HAND BOOKS FOR FELLOWSHIP IN HIV MEDICINE COURSE
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- Title
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HAND BOOKS FOR FELLOWSHIP
IN HIV MEDICINE COURSE
- extracted text
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FACULTY DEVELOPMENT
PROGRAMME
HAND BOOKS FOR FELLOWSHIP
IN HIV MEDICINE COURSE
CMC - RCSHA PROGRAMME
CHRISTIAN MEDICAL COLLEGE
2005
FACULTY DEVELOPMENT PROGRAMME
*
HANDBOOK ON SELECTION PROCESS
FOR
FELLOWSHIP IN HIV MEDICINE
CMC, Vellore
Index:
SI. No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
A
Title
Introduction
Instructions for preparation of a flyer
Instructions for preparation of prospectus and application form
Instructions for advertisement for course
Instructions for dispatch of application forms
Instructions for receipt of application forms
Instructions for selection process
Template for a flyer
Template for a prospectus
Template for the application form
Application review checklist
Data base for application received
Instructions for evaluation of the application forms
Mark sheet to evaluate the application form
Guidelines for scoring of the application form
Tracking sheet of the application forms
Tracking sheet for evaluators
Database of marks scored
Guidelines for selection committee meeting
Letter to unsuccessful candidate
Letter to successful candidate
Data base of selected candidates
Page No.
1
2
2
3
3
3
4
5
6
10
26
26
27
28
29
31
32
33
34
35
36
41
4
1
Introduction:
This hand book is a guide to the selection process for the Fellowship in HIV Medicine. It is
suggested that each core team modifies and adapts the process to meet their local needs. In the
following pages you will find the details of the process of selection. Sample templates of letters and
forms are included.
__________ Steps in selection process
Preparation of a flyer________________
_________
Dissemination of information and developing networks
Preparation of prospectus and application
Advertisement for the course
Dispatch of prospectus and application forms
Receiving applications
Last date for receiving application forms
Processing of application forms
.
Selection committee meeting
Announcement of selected candidates
____
Commencement of course________
Suggested Timeframe
By August 31 2005_____
Through September 2005
By September 20z 2005
By October 20,2005____
By October 20, 2005
October-December
By December 4 2005
By December 16 2005
By December 18 2005
By December 20 2005
By February 27 2006
2
Instructions for preparation of a flyer
Dissemination of information and developing networks - by August 31, 2005
1. Study the draft flyer (see page 5) which was prepared for the CMC course.
2. Modify, adapt and finalise to your local needs
3. Prepare an address list for dispatching the flyer
This list needs to include:
State AIDS societies
IMA lists of doctors
Government hospitals
NGOs and community based organizations
State and regional networks
List of alumni of your own institutions
E-groups for dispatch of flyer
Conferences and meetings where they may be distributed
This list needs to be extensive and comprehensive and the dispatch should probably be at least
300-500 mailings.
4. Dispatch of flyer to mailing list
5. Prepare a list of individuals and organizations to be personally contacted. Follow up the
mailing with a personal phone call
Instructions for preparation of prospectus and application form - by September 20,2005
1. Study the prospectus and application form prepared for the CMC course, (see page 6 & 10)
2. Modify and adapt to your local needs. It will have to go through several drafts before
finalizing.
3. Before finalizing the prospectus and application form you need to:
a. Confirm the dates and timings of your contact courses I-IV.
b. The dates of starting and completing the course are fixed for all the four regional training
centres.
c. Prepare the list of your course faculty.
d. Ask the members of your core team to study these (prospectus, application form, dates and
faculty list) and obtain their suggestions.
e. Request a careful proofing of the prospectus and application.
a
f. Send a copy of the prospectus and application to Course organizer, DLC (CMC) and RCSHA
for final approval.
Request administrative approval from your Dean.
g- TxLllLlx, - Decide on the format and layout. Prepare a print proof and carefully proof read it.
4. Printing Decide on the number of copies to be printed. We suggest that you print about 300 - 500 copies
of the prospectus and application forms.
u i.
r
.__
r
—
—
J
and
application
form
for
up-load
on
the
CMC
and
RCSHA
websites,
5. Send the prospectus
list for dispatch of prospectus and application forms.
6. Prepare address
i
4
3
Instructions for advertisement for course in papers, magazines and journals - by October 20, 2005
Prepare advertisement for course in:
Local and regional dailies
Medical journal and magazines
E-groups
We suggest the advertisement be timed coincident with the release of your prospectus.
Instructions for dispatch of application forms (October - December 2005)
1. It is suggested that the training officer be responsible for dispatch of prospectus and
application forms.
2. Set up the system for dispatch of the application forms which is specified below.
3. S/he needs to maintain a file of addresses and correspondence related to the dispatch.
4. The prospectus and application forms are sent initially to the prepared list of addresses (which
may include about 100 addresses).
