eHEALTH-July-2011-[20-26]-Revolutionising Pedagogy@ a Distance

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20 > www.ehealthonline.org > July 2011

IGNOU has been constantly contrib-uting significantly towards the educa-tion with the objective of augmenting educational avenues and for providing in-service training for medical, nurs-

ing, paramedical and allied personnel through the distance education mode. Today, it serves the educational aspirations of over 3.0 mil-lion students in India and 36 other countries through 21 schools of Studies and a network

igNoU, school of health sciences, educates students at the grass root level and provide in-service training for medical, nursing and paramedical courses through a multimedia approach

By Dr Biplab Jamatia

Revolutionising

Pedagogy@ adistance

of 61 Regional Centers around 60 overseas centers. The School is a pioneer in develop-ing competency-based programmes in vari-ous disciplines of Health Sciences. Innovative approaches in medical programmes include hands-on training, which is provided through diversified approaches of a network of colleges and districts-level hospitals.

To achieve this, the School has been col-laborating, and exchanging ideas, with vari-

ous national and international organisations like World Health Organisation (WHO), United Nations International Children’s Emergency Fund (UNICEF), Ministry of Health and Family Welfare (MoHFW), Vol-untary Organisations like ‘ACTS Ministries’, GOI, National Board of Examination (NBE), Association of Rural Surgeons of India (ARSI), Trained Nurses Association of India (TNAI), Nursing Institutes in Seychelles and

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21 July 2011 < www.ehealthonline.org <

Narayana Hrudayalaya and many other. IGNOU has adopted a multimedia ap-

proach to enable students who seek such courses irrespective of age, region or formal qualifications. The objective of IGNOU is to democratize higher education by taking to the doorsteps of the learners and pro-vide access to high quality education to all through a team of teachers called as Aca-demic Counselors.

The School of Health Sciences was set up in the year 1991. The various functions of the school are planning, developing and launch-ing of Degree, Diploma and Certificate Level Programme for various categories of health professional: health awareness courses for the general public and conducting research on health issues. The school adopts a diversi-fied approach to educate students through a three-tier system i.e. medical colleges [ Pro-gramme Study Centres(PSCs)], District hos-pitals[ Skill Development Centres(SDCs)] and the work places of enrolled doctors, provide hands in training.

There are various programmes initiated by School of Health Sciences to develop and build an infrastructure to revolution-ize career opportunities through distance learning.

Post graduate diploma in Maternal and child Health (PgdMcH)Post Graduate Diploma in Maternal a Child Health (PGDMCH) Programme is a one-year programme of 36 credits (18 credits in theory and 18 credits in practical). This programme was launched in 1997 and has undergone two revision’s. The 2nd revised programme is being implemented since Jan-

uary 2008. The number of PSCs established till date are 32.

This Programme is a comprehensive pack-age of Community Medicine/PSM, Obstet-rics and Gynaecology and Paediatrics so as to give an integrated knowledge on the MCH care. The Reproductive and Child Health (RCH) Programme, the Integrated Manage-ment of Neonatal and Childhood Illness (IMNCI) , Adolescent-Friendly Reproduc-tive & Sexual Health (AFRSH) Service, and other approaches of Government of India to improve the various morbidity and mortality indicators related to MCH care forms the part of this package. The programme aims at up-dating the knowledge and skills of practicing doctors and those placed in a peripheral set up like Primary Health Centre/Community Health Centre. The package would also be beneficial for doctors at all levels engaged in the MCH care in different capacities.

oBJectivesThe broad objectives of this programme are to:• imbibe comprehensive knowledge of

ongoing Maternal and Child Health Pro-grammes and be able to manage Health Care Services at different institutional levels;

• tacklethediseaseoutbreaksandeffectively

manage the National Health Programmes especially in relation to MCH services;

• provideantenatalcare including thoseofhigh risk pregnancy, conduct normal de-livery, handle common emergency care related to pregnancy and its outcome and identify referral situations;

• managecommongynaecologicalmorbid-ity and provide family planning services;

• providenewborncare,identifyhighriskbabies, diagnose and manage common childhood

• morbidityincludingemergencies;and• acquireknowledgeonnutritionalneeds,

assess growth and development of children and manage their respective problems.

