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

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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

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Overview

• Situation of OM training in India
• "PG Certificate Course in Occupational Health"
• Structure
• Teaching Methods Practical, Clinical
• Assessment Plan
• Evaluation

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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 2003 Certificate Course in Occupational
  Medicine and a MSc. Industrial Hygiene Safety
  as distance-learning programs

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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

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Post-Graduate Certificate Course in Occupational
Healthat SRMC in Chennai2004-2005
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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 systemeach tutor has 2 - 3 students

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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

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Practical Skills - Teaching Methods

• Technical skills
• Workplace skills
• Communication skills
• Clinical skills

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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)

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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

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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

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Selection of Patients seen

• Lung cancer
• Silicosis
• Asbestosis, pleural mesothelioma
• COPD/asthma
• Byssinosis
• Baritosis (DD silicosis)
• Eye injuries
• Lead poisoning
• Manganese poisoning

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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 Exam2 theory papers,
  practical oral exam

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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!

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Evaluation of Subjective Impact

• Questionnaire Survey
• Scale 1 to 10
• 1very poor -- -- 10very good
• Question
• "My capability was before and is now "

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Evaluation of Subjective Impact
CATEGORY "Before" "After" Average difference
Knowledge in Occ Medicine 2.67 8.40 5.73
Use spirometer audiometer 3.00 8.60 5.60
Conduct Industrial Hygiene Measurements 2.40 7.80 5.40
Professional Attitude 3.67 9.07 5.40
Use of internet 3.53 8.73 5.20
Assess risks 2.93 8.07 5.13
Advise management 2.93 8.00 5.07
Practical skills 3.73 8.60 4.87
Accident investigation 3.53 8.33 4.80
Occup disease recognition 4.00 8.67 4.67
Conduct epidemiological studies 2.27 6.60 4.33
Calculate economic impact 3.00 7.57 4.27
AVERAGE 3.28 8.26 4.96
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Thank You !!

• www.srmc-ehe.org
• NLWagner_at_web.de
• ehesrmcpg_at_hotmail.com

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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

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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