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.

Lucio leprosy with lucio phenomenon.

Leprosy is one of the commonly seen disease in any dermatology outpatient department in our country. India accounts for a major portion of the leprosy patients in the world. All types of the disease, such as tuberculoid, borderline, lepromatous, neuritic and indeterminate leprosy, are seen. However, "lucio leprosy" which is considered a special type of lepromatous leprosy characterised by diffuse involvement has not been reported from India. We are presenting here two cases of "lucio leprosy" with "lucio phenomenon", the lucio phenomenon being a special type of lepra reaction seen in lucio leprosy.