assignment for iron deficiency anemia which can be used to assess objectives from Pathology, Pharmacology and Internal medicine. This can be conducted during lecture or practical session.
Similarly integrated MCQs can be conducted during lectures or practicals
Here is the example of integrated structured essay which can be used to assess objectives in physiology and pathology related to anemia. Here structured assays can be given during lectures or practical sessions
Here the example of integrated short answer on lab diagnosis of enteric fever which can be used to assess objectives from microbiology and Internal medicine. This can be conducted in lecture or practical session.
Here it is example of Peripheral smear of iron deficiency anemia. Which can be used as integrated OSPE (Objective Structured Practical Examination)in practical session.
Here the example of case of iron deficiency anemia. It can be used to asses objectives from pathology and Internal medicine can be assessed as integrated OSCE(Objective structured clinical examination) . This can be conducted in practical session.
