Assessment of the patient-information-communicator’s Online-learning portfolio for Dr Arti Jat March 2016

Experience:

Patients are interviewed by the learner and s/he also creates their HIPAA de-identified online-health-records that may contain their history and clinical images other than their investigations

Done and recorded in individual patient-records by Dr Arti here: https://www.blogger.com/profile/08543457215724518158

Reflection-

Here the learner is concerned with how things happen by attempting to see them from different perspectives and relying on one’s thoughts, feelings and judgement. (Reference 1)

History documented by Arun Chaudhary: 32 M

c/o - ..Fracture of Subtrochantric left femur ..
Fever since 2 days ago ..

H/O - Before 15 days ago patient slip from upstairs and fall down in rolling way ..So , it causes the fracture of left femur bone ..
Swelling is also on whole left leg ..

CLL, COPD: http://www.udhc.co.in/INPUT/displayIssueGraphically.jsp?topic_id=1375

Leg swelling se fever kaise aata hai Arun?

Like · Reply · 1 · March 25 at 11:10am

Arun Chaudhary Ni sir ..ho skta h ..vo bta rha tha k vo niche tha to usko fever ni tha but jb MMW me aaya to usko fever aaya ..isliye ..sir ...

Like · Reply · 1 · March 25 at 11:12am

Rakesh Biswas Woh MMW mein aya sirf fever monitoring ke liye. 

Like · Reply · 1 · March 25 at 11:14am

Arun Chaudhary Ohhhh sir ...but vo bta rha tha k usko yahi pe fever aaya tha ..pehle ni tha

Like · Reply · March 25 at 11:20am

Arti Jat Fracture are a stress for the body and it can be very normal to have a mild tem. In the few days only

Unlike · Reply · 1 · March 25 at 11:23am

Rakesh Biswas Yahi ka matlab uka LNMCH raha hoga Arun. smile emoticon Use fever turant operation ke baad aya tha. Arti ke hypothesis (upar jo woh keh rahi hai) ke liye koi evidence based link milega?

Like · Reply · March 25 at 11:33am

Arti Jat https://www.zocdoc.com/.../can-breaking-a-bone-cause-fever

Can breaking a bone cause fever? | Zocdoc Answers

ZOCDOC.COM

Like · Reply · Remove Preview · March 25 at 11:36am

Rakesh Biswas Thanks Arti yeh abhi bhi sirf ek kahani aur hypothesis lag raha hai (humare mareez ko lo to shayad do ho jai) par humen thoda aur scientific data chahiye hoga.

Like · Reply · March 25 at 11:41am

Rakesh Biswas Yeh article http://www.ncbi.nlm.nih.gov/pubmed/23412504thoda sa zyada scientific lag raha hai? Par kya yeh humare sawaal ka poora jawab de paa raha hai?

Incidence, risk factors, and diagnostic evaluation of postoperative fever in an…

NCBI.NLM.NIH.GOV|BY PETRETTA R , ET AL.

Conceptualization-

Here learning is achieved by rigorous thinking (reflecting), using a systematic approach to structure and frame the phenomena being experienced. Emphasis is placed on the definition and classification of abstract ideas and concepts, aiming at precise conceptual categories. (Reference 1)

Fever is often observed postoperatively particularly after fracture surgery. The postulated mechanisms may involve an immune mediated process

Action-

The learner attempts to influence people and change situations as necessary. (Reference 1)

Arti Jat K/c/ocll. With copd

C/o- breathing and cough 

O- pt. Is Stable

A - cll with copd 
P-. Nebulization 
Tab deriphyllin
Tab. Voveron
Tab. Almaxo
Tab. Aciloc
Tab. Allopurinol
Tab ultracet semi.

Like · Reply · March 25 at 10:19am

Rakesh Biswas Inka respiratory rate abhi kitna hai aur kal kitna tha yeh jan na zaroori hoga Arti unka breathing difficulty ki progress jan ne ke liye.

Like · Reply · March 25 at 10:30am

Arti Jat R.r. - 20.

Cognitive/Intellectual Action

Taking patient histories (in patient’s voice) and taking clinical images and recording them in blogs

http://udhc224.blogspot.in/2016/03/a-50-year-old-man-with-lower-and-back.html 

http://udhc223.blogspot.in/2016/03/a-68-year-old-woman-with-chest-pain.html 

Entire profile of online-records created here by Dr Arti: https://www.blogger.com/profile/08543457215724518158 

Using structured templates to record patient findings such as Mini-mental scores, depression scores, quality of life scores etc

 Arti you have written Nutrition - poor diet for this patient? Can you elaborate? Varsha maam please guide her.

Like · Reply · 1 · March 21 at 8:50pm

Varsha Shrivastava Sure sir

Like · Reply · March 21 at 11:47pm

Arti Jat Sir ho gya aj 1bje ...or varsha mam ne diet chart bi bna kr de diya

Making an optimal assessment and plan for the patient

Can be seen in individual patient records created by Dr Arti here: https://www.blogger.com/profile/08543457215724518158 

Writing an order for pharmacological therapy (only for those with a licence)

Physical/Motor Action:

Assisting in data collection not only directly from the patient’s bedside but also from the patient’s radiology, labs and procedures and documenting it with images

Done and recorded in individual patient-records here: https://www.blogger.com/profile/08543457215724518158 

Performing physiotherapy (only for those with a licence)

Done and recorded in individual patient-records by Dr Arti here: https://www.blogger.com/profile/08543457215724518158

Learning points-

These can be either based on the case or the number of learning points gained by the learner during the entire week.

Fever post fracture

Respiratory vitals assessment

Reference:

1)    Kohonen,V. 2009 Learning to learn through reflection – an experiential learning perspective. Full text downloaded on March 28^th 2016 from http://archive.ecml.at/mtp2/Elp_tt/Results/DM_layout/00_10/05/Supplementary%20text%20E.pdf

Further reading:

Methodological differences that our 'constructivist' program has with traditional programs here in this link:http://images.slideplayer.com/10/2754034/slides/slide_20.jpg

Portfolios: Learning and Assessment in Medical Education Catherine Moltzan MD FRCPC: downloaded on March 28^th 2016 from https://umanitoba.ca/faculties/health_sciences/medicine/education/pgme/media/Portfolio_Presentation_copy.pdf

Images of Portfolio Based learning: 

http://image.slidesharecdn.com/dublin2016-balancing-160323110905/95/dublin2016-balancing-2-638.jpg?cb=1458731715,

http://image.slidesharecdn.com/dublin2016-balancing-160323110905/95/dublin2016-balancing-24-638.jpg?cb=1458731715

Sample ‘patient-information-communicator’ weekly-learning-portfolios recorded here:

http://userdrivenhealthcare.blogspot.in/2016/03/assessment-of-patient-information_28.html

http://userdrivenhealthcare.blogspot.in/2016/03/experience-patients-are-interviewed-by.html

http://userdrivenhealthcare.blogspot.in/2016/03/assessment-of-patient-information.html

http://userdrivenhealthcare.blogspot.in/2016/03/assessment-of-patient-information_87.html

Sample UDHC Case-study:

http://userdrivenhealthcare.blogspot.in/2016/03/udhc-case-study-from-online-patient.html

Check-list for patient-safety near miss reporting (toward quality improvement):

http://www.jabfm.org/content/28/4/452/F1.large.jpg

http://www.jabfm.org/content/28/4/452.full