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KERN’S SIX STEP APPROACH
CURRICULUM DEVELOPMENT
REDUCING THE PREVALENCE OF
ANEMIA IN ANTENATAL CASES
RED BLOOD
RED BLOOD
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Dr. G.Bhuvaneswari
Dr. John Mathew
Dr. Milind V. Bhutkar
Dr. P.Rajavel Murugan
Dr. Tripti Merial Jacob
Dr. Umapathy Sembian
Dr. K.M. Mythreyee
MENTOR
Dr. BLESSED W
STEP I
PROBLEM IDENTIFICATION
• To reduce maternal mortality due to anemia
• To improve pregnancy outcome
STEP I
IMPORTANCE OF THE PROBLEM
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Preventable cause of Maternal Mortality
Anaemia causes 40% of MMR
2/3rd increase in perinatal mortality
Increase in incidence of IUGR
Decrease in inter generation growth
STEP I
GENERAL NEEDS ASESSMENT
CURRENT APPROACH
No definite strategy to address awareness,
diagnosis and preventive aspects.
No training / orientation on anemia in pregnancy
for CRRIs
STEP I
GENERAL NEEDS ASESSMENT
IDEAL APPROACH
• CRRIs should be more aware of anemia
complicating pregnancy.
• They should have more knowledge and training
in diagnosis and preventive aspects of anemia.
• Antenatal women should be motivated for
prevention of anemia and nutritional therapy
STEP II
TARGET NEEDS
Target - CRRIs
Pre test questionnaire to know the level of
awareness and knowledge about diagnosis,
prevention and management of anemia in
pregnancy
Step III
GOAL
• To reduce prevalence of anemia in
antenatal cases
STEP III
OBJECTIVES
• To conduct training session for all CRRIs
posted in OG department
• To impart knowledge on anemia to all
CRRI and make them competent to treat
• To create awareness on prevention of
anemia to antenatal mothers through
CRRIs
STEP III
COMPETENCY
At the end of internship CRRI
should be efficient to
diagnose and manage
anemia in pregnancy
STEP III
SLO
SLO
TL
METHOD
EXPERT
ASSESSMENT
After the
training CRRI
should be able
to diagnose
anemia in
pregnancy
Lecture, case
demo, clinical
discussion
Gynaecologist
Post Intervention
questionnaire
Haemoglobin
estimation by
sahli’s method
Practical
Clinical
demonstration pathologist
Able to counsel / Role play
reassure the
relatives in
severe cases
Physician
OSPE
OSCE
STEP IV
EDUCATIONAL STRATEGIES
DERIVING THE CONTENT
• WHO GUIDELINES
• ICMR GUIDELINES
STEP IV
EXPERTS/RESOURCE
• PHYSICIAN
• OBSTETRICIAN
• COMMUNITY MEDICINE FACULTIES
STEP IV
EDUCATIONAL STRATEGIES
Time table
DAY
SESSION
T-L METHOD
RESOURCE
I
2PM-3PM
LECTURE
PPT
OBG
II
3PM-4PM
LECTURE
PPT
PHYSICIAN
II
11AM-12.30PM
CASE DEMO
OBG
III
11AM-12.30PM
CLINICAL
DISCUSSION
OBG
IV
11AM-12.30PM
CLINICAL
DISCUSSION
PHYSICIAN
V
2PM-3PM
PRACTICAL DEMO
CLINICAL
PATHOLOGIST
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VI
ASSESSMENT
OSCE, OSPE
STEP V
CURRICULUM ORGANIZATION
SECURING RESOURCES
All Assistant Professors in 3 dept - trainers
All Professors
- assessors
Facilities
Lecture in seminar hall
Discussion in clinical annex
Projectors with screen
Chalk board in clinical annex
STEP V
CURRICULUM ORGANIZATION
SUPPORT
• Obtain permission from Dean
• Concurrence of HODs of Medicine, O&G
and community Medicine
• Get support from colleague Asst
professors
• Motivate CRRIs
Step V
CURRICULUM ORGANIZATION
Barriers
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TIME FACTOR FOR FACULTY AND CRRI
CONSENT FROM THE PATIENT
SUPPORT FROM ADMIN
AV AIDS
STEP V
CURRICULUM ORGANIZATION
Implementation
Phase in -
from 2nd week of OG posting onwards
in AN clinic
Antenatal clinic in Primary Health
STEP VI - EVALUATION
SHORT TERM – REACTION
QUESTION
INDICATOR
DATA SOURCES
DA TA
COLLECTION
METHODS
ARE THE CRRI
CAPABLE OF
ANSWERING
QUESTIONS?
80%CRRI SHOULD
GIVE CORRECT
ANSWERS
CRRI
POST
INTERVENTION
QUESTIONNAIRE
STEP VI - EVALUATION
INTERMEDIATE TERM - TRANSFER
QUESTION
INDICATOR
ARE THE CRRRI 80%OF
CAPABLE OF
RESPONDERS
TREATING AND
INCORPORATING
NUTRITIONAL
MODIFICATION
TO PREVENT
ANEMIA??
SOURCE
DATA
COLLECTION
METHODS
TRAINED
GROUP
QUESTIONNAIRE
- EMAIL
STEP VI – EVALUATION
RESULTS
INDICATOR
DATA SOURCE
50% REDUCTION AN REGISTER
IN PREVALENCE
DATA
COLLECTION
METHODS
REGISTRY
SURVEY
PROCESS EVALUATION
• HAVE WE TRAINED TO DIAGNOSE
ANEMIA??
• ARE ALL THE TARGET GROUP CONFIDENT
ENOUGH
TO TREAT ANEMIA???
• ARE ALL THE ANTENATAL WOMEN CLINIC
AWARE OF ANEMIA AND PREVENTION???