Post graduate diploma in Hospital and Health Management (PgdHHM)Post Graduate Diploma in Hospital and Health Management (PGDHHM) Pro-gramme comprises 32 credits (18 credits in theory and 14 credits in practical) including project work. This programme aims at im-proving the managerial skills of practicing Doctors, Health Professionals and Allied Health Care Professionals working in health care professions for providing effective and efficient hospital and health care services. This programme was launched in January 2001. The number of Programme Study Centres activated at present are 23.

oBJectivesThe broad objectives of this programme are to:• acquire theoretical knowledge and

develop practical skills to apply scien-tific approach to management of peo-ple, materials, finance, communication and for organizing work and managing resources;

• learnmodernmanagement techniques

total number of the enrolled students of the various programmes

SN Name of the Programme Launched Year Number of Enrolled Students

1 PGDMCH 1997 6828 2 PGDHHM 2001 4703 3 PGDGM 2004 1443 4 PGDCC 2006 994 5 PGCE 2008 223 6 PGCOI 2008 175 7 BSCHOT 2007 618 8 PGDACP 2009 85 9 CHCWM 2006 912 10 PGDDHM

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course code course title course credits total

Theory Practical Theory Practical Credits

MME-201 MMEL-201 Preventive MCH 6 6 12

MME-202 MMEL-202 Reproductive Health 6 6 12

MME-203 MMEL-203 Child Health 6 6 12

Total Credits 18 18 36

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like inventory control; economic order quantity (EOQ), operational research and organizational development, man-agement information system etc.

• learnmethods of problem solving anddecision making and plan in advance to face the problems of hospital man-agement; and assess the clinical and non-clinical needs of patient care, and understand the administrative and

• technical requirements of physiciansand paramedical personnel.

eligiBilityThe eligibility for the different categories of the target group is:• Medical/DentalgraduatesfromaMedi-

cal/Dental institute of India or other countries recognised

• ByMedicalCouncil of India (MCI) orDental Council of India (DCI).

• GraduatesinIndianSystemofMedicine,Homeopathy, Nursing and Pharmacy recognised by the Respective Councils with three years of hospital experience.

• CandidatesholdingMBAdegreeorPGDiploma in Financial, Material or Per-sonnel Management

• Withfiveyearsofhospitalexperience.

Post graduate diploma in geriatric Medicine (PgdgM)Post Graduate Diploma in Geriatric Medi-cine (PGDGM) Programme is a one-year Diploma Programme of 32 credits (14 cred-

its in theory and 18 credits in practical). This programme was launched in January, 2004. The number of Programme Study Centres activated at present are 17. This programme will equip the practicing doctors with knowledge and skills in the field of Geriatric

Medicine and enable them to deal with the special problems faced by the elderly.

With increased expectancy of life over the years, the proportion of elderly population is fast increasing. Aging is inevitable and ir-reversible. The epidemiology and the clinical features of diseases vary in this age group and drug dosages and interactions also dif-fer. Geriatric management requires not only medical interventions but also special eco-nomic and environmental interventions. This programme aims at not only enhanc-ing the knowledge but also multiskilling the doctors so as that they can provide primary level care to the elderly.

oBJectivesThe broad objectives of this programme are to:• upgrade the knowledge and skills for

providing comprehensive health care to elderly;

• inculcate the inter-disciplinary ap-proach for diagnosing and management of geriatric health problems; and

• improve the clinical, social and com-munication skills by providing hands on training in Medical colleges and district hospitals.

Post graduate diploma in clinical cardiology (Pgdcc)India, with over a billion population requires a few thousand cardiologists to be trained.

