Distance-Learning Program in Occupational Medicine An Experience from Chennai/ India

1. Distance-Learning Program in Occupational Medicine An Experience from Chennai/ India Norbert L. Wagner MD, PhD Department of Environmental Health EngineeringSri Ramachandra Medical College & Research Institute Chennai / India

3. Overview • Situation of OM training in India • "PG Certificate Course in Occupational Health" • Structure • Teaching Methods: Practical, Clinical • Assessment Plan • Evaluation Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

4. Situation of OM Training in India: • Only 2 training facilities for OM in India • Output ~ 40 company doctors per year in 3-month residence program • Medical Specialty of Occupational Medicine does not exist • Distance learning has a very bad reputation and is often of very low quality • Start in 2003Certificate Course in Occupational Medicineand a MSc. Industrial Hygiene & Safety as distance-learning programs Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

5. Impact of German Development Cooperation • Center of International Migration CIM(branch of German GTZ) posts "experts": • One Safety Engineer since 5 years • One Occupational Medicine specialist since 3.5 years Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

6. Post-Graduate Certificate Course in Occupational Healthat SRMC in Chennai2004-2005 Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

7. Structure 2004-2005 • Blended course structure: contact programs + self-learning • Web-based course over one year • 3 contact programs of 9 days each (27 days total) plus 1 repetition session • Tutor system:each tutor has 2 - 3 students Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

10. Teaching Methods • Self-Learning Modules on Web: • Knowledge transfer (reading & exercises) • limited practical skills: case studies, photos • Contact Programs • Problem-solving-, team working-, communication & reporting skills • practical training: audio, spiro • clinical training: patient examinations & discussions Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

11. Practical Skills - Teaching Methods • Technical skills • Workplace skills • Communication skills • Clinical skills Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

12. Technical Skills • Small groups of 2-3 students • 24 hours (12% of CP) • Industrial Hygiene • Measurements of dust, noise & illumination, heat stress (4 hours each) • Occupational Medicine Practice • audiometry (8 hours) • spirometry (8 hours) Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

13. Teaching the skills … Checklists & Forms • Questionnaire Occupational Medical History • Checklist Hazard Identification • Checklist Chemical Safety • Checklist Manual Handling of Heavy Loads • Checklist Office & VDU Ergonomics • Checklist OSH Management System • Root-Cause-Analysis Documentation Form • Workplace Visit Report Form Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

14. Clinical Skills • Patient examination & case discussions in groups of two students • Cooperation with ESIC Hospital Chennai, "Occupational Disease Ward" with Dr. Anbarasan and Dr. Ananthan • 16 hours total (9%) • 24 Patients examined and discussed Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

15. Selection of Patients seen • Lung cancer • Silicosis • Asbestosis, pleural mesothelioma • COPD/asthma • Byssinosis • Baritosis (DD: silicosis) • Eye injuries • Lead poisoning • Manganese poisoning

16. Assessment Plan 2004-2005 • Graded assignments: 29 • Graded voluntary assignments: 9 • Checklists & questionnaires: 50 • Internal exams: closed book 6 • Web-based tests: open book 6 • Project Paper • Formal University Final Exam:2 theory papers, practical & oral exam Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

17. What Challenges Encountered? • Computer literacy & low connectivity • Self-Learning & Critical Thinking was not trained and is often actively discouraged • Book knowledge & memorizing is the traditionally goal of education • Frontal teaching by "guru" is often considered the best teaching! Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

18. Evaluation of Subjective Impact • Questionnaire Survey • Scale: 1 to 10 • 1=very poor -- -- 10=very good • Question: • "My capability was before … and is now …" Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

19. Evaluation of Subjective Impact

21. Thank You !! • www.srmc-ehe.org • NLWagner@web.de • ehesrmcpg@hotmail.com Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

22. Practical Skills Technical skills • Industrial Hygiene instruments, audiometer, spirometer Workplace skills • Checklists, Protocols, Questionnaires & Forms Communication skills • Group discussions, presentations & reports Clinical skills • Patient examinations, case presentations Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering

23. Training IT Skills • Training on computers during contact (12 hours) • Entire course is web-based Software: CourseForum™ & Blackboard™ • Websites are part of assignments e.g. ILO Encyclopaedia, MSDS • CDs are teaching materials e.g. NIOSH, ATSDR • Web-based exams are mandatory Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering