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

Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering Overview 1.Situation of OM training in India 2."PG Certificate Course in Occupational Health" Structure Teaching Methods: Practical, Clinical Assessment Plan 3.Evaluation

Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering 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

Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering 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 Post-Graduate Certificate Course in Occupational Health at SRMC in Chennai

Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering Structure 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 students

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

Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering 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 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 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

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

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

CATEGORY"Before""After" Average difference Knowledge in Occ Medicine Use spirometer & audiometer Conduct Industrial Hygiene Measurements Professional Attitude Use of internet Assess risks Advise management Practical skills Accident investigation Occup disease recognition Conduct epidemiological studies Calculate economic impact AVERAGE Evaluation of Subjective Impact

Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering Thank You !!

Sri Ramachandra Medical College & Research Institute Department of Environmental Health Engineering 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 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