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E-learning can help bridge a major gap in continuing medical education for doctors

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India’s medical education system lacks outcomes based learning (OBL) experiences for students. According to some experts, OBL has the potential for dramatic and even revolutionary changes in medical education. However, it carries with it significant challenges. Here is a company that functions on an OBL model and intends to sensitise healthcare providers in India with its benefits. Hans Albert Lewis, Founder and CEO, DocMode explains more in conversation with Raelene Kambli

What is the significance of outcome based learning for medical professionals?

In simple terms, outcome-based learning (OBL) is reverse engineering. This style of learning is based on having an end goal in mind, or what the learner is expected to deliver.
Outcome based learning (OBE) approach is need based, specifies outcomes and levels of outcomes, which shifts focus from teaching to learning.

How does Docmode fit into this space?

As our tagline goes, “DocMode – From Learning to Practice”, we are a global platform for outcome based learning (OBL). We understand the need for constant learning among all individuals in healthcare which is a field that is evolving every single day. We have partnerships and associations with leading medical schools/ universities and medical associations like ICO, Cleveland Clinic, Royal College of Physicians of Edinburgh, Indian Dental Association, FOGSI, to name a few. Our partners help to create, review and launch courses which range from diagnosis and treatment guidelines, to industry practices, learners are also encouraged to interact with the faculty via discussions boards thus helping them to better clinical acumen in their daily medical practice. Our vision is to become an integral part of the healthcare professionals daily routine with essential resources for their learning and practice

Do you think India’s medical education system needs an overhaul?

In 2018, MCI changed the syllabus after almost 21 years. This recent announcement to shift undergraduate MBBS syllabus from knowledge-based to an outcome-based course with a focus on attitude, ethics, and communication (AETCOM) is a good move towards value-based education.

But as we all know, medical developments are evolving on a daily basis, right from the discovery of new drugs and molecules, to technological advancements towards diagnosis and treatment. The present medical education syllabus is stuffed with a lot of knowledge components, in medical education terms. The medical education system needs to have a mechanism of giving and receiving feedback. We have to see what the newly formed National Medical Commission (NMC) which has been brought in to replace Medical Council of India in as law through the Parliament will do.

What are the changes that the newly constructed 33 member body of NMC should consider?

Though already quite a lot of changes have been implemented at the undergraduate level with the introduction of outcome-based AETCOM syllabus, NMC now needs to redefine the educational system at post graduate and CME level. Offer opportunities for doctors and PG students to learn via different mediums like:

E-learning – Provide incentives for learners to join unbiased e-learning courses. This will help learners to gain insights about the latest developments in that segment. Learn from industry key opinion leaders, participate in discussion forms with them, etc. Opportunities like these should be made a part of the educational system and credit should be offered to learners if they submit certificates.

Mentor and educator – Practising doctors should be motivated to become mentors for undergraduate students and PG students as well. With feedback systems, both educator and learner stand to benefit from the engagement.

Further, submission of clinical research abstracts to publications should be encouraged as this will help to create an environment of evidence-based medicine and further lead to an evolution towards outcome-based education.

How can India develop a national programme for outcomes-based medical education and research?

As mentioned in the new programme for outcome-based undergraduate medical education is been implemented across India, we hope this success paves way for PG and CMEs.

Here are some thoughts on how we can initiate taking steps towards OBE:
Documentation – One of the key elements of practising evidence-based medicine is the initiation of documentation. This further helps in developing better outcome-based learning for both the educator and the learner.

Involve public and private HCPs in education – Involve HCPs from public and private hospitals and primary healthcare centres towards the development of syllabus, invite them for industry lectures.

Compulsory research – Investigations of disease and epidemic should be a part of the syllabus, as this helps learners to analyse data, understand the life cycle of disease, understand new evolutions, and how to treat them. Further, this becomes a learning material for other learners and HCPs for future reference.

What are medical schools required to do to include outcomes-based learning?

As highlighted above, MCI has already initiated the implementation of new outcome-based learning syllabus for undergraduates. MCI and hospitals should actively encourage learners to join unbiased learning courses online. E-learning can help to bridge a major gap in continuing medical education for doctors, as this offers self – paced learning, so learners can focus on their practice and undergo training simultaneously. In addition to this, they can participate in discussions with international faculty and industry KOLs to get insights on new developments. It is high time we recognise different mediums of learning, as medicine and technology are evolving at a faster pace.

Share examples of effectiveness of outcomes-based learning in healthcare?

Though there are a lot of case studies which highlight how outcome-based learning helped to identify disease patterns and establish new guidelines for future use case scenarios, here is one case study, which is very close to me. This exactly helps us to understand how OBE can become a game-changer in medical learning.

Hyperthyroidism disorder – Thyroid diseases are common in India and the country faces a significant burden of this disease. This condition is different from other diseases in terms of diagnosis, accessibility of medical treatment and visibility of swelling. To combat this problem, the Indian Thyroid Society launched CME courses to train primary healthcare practitioners, specialists, and medical professionals to understand thyroid disease, diagnose this condition and treat it. The society also conducted surveys across India in 2015 to identify prevalence of this condition. Further, the society along with scientific publications launched guidelines to treat hypothyroidism. These guidelines now have become base to diagnosis and treat hypothyroidism, it also emphasises all adults after the age of 35, should undergo tests and these should be repeated every five years. This use case scenario highlights that if 100 people are suspected to have hypothyroidism, maybe 25 to 30 per cent are being detected, diagnosed and treated. The rest 60 to 70 per cent are still not aware of it. But now with guidelines in place, doctors are able to manage hyperthyroidism in India. We have also observed such case studies for professional learning impacting in awareness of both chronic and acute diseases among the general public.

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