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Theory Practical Credits

PGDHHM-001 Introduction to Management-I 3 2 5

PGDHHM-002 Introduction to Management-II 3 2 5

PGDHHM-003 Organization and Management 3 2 5 of Hospital

PGDHHM-004 Clinical, Diagnostic and 3 2 5 Therapeutic Services

PGDHHM-005 Support and Utility Services 3 2 5 and Risk Management

PGDHHM-006 Health System Management 3 2 5 Project work - 2 2


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course code course title course credits

Theory Practical

MME-004 Basic Geriatrics 6 -

MME-005 Clinical Geriatrics 8 -

MMEL-004 Basic Geriatrics - 6

MMEL-005 Clinical Geriatrics - 12

Total Credits 14 18

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Theory Practical Credits

BHM-001 Fundamental Environment and 4 - 4 Health, Health Care Waste Management Regulations

BHM-002 Health Care Waste Management; 6 - 6 Concepts, Technologies and Training

BHM-003 Project - 4 4


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Contrary to this, today we produce only around hundred cardiologists with DM/DNB qualifications. Unless we address this issue of training a large number of cardiolo-gists, especially for treating heart patients in an average district town/semi-urban area, the situation will not change much. To address this issue School of Health Sciences is devel-oping a 2-year programme for MBBS doctors in collaboration with Narayana Hrudayalaya, Bangalore. This is a 72 credits programme comprising of 30 credits in theory and 42 credits in practical. In this programme the young medical graduates will be intensively trained for two years through an extremely well structured programme. It will be imple-mented through leading cardiac institutions in the country. The programme was launched in January, 2006. The number of Programme Study Centres activated at present are 61.

oBJectivesThe broad objectives of this programme are to:• imbibe comprehensive knowledge of

ongoing Common Cardiovascular Dis-eases and be able to manage Health Care Services at different institutional levels;

• provide cardiac emergency at variousplaces i.e. smaller town, district town;

• provide services related to the Elec-trocardiography, Stress Test, Holter Monitoring, Echocardiography, Cardiac Radiology and related non-invasive services, including diabetes mellitus;

• providenon-invasivepeadiatriccardiol-ogy including peadiatric cardiac emer-gencies;

• acquireknowledgeoftheriskfactorsofthe cardiovascular diseases; and

• providepreventivecardiologyandcardiacrehabilitation services to the community.

certificate in Health care Waste Management of south-east asian countries (cHcWM)The concern for bio-medical waste manage-ment has been felt globally with the rise in

deadly infections such as AIDSand Hepatitis B and indiscriminate disposal of health care waste. The main bottleneck to sound health carewastemanagement practices is lack of training and appropriate skills to manage waste by different health carefunctionaries. To cater to the needs of health care function-aries and impart good waste management practices, a six-month, 14credits Certificate Programme in Health Care Waste Manage-ment has been developed in collaboration with WHO-SEARO. The programme has been deveoped for the South East Countries Partner Institutions (Programme study cen-tre) have already been established in Bangla-desh and Nepal. A few more centres in other South East Asian Countries are in the offing.

oBJectivesThe broad objectives of this programme are to:• sensitize the learner about health care

waste and its impact on our health and environment;

• acquaint the learner about the existinglegislation, knowledge and practices re-garding infection

• control and health care waste man-agement practices in the countries of South- East Asia Region; and

• equip the learnerwithskills tomanagehealth care waste effectively and safely.

eligiBilityDoctors, Nurses, Paramedics, Health Man-agers and others with a minimum of 10+ 2 qualification.

B.sc. (Hons.) in optometry and ophthalmic techniques (BscHot)B.SC.(Hons.) in Optometry and Ophthal-mic Techniques (BSCHOT) is a four-year degree programme and is aimed to develop a multipurpose ophthalmic manpower in the country. This programme comprises of 128 credits (52 credits theory and 76 credits practical). This programme was launched in July, 2007. The number of Programme Study Centres activated at present are 19.

oBJectivesThe Programme has been launched with broad objective of training the students in optometry various ophthalmic procedures. After going through this programme the

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course name of the course credits of credits ofcode theory courses Practical courses

MCC-001 Fundamentals of 4 – Cardiovascular System-I

MCC-002 Fundamentals of 4 – Cardiovascular System-II

MCC-003 Common Cardiovascular 6 – Diseases-I

MCC-004 Common Cardiovascular 4 – Diseases-II

MCC-005 Common Cardiovascular 4 – Diseases-III

MCC-006 Cardiovascular 4 – Epidemiology

MCC-007 Cardiovascular Related 4 – Disorders

MCCL-001 Cardiovascular Evaluation-I – 8

MCCL-002 Cardiovascular Evaluation-II – 6

MCCL-003 Management of Common – 10 Cardiovascular Diseases

MCCL-004 Management of – 4 Congenital Heart Diseases

MCCL-005 Preventive Cardiology – 8

MCCL-006 Intensive Coronary Care – 6

Total 30 42

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students shall be able to:• assisteyespecialistsinbigeyehospitals,

eye care health units, etc., as refraction-ists, orthoptists, theatre assistants and refractionists;

• get themselves self employed as opti-cians, optometrists and refractionists;

• estimateerrorsofrefractionandbeableto prescribe glasses;

• maintainophthalmicappliancesandin-struments; and

• assess ocular motility disorders andprescribe adequate treatment including eyeball exercises.

eligiBilityThe candidates should have passed 10+2 ex-amination of CBSE or equivalent with Eng-lish, Physics, Chemistry, and Biology with at least 45% marks.

Post Graduate Certificate in Endodon-tics (PGCE) Programme is a one-year Cer-tificate Programme of 30 credits (14 credits

theory and 16 credits practical) developed by IGNOU in collaboration with Dental Council of India (DCI). This programme has been launched from July, 2008. Fifteen Programme Study Centres are activated. This programme will equip the practicing doctors with enhanced knowledge and skills in the field of Conservative Dentistry.

oBJectivesThe broad objectives of this programme are to:• enhancetheknowledgeandskillsinthe

field of conservative dentistry.• beabletoassess,diagnoseandmanagethe

cases which require specialized interven-tions in the field of conservative dentistry.

Post graduate certificate in oral implantology (Pgcoi)Programme of 30credits (14 credits theory

and 16 credits practical) developed by IG-NOU in collaboration with Dental Council of India (DCI). This programme has been launched from July, 2008. Twelve Pro-gramme Study Centres are activated. This programme will equip the practicing doc-tors with enhanced knowledge and skills in the field of Oral lmplantology.

oBJectivesThe broad objectives of this programme are to:• enhancetheknowledgeandskillsinthe

field of oral implantology.• beable toassess,diagnoseandmanage

the cases requiring dental implants.

Post graduate diploma in acupuncture (PgdacP)Acupuncture is a traditional method of therapy which is very well recognized world over and well accepted by the people as it does not have any side effects. This method has been found to be useful in all types of diseases specially the chronic diseases. Moreover the cost of the treatment is less as compared to the other systems of medicine. Post Graduate Diploma in Acupuncture is the first medical programme which is being offered online. The programme is the one year duration and it aims to help graduates of different systems of medicine to learn a new therapy and utilize it for patient benefit in treating acute and chronic diseases.

There are many more initiatives and new courses are to be launched from next ses-sion onwards. Students in the peripheral ar-eas look forward for such this flexible mode of education which has further helped them to prepare and appear in exams as per their convenience. Such an approach to educate students through technology and other multimedia modes of teaching has brought people closer.

As a world leader in Distance educa-tion, IGNOU has further set an example to be one of the most prestigious institutions to provide medical courses through high end academicians and professors. In January, 2010, it was listed 12th in the webmetric ranking of Indian Universities, based on the caliber of its presence on the internet.

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course code course title theory/Practical credits

MDT 001 Fundamental of Endodonitcs Theory 4

MDT 002 MDT Clinical Endodontics I Theory 4

003 MDTL 001 Clinical Endodontics II Theory 6

MDTL 002 Practicals of Fundamentals of Practical 6 Endodontics

Practicals of Clincal Endodontics Practical 10

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Course I Basic Theory of TCM

Course II TCM Diagnosis

Course III Accupuncture and Meridians

Course IV Accupuncture and Moxibustion Treatment

Course V Scalp an Ear Accupuncture

Course VI Treatment of common disease by Accupuncture

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course code course title theory/Practical credits

MDT 004 Fundamentals of Oral Theory 8 Implantology

MDT 005 Advanced Surgical, Theory 6 Implantology

MDTL 004 Practicals of Oral Implantology-I Practical 8

MDTL 005 Practicals of Oral Implantology-II Practical 8

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Indira Gandhi National Open Uni-versity (IGNOU) offers post Gradu-ate Diploma in various medical specialties. The theory material is developed in a self instructional

style and the practical training is provided through contact sessions conducted in tertiary and secondary health institutions through a three-tier hands-on-training model which not only provides flexibility in pace and place of learning but also ensures that after completion of the training proc-ess, a student can actually practice the skills with confidence in his own work environ-ment. In addition, this three-tier system has integrated the pedagogy of skill learning and has ensured that the benefit of both, group learning and one to one learning is given to the students.

the ModelThe model describes the implementation of practical component in three steps at three levels. The tertiary level infrastructure (Medical College) where the academicians

skill training Process in Medical Programmes of ignou

could be involved as counselors conveys the second step of learning process. Second, the involvement of secondary level health infrastructure (District Hospital) where the subject specialists could help the students in repeatedly performing the skills and thus guide them practicing the skill that are taught in tertiary level. Third, the student performs his job at the primary level health setup. This could also be a clinic/health set up run by the student himself where the stu-dent tries to practice the learned skills with-out any supervision. In IGNOU parlance, these three levels are called as prorgramme study centre (PSC), Skill Development Cen-tre (SDC) and Work Place (WP) respectively. For administrative purpose, the programme study centers are linked up with the Re-gional Centres (RCs) which are a part of the IGNOU establishments. The PSC becomes the nucleus of programme implementation process. The Programme In-charge (PIC) is stationed at the PSC. He/she is normally a permanent faculty of the medical colleges with additional responsibilities of being the

PIC. He will primarily be monitoring the learning process of all students enrolled in his institution with the help of other coun-selors. The students will be required to come here to attend the contact sessions in theory and practical. The end assessment examina-tion would also be held here. Every student has an opinion to select his nearest SDC. The number of SDCs is not fixed. There could be as many SDCs as the number of students. SDC is selected as per the guidelines where students are allowed to practice the skills under supervision. At work place, the stu-dents will practice the skills without supervi-sion so that enough number of patients are examined by them before appearing in the termend examination for certification.

implementation Process of Practical componentEvery course has a practical component. The skills that the students need to learn under each course are listed in their programme guide. The skill training is divided into three parts i.e. training at PSC, training at SDC and

steps of learning implementation Process the Model

Text Reading Self Instructional Material Distance Education Setup

Demonstration with Discussion Programme Study Centre Tertiary Health Setup

Practice Under Supervision Skill Development Centre Secondary Health Setup

Practice for Self Confidence Work Place Primary Health Setup

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training at Work place. The students have to maintain record for each case as mentioned in their practical manual. For all the three places, the time division against each skill is also mentioned in the practical manual. At the PSC, students are demonstrated each skill. To ensure that they have understood the steps involved in each of the skills dem-onstrated, they should also practice the skills on at least one of the sample cases. If they get opportunity, they are allowed to practice the same skill on more number of patients at PSC. However, if they do not get more chances, they practice the same procedure at their allotted SDC.At the SDC, the students practice all the skills taught to them at the PSC. To guide them, there are counsellors at SDC. Depending upon the programme students has to perform the activities him-self under the supervision of the counselor. Guidelines are given to ensure that the minimum of patients/activities are practiced at SDC. Similarly, a student has so do un-supervised activities at the work place. These activities are recorded in the logbook.

log Book MaintenanceThe students are supplied with logbooks. This helps to ensure that the skill training is imple-mented in a standardized manner throughout the country. The logbooks are countersigned

by the counselors of medical college/SDC so that the learning defects of the students are identified in time and reinforcement of training could be provided. The programmes where logbooks are not supplied, major head-ings/formats for recording the activities/case records are provided in the practical manu-als. Students are required to write down the details of procedures. They have to maintain record for all the cases they perform at SDC and the work Place.

In some programmes, logbooks carry a weightage of 10% marks in the final evalua-tion. This further enhances the regularity of maintenance of logbooks by students.

teleconferenceIn the teleconferencing sessions, subject experts are invited to deal on various sub-ject areas as marked for that session. While dealing with the theory component, prin-ciples/concepts dealt in different units are highlighted and the questions arose by the students are replied with the help of exam-ples so that they could link them to practi-cal activities. In the practical component, important clinical examination procedures are dealt with and attempts are made to deal with rare patients and where possible, show them live or get video clips. Discussions are also generated with the help of models or with the video clips of five to ten minutes on certain procedures. Attempts are also be made to make model case presentation, case discussion and simulate clinical rounds/ seminars. Most of the presentations follow the format of panel discussion or lecture demonstrations. Attempts are made to link the practical spells with the teleconference dates wherever feasible. This increases the participation of students. Some of the tel-econference sessions are also recorded so that students missing important sessions could go through these cassettes.

evaluation of studentsStudents undergo evaluation both in theory and practical component. In theory, the internal assessment is done through tutor marked assignments having weightage of 25 to 30%. In term-end examination, the weightage is 70%. In practical examina-tion, the internal assessment varies from 30 to 50%. It is essential to pass in the in-ternal component so as to become eligible

for term-end examination. The term-end examination includes long case, short case, spots and viva-voce. 50% of the examiners are external examiners. This helps to main-tain standard of the examination process. The framing of the examination questions, checking of the answer sheets are done by a panel of examiners of respective special-ties. Thus, at all levels of evaluation of a student professional quality is given prime importance.

MonitoringTo ensure proper implementation of the programme monitoring is done at three levels. Feedback from the peripheral setups (Skill development centres) is collected by the regional consultant who in turn sends bimonthly reports to programme coor-dinator. Feedback at state level is taken in the Regioanl Health Sciences Advisory Committee (RHSAC) meeting held one to twice a year. At the school level, feedback is collected directly from the students and counselors through performa that are incor-porated in the programme guide. Time to time feedback is also collected in structured performa from the Programme In-charge, Regional consultant, Regional centres. In addition, feedback is also collected in every 4-5 years while revising and updating the programmes. The regional health sciences advisory committee (RHSAC) is formed in every state which has the members from state health departments, Medical College having the PSC, Regional centre of IGNOU and the School of Health Sciences. As all the persons involved in the programme implementation meet together, the hurdles in implementation process are identified and the remedial measures are taken. This committee thus helps to streamline the im-plementation of practical component at all levels. The Regional Consultant is usually a retired medical person having a personal rapport at state level. This helps to promote the health programmes in states and win the confidence of professional colleagues as well as the state Governments. Health be-ing a state subjects the regional consultant’s personal efforts makes significant impact on popularising the programmes. The regional consultant by physical supervision to SDCs in the state ensures proper hands on training at peripheral level.

The regional health sciences advisory committee (RHSAC) streamlines the implementation of practical component at all levels to promote the health programmes in states by ensuring proper hands on training at peripheral level

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eHEALTH-July-2011-[20-26]-Revolutionising Pedagogy@ a Distance