Clinical informatics in medical education: A joint venture that holds promise.

Background and Objectives:Healthcare information technology(HCIT) has potential in patient care as well as medical education, but is yet underutilized. With shortage of good clinical material, e-learning helps in supplementing a lecture/demonstration by an online tutorial. This ‘blended learning’ helps in meeting deficiencies of the exclusively traditional methods. Besides, with time constraints, there is a need for collaborative, on-line/web-based learning with a flexibility that would enable the students to learn at leisure. Methods: Seven faculty and 18 post-graduate students(residents) were exposed to the concept of clinical informatics at the BVUMC digital library, various features of Cerner Corporation’s academic education solution(AES), software from US-based company (from Bangalore). Faculty participants were trained in building clinical cases into the system, entering investigations, medications and allergy information. They were trained in usage of message centre -giving and answering assignments, accessing links to medical terminology and reference material. Students had a point-of-learning ability to access medical literature and interdisciplinary management of a clinical case. Cases were built up step by step, so students were encouraged to evaluate and opine on patient’s status and further management. Throughout the course, the system tracked and stored student performance. Results: The software was found to be effective ( significant changes in pre and post test scores). The mean scores out of 20, pre and post test were 12.389 and 14.333. Paired T test and Confidence intervals were used for statistical analysis. T-Value = -5.93 P-Value = < 0.0001, i.e there was a significant increase in the score. Of the students, 88.89% students felt that this experience motivated them for self-learning and that on-line case discussion should become a compulsory part of residents training programme. Of the faculty, 85.71% strongly felt the major advantages were 1)chronic cases-teaching, building a repository of rare cases 2)exposure of students to problem-solving and decision-making 3)flexibility of teaching sessions in terms of time. Conclusions: By adoption of an Electronic-Hospital-Records- cases fed in digital format, students can learn in a simulated environment with interdisciplinary team collaboration and integrated teaching. EMR and HCIT has the potential to revolutionize medical education.

Paget-Schroetter syndrome.

A case of primary upper-extremity deep vein thrombosis (UEDVT) or Paget-Schroetter syndrome is reported. It is effort thrombosis usually affecting young healthy individuals and is a rare condition. Our patient was an elderly male with history of exertion using the left upper limb. He responded to limb elevation and anticoagulation. No other cause for thrombosis was found.

Intra-arterial thrombolysis in acute brainstem infarct.

A young male presented with vertebrobasilar ischaemic stroke. He was given intra-arterial thrombolysis, following which he showed gradual partial recovery.