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‘User driven health care':. Understanding the complexity of clinical experience through online ‘conversational learning’ networks. Bera Kaustav, 4 th Semester MBBS, Medical College Kolkata Biswas Tamoghna, 8 th Semester MBBS, Medical College Kolkata
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‘User driven health care': Understanding the complexity of clinical experience through online ‘conversational learning’ networks Bera Kaustav, 4th Semester MBBS, Medical College Kolkata Biswas Tamoghna, 8th Semester MBBS, Medical College Kolkata Biswas Rakesh, Professor, Department of Medicine, People’s College of Medical Sciences, Bhopal MEDICON, 2011, Mumbai, India
Understanding the complexity of clinical experience I NEED A DEMO!!!!!!!!! "A 23-year-old man presented to his physician with swellings behind his ear. He gave a 3 week history of night sweats, 4 kg weight loss over 3 months, multiple swollen lymph glands, and mild persistent headache. He was referred urgently to hospital." (BMJ Case Reports) BMJ Case Reports 2010; doi:10.1136/bcr.08.2009.2221
Conversational Learning A bit more details regarding the patient’s history No significant medical history Temp- 37.9°C, Pulse -84/min, BP normal, Soft, non-tender lymph nodes palpable at cervical, axillary, inguinal.. Associated fever? Characteristics? Normal Lab values provided Testicular examination Good thinking. Was Normal node biopsy no lymphoma. Reactive hyperplasia only. Bone marrow biopsy appeared reactive only too. Race? Smoking Drug history? take out one node for H/P connective tissue disease may be a possibility? Patient’s CT scan uploaded showing B/L Pl effusion & consolidation his condition deteriorated with fever, fluid retention, hypoalbuminaemia . 2 wks. into hosp. stay pruritic maculopapular rash over upper limbs The discussion continues…. Chronic Myeloproliferative Disorder ? Tiny.cc/bkdq3
AIMS and OBJECTIVES • Conversational learning toward clinical problem solving. • Web based Platform for communication between multiple levels of learners. • A Focus on Patient narrative and Empathy.
“I had returned home to England, precipitously from a trip to India, with high fevers, which rose to 105 degrees; a terse ‘Take Paracetamol’ being the only instruction from the GPs at our local clinic.” Days of fever later, my mother was finally advised by a friend to ring emergency services, and the doctor on call did not hesitate to call an ambulance. The rest, as they say, unfortunately, is history, my history
Since my eighteenth birthday I have watched this body undergo symptoms lifted off the pages of any basic book on this disease Over the years I have experienced fatigue, mouth ulcers, joint pains, lymphedema, lymphadenopathy, pleural and pericardial effusions, Sjögren's, Raynaud’s, hair loss, brain fog and depression. Not to mention the most banal of all – pain. I say banal, because it is an almost humiliating experience to have to describe pain on a numbered level of 0-10.
The term 'User' is a label that includes: • Health-professionals • Patients and their relatives • Anyone who uses the web and has a user name
Methodology • Study platforms: Web forums, Peer-reviewed journals, Emailing lists, Rural Remote Online Health Care. • Approaches : • Web based manual collection of data • Accurately modeling patient experiences • Discussions on relevant themes.
Analysing the data without stressing on numbers or statistics • Learning through free flowing conversations without any rules imposing a constant structure or narrative • Learning to solve real life clinical problems through a step by step approach
PRIMARY OUTCOMES • As a Medical Student we learn to • Unravel Key Learning Points • BY Both • Utilizing Background Knowledge • Learning to operate online search engines • Which adds to their foreground knowledge • Also prepares us for medical uncertainties beyond
SECONDARY OUTCOMES • Resources for other health professionals • Support and engagement for fellow doctors • Promotes interdisciplinary interest for life-long problem-based-online-learning These resources are essential for continuing health professional education.
No external funding received Conflict(s) of interest: Kaustav B and Tamoghna B are members of Executive Board of Tabula Rasa; Rakesh B is the editor-in-chief of IJUDH and Deputy Editor of BMJ Case Reports
ACKNOWLEDGEMENTS • Dr. Amy Price, University of Miami, USA • Dr. Carmel Martin, Northern Ontario School of Medicine, Canada • Dr. Ravi Ramakantan, Former HOD, King Edward Memorial Hospital, Mumbai, India. • Dr. Pranab Chatterjee, Medical College Kolkata, India THANK YOU