5. A process of quick dispatch of application forms in response to letters, e-mails and telephonic
requests needs to be planned.
Instructions for receipt of application forms (see page 26) (October - December 2005)
1. Set up the system for receipt and review of the application forms.
This should include:
a. Mail receipt of the application
b. Enter into list of applications received.
Review of"the application for all requirements - based on minimum requirements
c. ]
2
d. Filing of _applications
- accepted and rejected applications
Reply to rejected applications indicating deficiency and hold the application form disqualified
e. 1
till missing requirement is received.
f. Assign a roll number for each of the accepted application forms and file them carefully.
g. Make a list of the applicant's name, address, contact number, e-mail id and organization /
institution represented, against their roll number on an Excel sheet.
h. Prepare a photocopy of the application in a separate file.
4
Instructions for selection process
1. Finalise the details of the process of selection and dates.
a. Selection criteria
b. Selection committee
c. Final selection process
Identify a selection committee of at least 5 persons. The committee should include the course
organizer/s, one other member of the core team, a member of the faculty who is not on the
training team and the Deans' representative and RCSHA representative.
d. Dates for selection meeting
2. Plan a meeting with core team to finalise the selection process and criteria for selection.
3. Brief the selection committee members individually regarding the selection process.
4. Divide the original applications into 5 files to enable all the five committee members to
simultaneously evaluate the applications.
5. Prepare files for individual selection committee members with marking forms (see page 28).
6. Prepare a schedule for marking of the individual committee members with a tracking file (see
page 31 & 32)
7. Collect all the individual committee members marks and collate (see page 33)
8. Prepare for the selection committee meeting (see page 34)
9. Following the selection committee meeting, prepare the final list of successful applications.
10. Send letters first to successful candidates with agreement forms. Inform successful candidates
also by e-mail.
11. Following this send letters to unsuccessful candidates.
5
TEMPLATE FOR A FLYER
FELLOWSHIP IN HIV MEDICINE
With the progressive spread of the HIV epidemic in India, the need for HIV clinical services is
increasing many fold. The care of HIV patients is also hampered by the reluctance of health
professionals totake care of affected patients. As a result of this, doctors and hospitals involved
Xxxxlx^iToffeJSga one year clinical training Fellowship in HIV Medicine for doctors at a secondary
care level to address these deficiencies. Keeping in mind the time constramts of practising doctors,
this course consists of distance education, local projects and 6 weeks of contact at Vellore, m four
short parts Our approach is to select doctors who are already mterested and involved m HIV ca ,
upgrade their knowledge and skills in this field and to work with them to improve the capacity of
their hospitals in HIV care.
Course eligibility: MBBS qualification, interest in HIV care, employed in a secondary hospital (small
or medium size hospital or clinic) in India; doctors working with NGO's and m community care
projects will also be considered. Doctors from both non-governmental and governmental
Sfertton^criteria6; Experience and interest in HIV care, the capacity of their institution to ^Jertake
HIV care, a pr^jectoutline and the administrative support of their institution. Course fac ,_t£
xxxxxxxxx
irse consists of 4 contact programs at xxxxxxxx of 6 weeks
Course structure (1 year duration) 'The course
(16 modules over 4 months) and project work of 6 months
duration in total, distance learning course (
duration.
Contact courses- During the contact courses at xxxxxxx, the students will have hands-on clinical
enhance networking within their group.
Distance course: Hre distance learning modules are carefully
caretudy organised to f.cilimte acl.ee ieanung
aXheaseSd excercises, reflection on practice and constant feedback
improve its quality and utilisation, in p J
H
testing infection control and staff
xxxxxx faculty to develop outpatient, in-patient care, HIV testing, mtec
education.
February 27, 2006. The prospectus and application form
Next course: The next course will begin on ....
may be obtained from: xxxxxxxxxxxxx E-mail- xxxxxxx
The prospectus and application form may also be downloaded from xxxxx
The last date tor submission of applications is December 4, 2005.
6
TEMPLATE FOR A PROSPECTUS
FELLOWSHIP IN HIV MEDICINE
INTRODUCTION:
With the progressive spread of the HIV epidemic in India, the need for HFV clinical services is increasing. To
address this need, a group of trained health professionals equipped to take care of HIV patients is required. However for
most practising doctors today, HIV medicine was not a part of the curriculum at the time of their training. Also,
knowledge and practices in this field are steadily changing requiring constant updating. Currently there are very few
training programmes suited to the needs of practising doctors for upgrading their knowledge and skills in HFV care.
This one year Fellowship in HIV Medicine is the response to address these deficiencies. Keeping in mind the time
constraints of practising doctors, this course consists of distance education, local projects and 6 weeks of contact at the
center, in four short parts. Our approach is to select doctors who are already interested and involved in HIV care, upgrade
their knowledge and skills in this field and to work with them to improve the capacity of their hospitals to care for HIV
affected patients.
THE OBJECTIVES OF THE TRAINING COURSE
(i)
To enable the participants to improve their knowledge and skills in HIV care.
(ii) Enable the practical development of accessible and high quality HIV clinical services in their hospitals.
EDUCATIONAL APPROACH
By a judicious combination of contact programmes, distance courses and project work, the course is designed to
allow participants to continue their regular work and learn within the context of their own practice. Detailed work plans
will be designed for each participant, according to his or her own time constraints and work schedules. The faculty will
guide and support the participants through regular e-mail and telephonic contact. Learning resources for the project will
be provided as part of the training.
ELIGIBILITY CRITERIA
(i)
MBBS
(ii) Employed in a secondary hospital (small or medium size hospital or clinic) in India; doctors working with NGO’s
and in community care projects will also be considered. Doctors from both non-governmental and governmental
organisations are eligible.
(iii) Participants should have demonstrated an active interest in HIV care; preference will be given to those already
involved in HFV care.
(iv) Priority will be given to applicants working in and around this geographical region.
4-
(v) Commitment to develop and implement a clinical care project in tlieir hospital. (The candidates have to submit their
broad plans for such a project as Part B of the application form. Participants will be guided in developing and
implementing this project during the course.)
(vi) Support from the administration of the hospital/organisation for undertaking the course and implementing the
project. The Medical Superintendent or Senior Administrator/ Physician of the hospital must nominate the candidate.
(vii) Participants are required to identify a local project guide within their institution or from nearby who will provide
local guidance during the project planning and implementation.
SELECTION
The candidates will be selected on the basis of the information in their application, according to the following
criteria: (a) experience and academic qualification of applicant; (b) applicant’s interest in HIV care; (c) capacity of the
institution to undertake HIV care; (d) quality of the project outline; and (e) administrative support from the institution.
COURSE DURATION: 12 months (February 27, 2006 - February 26, 2007)
STRUCTURE OF COURSE
1.
First Contact Course (CC-I) at the center of 6 days duration for all participants, February 27 - March 4, 2006.
2.
3.
Distance Learning Programme (DC) of 12 modules from March to June 2006.
Second Contact Course (CC-II) at the center of 2 weeks duration. This will be in groups of 7 participants each,
4.
between March and April 2006.
In-service training (CC-III) at the center of 2 weeks duration between July and October 2006 m groups of three
5.
students each.
Project Implementation Phase (PP) of 6 months from August 2006 to January 2007.
6.
Fourth Contact Course (CC-IV) of 5 days duration in February 2007.
CC-r course orientation, basic clinical skills training, introduction to distance learning, computer skills accessing
educational resources, project management skills and role of an HIV physician. Development of the outline of the project
CC-lT development of clinical skills through practical exposure to clinical care at the center; development of project
Sirh^dsirdid^^
a registrar in the in-patient and outpatient service. The student will have an
^dualised curriculum plan to meet their training needs. This will include a requisite number of patient work-ups, case
S^r“Xc^ and theory assessments, discussion of future plans and
networking between participants.
at the development of requisite knowledge for clinical
of case based problems, reflection on practice and regular feedback.
1. HIV and the nervous system
2. HIV and women
3. HIV and children
4. Safe blood banking
5. HIV and fever
6. Infection control and exposure prevention
7. HIV and the gastrointestinal system
8. STIs, RTIs and HIV
9. HIV: Basic science and laboratory testing
10. Psychological care of HIV infection
11. Anti-retroviral treatment
12. HIV and the respiratory system
Each module will consist of:
• Case based activities
• A tutor marked assignment
• Reading and references
Each module will require about 6 hours of work and has to be completed within one week. They will be sent to
the participants in advance. Participants will work through the module and submit a tutor-marked assignment by post at
the end of the week. The submission of the assignment will be an essential requirement for completion of the module.
PROJECT PHASE (duration 6 months)
The object of including a project in this course is to strengthen and supplement the HIV care services in the participants’
hospitals. By the end of the course, there would be available for the hospital/institution an adequate and functioning
system with the following minimum components, appropriate to the local context:
• Outpatient clinic
• Inpatient care
• HIV testing
• Infection control and exposure prevention system
• Counselling
• Staff education
The basic project plan must aim at ensuring these facilities.
Depending on the level of care and local health needs, the project may also include:
• Education of GPs
• Networking with local health care providers
• Development of an HIV policy
• Setting up of an HIV team
• Home based care
• Networking with community organisations
• Needle exchange programme
involved in HIV care
The basic outline of the project must be submitted as part of the application. One faculty member will guide the
participant in project planning and implementation. The participant will submit the detailed project outline at the end of
CC-I, and the detailed project proposal during CC-II. The project proposals will be reviewed and approved. The
participant would implement the project during the project phase. The supervising faculty will provide on-going guidance.
The student will submit two interim reports during the project phase and one final project report during CC-IV.
REQUIREMENTS FOR COURSE COMPLETION:
a) Completion of requirements of the contact and distance courses;
b) Implementation of a clinical care project; and
c) Satisfactory performance in theory and practical assessments at the end of the course.
TIME COMMITMENTS
Participants are required to attend CC-I, CC-II, CC-III and CC-IV at the center. The total time requirement for contact is a
total of 6 weeks. In addition they will need to spend about 6 hours every week for course related work during the entire
period of the course. During the last month of the course they may require additional time at their local institutions to
prepare their final project report and prepare for the theory and clinical examinations.
ASSESSMENT SYSTEM
The participants will be evaluated on the basis of their completion of the contact courses, the distance learning course,
project work and the final examination that includes theory papers, OSCE, practical assessment and project presentation.
OUTCOMES
The participants who fulfill the requirements of course completion will be awarded the Fellowship in HIV Medicine
from the regional training center certifying their proficiency in HIV care.
They will have the knowledge and skills to develop a comprehensive clinical care service.
The HIV clinical care service of the participant’s hospital would have been significantly enriched through the project
implemented as part of the course.
They would become part of a mutually supportive HFV care network through the contacts developed.
AWARD
A certificate of Fellowship in HIV Medicine will be awarded to the participants on completion of the 6 weeks of contact
courses, acquiring a pass grade on the tutor marked assignments, completion of the project work and perform
satisfactorily in the theory and practical assessments.
IMPORTANT DATES
Applications must reach the center by December 04, 2005.
Selected participants will be informed by December 20, 2005.
Contact Course I to start on February 27, 2006
COURSE FACULTY
10
TEMPLATE FOR THE APPLICATION FORM
FELLOWSHIP IN HIV MEDICINE
2006
APPLICATION FORM
Instructions:
Complete, typed applications, along with all supporting documents, must be received by December 04, 2005.
The completed application should include:
1. Completed and signed Application Form
2. Parts A and B
3. Part C to be attached in a sealed envelop
3. Curriculum Vitae
4. Photocopy of degree certificates
5. Photograph of the applicant
Submit materials by registered post/courier to:
Course Coordinator,
Tel:
E-mail:
Ext.
FAX:
(Electronic submission through e-mail is also advised, followed by completed application by registered post)
Additional application forms are available on the website:
Please review the summary below that describes each part of the application.
1. <Complete each part of the application form within the space provided.
as a PDF
2. If you prefer to work onl a word processor, the application form may be downloaded
file, completed on your computer and then printed out.
Ensure that your name and hospital’s address are printed on each sheet in the space provided.
3.
SUMMARY
PART A. Hospital:
x Description of your hospital
x HIV clinical care activities in your hospital
x Your role in the hospital.
PART B. HIV Project:
f
K
.
ix Description of the clinical care project that you would like to implement m your hospital during your
x
x
x
course.
Purpose of instituting this project.
How you would implement this project?
How you are going to assess whether your project’s goals were achieved at the end of the course?
PART C. Hospital Support and Mentoring:
The Medical Superintendent, Hospital Administrator, your head of department or senior physician must fill this
section. We advise that this person works with you to complete Part A and Part B also.
In this section they will be asked whether they agree with:
„ your assessment and description of the hospital.
□ the current status of HIV care.
Th^bXldti.. indicate their support tor your efforts. Part C is cridctrl. A strong and dear statement of
support from your Admiui.trutive Head will be an important criterion for your selection. You may also
append up to three letters from members of your staff ludleatiug their support for your efforts.
if you are not working in a hospital please contact the Course Coordinator, HIV Physician Training Program
regarding who the appropriate person to fill Pari C of your form. The tenn hospital „ toe appl,oatton broadly
refers to any health car. facility, clinic, practice, project or hospice whichever is approprr.te to your context.
APPLICATION FORM
Declaration: I hereby confirm that the information submitted in this application and all supporting documents is complete
and true.
Date:
Applicant’s signature:
Applicants name:
(Family name)
(First name)
Name of Hospital/clinic/project (that you are currently working in):
Year of completion
University:
Degree(s):.
Department:
Current designation:
Date since you are employed in the hospital:
Are you working part time or full time:
If part-time, indicate how hours and days
in the week you are working for the organisation:
Complete mailing address:
Permanent address:
E-mail address:
Phone number:
How did you hear about the course?
Letter
e
Newspaper advertisement
0
Magazine advertisement
0
0
0
0
Internet
E-group message
Informed by a friend or colleague
Name:
Hospital (Place) :
PART A
HOSPITAL DESCRIPTION
1. Total Number of Beds
2. Number of Departments
Average Bed occupancy:
4.
5.
a. Operation Theatre
b. Labour room
3. Names of Departments:
5. Lab facilities (list of major tests done)
6.
7. Average number of:
outpatients/day
in-patients/month or year
8. Total number of staff
__
Doctors
MBBS
PC’s
Graduates
Nurses
Certificate
9.
Facilities available:
When was the hospital started and who was it started by?
10. What were the goals for which the hospital was started?
Radiology (list of tests available)
surgeries/day or week.
deliveries/day or week
Lab technicians
Physiotherapists-
X-ray technicians
Counselors
Social worker
Name:
Hospital (Place) :
11. Who owns and administers the hospital now?
12. Does your hospital have any special focus in the type of patients it attempts to take care of?
13. How is your hospital funded? Is there provision for patients who cannot afford treatment (Give details)?
Name:
Hospital (Place) :
HIV CLINICAL CARE
16. How is HIV clinical care organized in your hospital?
Tick the appropriate HFV services available:
□
Out-patient care
□
Staff education
□
In-patient care
□
Home based care
□ Counselling
□
Patient support group
□
HFV Testing
□
Community based prevention
□
Infection control
□ Any others:
17. Approximately how many HIV patients are taken care of:
No. of out-patients (per month or per year)
No. of in-patient (per month or per year)
No. of counselling sessionsfcer month or per year)
No. of HIV tests (per month or per year)
18. Which department/s sees HIV patients?
19. Approxim^y how many staff® involved in treating HIV patients? Are alt ataff involved in HIV care? II tee is an
HIV team, please specify.
Name:
Hospital (Place) :
20. How would you assess the openness with which your hospital takes care of HIV patients?
Are patients seen regularly in the out-patient?
Are patients regularly admitted?
Do HIV patients have deliveries in your hospital?
Do HIV patients have surgery in your hospital?
Is there separate isolation of HIV patients in your hospital?
Yes
Yes
Yes
Yes
Yes
/
/
/
/
/
No
No
No
No
No
21. What are the community-based services for the prevention and care of HIV that are available in your hospital?
Tick the appropriate services available:
□ Voluntary counseling and testing
□ Prevention of mother to child transmission
□ Sex worker program
□ Trucker program
□
□
□
□
School education program
IV drug use program
Public education program
Others:
22. Describe your role in the HIV clinical services.
23. Describe the strengths and weaknesses of HIV clinical care provided by your hospital.
What is your assessment of the needs of your hospital in the area of HIV services.
Name:
Hospital (Place) :
LIBRARY AND COMPUTER FACILITIES
24 Does your hospital have a library? If so please provide some details of adequacy of the hbrary
(books and journals). Do you have access to outside hbrary resources.
25. Do you have access to computers:
Yes
/
No
26. Where do you have computer access:
0
Home
e
Office / Hospital
0
Cyber-cafe
27. Do you use computers for (tick appropriately).
0
o
0
0
Word processing (correspondence)
Data processing (patient records, data analysis)
Web browsing (accessing medical information)
E-mail
28. How many hours in a week would you normally use a computer?---29. How many computers does your hospital have? --------------------
30. Are there any computers in the hospital for educational/medical use? Yes / No
Name:
Hospital (Place) :
ROLE OF THE APPLICANT IN THE HOSPITAL & DECISION MAKING IN THE HOSPITAL
Note: An important objective of this course is to improve and expand the clinical services in regard to HIV care in your
hospitals. Thefollowing questions relate to the possibilities for such change in your hospital.
31. Describe the nature of your clinical work?
32. Are you involved in any teaching activities?
33. Are you working with local NGO’s or GP’s? If so, describe the activities that you undertake with them.
Name :
Hospital (Place) :
—
-_______
34. Who is responsible for making decisions in the hospital and how are the decisions implemented?
35. Describe your position in the hospital, particularly with respect to your role in introducing or making changes.
36. Indicate how you hope to have your plan for HIV care accepted and implemented.
€
Name:
Hospital (Place) :
PART B
HIV/AIDS PROJECT
Describe in detail a project that you plan to initiate related to improving the quality and accessibility of HIV clinical care
provided by your hospital to PLWA. Must include: purpose, goals, methods that you propose to use, feasibility including
inputs and costs (supplies, personnel, equipment and time).
1. Title of Project:
2. Background of project; statement of need of your hospital and local area:
3.
Aims/Purpose:
4. Methods:
5. Feasibility:
6.
Costs:
J
Name:
Hospital (Place) :
PROJECT EVALUATION
7.
How would you evaluate the effectiveness of the project when completed?
8.
List the improvements that you expect as a result of your project?
9.
What would be the measurable / assessable indicators of these improvements? How do you plan to assess these
outcomes? (Please be as specific as possible)
Ml
10. Who would be your local project guide?
Name :
Hospital (Place) :
PART C
SENIOR ADMINISTRATIVE OFFICER NOMINATION & CONFIDENTIAL EVALUATION
To the senior administrative officer nominating the applicant:
Please provide answers to questions 1-4 listed in separate pages below. Insert Part C into a sealed envelop and sign across
the seal. Your confidential evaluation should be mailed along with the applicant form.
1. Please review Part A of the application regarding the description of the hospital, HIV care activities and the
applicant’s role in the hospital. Please indicate whether you agree with these general descriptions provided by the
applicant. Also indicate your own opinions or changes if any.
(
Name:
Hospital (Place) :
Plea?e^^Ly?uy^eran™e^i!t She^^lkant. Indicate whether you would consider the individual suitable for
the course? Do you think that she/he would continue to work in your hospital after completing the course.
Name:
Hospital (Place) :
3. HIV PROJECT - PART B
Please review the project that the applicant would like to implement as part of the program. Is it realistic? Do you think it
would be addressing a need in your hospital? Do you believe that this individual would be effective in ^implementing the
program?
1
26
APPLICATION REVIEW CHECKLIST
Each application should be checked for the following:
1. Completed and signed Application Form
2. Parts A and B
3. Part C to be attached in a sealed envelop
3. Curriculum Vitae
4. Photocopy of degree certificates
5. Photograph of the applicant
Incomplete application forms are considered disqualified.
DATABASE FOR APPLICATIONS RECEIVED
SL#
Roll#
Names
Address
Contact details
Organisation
represented
State represented
Name:
Hospital (Place) :
4. SUPPORT FROM THE HOSPITAL
How supportive would you be of the proposed clinical care project of the applicant? In what ways would you provide
support for the project and help the applicant in implementing it? Please be as specific as possible (time, resources,
administrative support and manpower)? Would your organization be able to provide financial support for the project or
alternately raise the funds required for it?
Applicant’s name:
Hospital
Nominating officer
(Name)
Designation
Phone
E-mail
Address
Date:
(Nominating Officer’s Signature)
27
INSTRUCTIONS FOR EVALUATION OF THE APPLICATION FORMS
•
Each application form consists of:
a. Details of applicant and hospital (Part A)
b. Project proposal (Part B)
c. Recommendation from the administrative officer (Part C)
d. Curriculum vitae and copies of degree certificates
e. Recommendation letters from colleagues (if attached)
•
Please study the format of the application form and marking sheet and clarify doubts if any, with the
course organizer.
You will receive:
a. Four separate files (File A, B, C, D, E) of application forms consisting of 10 - 15 applications
arranged according to the roll numbers.
b. One file with the marking sheets for all the application forms that you will be receiving for
evaluation and a sheet with the guidelines for evaluating the application forms.
•
•
•
•
•
•
•
Please do not remove any papers from the files.
On completion of one set of application forms (one file), you will receive the next
set of applications.
Please read the application forms carefully and then enter the marks in the
marking sheet
You may keep a file with you for a maximum of 4 days. Kindly complete you.r task within this time.
The day by which all application forms should be returned is xxxxxxx.
The marks awarded by the selection committee members for each applicant will
be tabulated and analyzed once the application forms are returned.
The final selection committee meeting will be held on xxxxxx
Kindly take this note as an invitation to be present for the final selection committee meeting.
Thank you.
28
FELLOWSHIP IN HIV MEDICINE 2006
MARK SHEET TO EVALUATE THE APPLICATION FORM
Name:
Name of evaluator:
SI. No.
Roll No:
Items to evaluate
APPLICANT___________________________________
Ia
Academic qualifications and achievements___________
lb
Clinical experience and expertise___________________
HIV clinical work________________________________
Ic
Id
Other involvement in HIV care_____________________
Position in the hospital / organization_______________
Ie
Prior experience of understanding projects / initiating
If
changes within an organization_____________________
I -Total________________________________________
HOSPITAL / ORGANIZATION___________________
II
Well functioning hospital/ clinical/ organization with
Ila
good patient load________________________________
Priority for patients who cannot afford care
II b
Non- profit making organization - private / public
lie
Involvement in HIV care
_______________________
II d
Presence
of
different
components
that may enable the
He
development of HIV care______________ ___________
Presence of a team or other persons who would support
' II f
the applicant's effort______________________________
II - Total____________________
PROJECT
III
Well thought out idea______________
Illa
Potential to benefit care of PLHAS ________________
mb
Feasibility
______________________
III c
Can it be evaluated
_______________
niji
Inclusion
of
the
minimum
components
recommended
III e
Quality of the write -up_________ ______________ __
III f
IH-Total________________________ _______________
MOTIVATION OF THE INDIVIDUAL
IV
INSTITUTIONAL SUPPORT
V
Project guide
__________ _____
_______ GRAND TOTAL
_________________________
Signature of the evaluator with date of completion:
Maximum
marks
I
15
15
30
15
10
15
100
20
10
10
30
15
15
100
15
25
15
15
15
15
100
100
100
500
Applicant score
29
GUIDELINES FOR SCORING OF THE APPLICATION FORMS FOR FHM
I. APPLICANT:
Kindly study the applicant's CV
la. Academic qualifications and achievements:
MBBS - 5 marks
MBBS + 2 years experience - 10 marks
MBBS + 5 years experience -15 marks
MBBS + PG degree - 15 marks
lb. Clinical experience and expertise:
< 2 years - 5 marks
2-4 years - 10 marks
5-9 years - 13 marks
> 10 years - 20 marks
Kindly study the work experience - type, role in HIV services. Refer Par
IC n^Evidence^ direct involvement in medical care (IP / OP). Refer Part A 31,32,33 - 30 marks
ld. Other involvement in HIV care:
Counselling, laboratory, networking, staff education -15 marks
le. Position in the hospital / organization:
Ability to network and develop a team, implement a proj .
lf. Prior expe^tence of understanding projects / initiating changes within an
organization:
Refer Part A - 31 -36
TT.
HOSPITAL
/ ORGANIZATION:
II.
Ila Well functioning hospital with good patient load:
'
Kindly study the basic general facilities to incorporate HIV care - lab,
commurdty work (Refer Part A - 21), IP& OP patient load, counseling,
departments. Refer Part A -1 - 8.
ttu
lib. Priority fnr
for natients
patients who
who can not afford care.
Refer Part A - 13
lie. Non profit making hospital:
Refer Part A - 10,11,12,13
lid. Involvement in HIV care:
Refer Part A - 16,17,18, 20,21,23
He. Presence of different components that may enable the development
HIV care:
persons who would supper.
.PPhoanfs ellor.:
Refer Part A-16,19,21. Look for presence of support lette .
III. PROJECT:
Refer Part B
IV. MOTIVATION:
Kindly look for care with which the application is written, level of
involvement in HIV / AIDS care, commitment to HIV / AIDS care.
V. INSTITUTIONAL SUPPORT:
Kindly study the specific resources that the hospital will provide for. Refer
Part C.
31
TRACKING SHEET OF APPLICATION FORMS FHM 2006
Name of the
evaluator
Date of receiving the
application form
Signature
Date of return
File A-------------
File A
File:B-----
File:B-----
File:C-----
File:C-----
File:D —
File: D
File:E
File:E
File A
File A-----
File:B
File:B--------
File:C------
File:C-----
File: D------
File: D
File:E
File:E
File A-
File A
File:B-----
File:B-----
File:C —•
File:D-------
File:E-------
File A
File:B
File:C
File: D-----
File:C------
File: D----File:E
File A
File:B-----
File:C------File: D------
_____ File:E File:E----------- —
—
on xxxxxxx
The selection committee meeting is to be held
Signature
f
Date
checked
32
TRACKING SHEET FOR EVALUATORS FHM 2006
Information about the file: File Name: A
Roll. Numbers from
Name
Roll.No
L
Remarks :
Kindly put a tick ( ) against the name of the candidates whose application forms you have evaluated in the
column marked for you. Thank you.
33
DATA BASE OF MARKS SCORED
SI. #
Roll#
Names
Mark
Rank
Each evaluator
Mark
Rank
Mark
Mean score
Rank
34
GUIDELINES FOR SELECTION COMMITTEE MEETING - FELLOWSHIP IN HIV MEDICINE
PROGRAMME - 2006
The marks are arranged according to the following format
1. Each selection committee members marks have been ranked individually.
2. The number of selection committee members who have marked each apphcant in the first 15 (1-15) and in
first 25 (1-25) is noted in the rank order.
3. The merit list order is as follows:
a. Applicants where 4 selection committee members have ranked them in first 15
b. Applicants where 3 selection committee members have ranked them in first 15
c. Applicants where 2 selection committee members have ranked them in first 15
d. Applicants where 1 selection committee members have ranked them in first 15
e. Applicants where no selection committee member has ranked them in first 15 but 2 of them have ranked
them in first 25.
f. Applicants where no selection committee member has ranked them in first 15 but one of them have ranked
them iii first 25.
f. Applicants where no selection committee member has ranked them in first 25.
4. Under each of the above category the merit list is arranged according to highest average score.
Other criteria:
1. Any candidate who does not have part C is disqualified.
2. Persons who are from an organization who have already had a student trained in the Fellowship
programme would be selected only if there is no other suitable candidate. This should be based on sufficient
justification to train another person to enhance the capacity of the organization.
3. If there are equal marks between two candidates, a person who has applied in a previous year would be
given preference.
4. A minimum of 50% of candidates selected should be from the non-governmental /private sector.
5. Priority should be given to ensure even regional distribution between states.
6. A maximum of 20 - 25% of candidates (3 - 4) would be selected from states outside the region. When
selecting candidates from outside the neighboring states, it must be reasonably certain that these candidates
will be able to travel the distance to the center, provided leave and financial support for staying 6 weeks of the
contact programme.
7. If two applicants are working for one organization, one will be selected except if the two are working in
separate places.
8. Persons who will be studying another full time course at the time of commencement of the Fellowship in
HIV Medicine programme will not be selected.
9. Priority would be given to applicants:
o From organizations involved exclusively in HIV work.
o Who are exclusively involved in HIV work.
o Who have demonstrated substantial prior HIV work.
o From backward areas where there is no HIV clinical service.
o Recommended by HIV positive persons / organizations.
10. Special consideration will be giv<en to persons working in community based organizations involved in HIV
work but not currently having hospital based or clinical based services.
11. After reviewing the score sheets the committee would go down the rank order discussing each applicant
and making a selection by consensus. Xxxxxx applicants will be selected and a waiting list of 10 applicants will
be prepared.
35
LETTER TO UNSUCCESSFUL CANDIDATE
Date
Dear
Sub: Fellowship in HIV Medicine 2006.
I regret to inform you that your application to the Fellowship in HIV Medicine programme
for 2006 was not considered favourable. We are restricted by the numbers that we could select into
the programme from a region based on the prevelence. We appreciate your interest in our
programme and thank you for the opportunity to consider your application. The selection
committee has unfortunately turned down your request after a careful examination of the submitted
forms.
O
We certainly admire and appreciate what you are doing in this difficult area of need. We
encourage you to continue in your work and reapply next year.
With regards,
Yours sincerely.
36
LETTER TO SELECTED CANDIDATE
Dear
Date
We are happy to inform you that you have been provisionally selected for the Fellowship in HIV
Medicine 200 . We would like you to send an immediate confirmation of your participation by
e-mail to xxxxxxxxxxx or by FAX to xxxxxxx or by telegram as soon as you receive this letter.
You are required to officiary confirm your participation by signing the enclosed agreement form
and returning it by xxxxxxxxx.
On behalf of xxxxxxxx, I would like to congratulate you and your institution for having qualified in
this year s selection. The selection has been based on our evaluation of your work and interest in HIV
care, your institutional support and project plan. We look forward to the course as an opportunity to
develop a partnership between our institutions towards strengthening HIV care.
We look forward to receiving your confirmation message followed by the signed agreement form
If we do not hear from you by xxxxxxx, we would assume that you are not planning to participate in
the training program and proceed to call the next person on the waiting list. If you have any
clarification in this regard please do not hesitate to contact me at xxxxxx (office)/ xxxxxx (res.).
Enclosed with this letter is a four-page agreement form for participating in the course. Please read
the form carefully and follow instructions below.
a. Page 2 should to be signed by you.
b. Page 3 should be signed by your local project guide.
c. Page 4 should be signed by the chief administrative officer of your organization.
The duly filled and signed forms should be returned to Course coordinator, xxxxxxxx
by
xxxxx.
With regards.
Yours sincerely.
AGREEMENT FOR ENROLLMENT IN THE FELLOWSHIP IN HIV MEDICINE COURSE - 2006
The Fellowship in HIV Medicine 2006 aims to enable the participants to improve their knowledge and skills
in HIV care and develop accessible and high quality HIV clinical services in their hospitals. The course duration
is 12 months (February 27, 2006 to February 2007). It consists of:
1 First Contact Course (CC-I) at the center of 6 days duration for all participants from
3.
February 27 to March 4, 2006.
Distance Learning Programme (DC) of 12 modules from March to June 2006.
Second Contact Course (CC-II) at the center of 2 weeks duration. This will be in groups of 8 (Batch I) and
4.
7 (Batch II) participants between March and April 2006.
In-service training (CC-III) at the center of 2 weeks duration between July and October 2006 in groups of
5.
6.
three participants each, in five batches.
Project Implementation Phase (PP) of 6 months from August to January 2006.
Fourth Contact Course (CC-IV) of 5 days duration for all participants in February, 2007.
2.
•
1.
2.
3.
4.
The requirements for the course completion are:
Completion of contact and distance courses: Participants are required to attend all the contact courses
CCI - IV (total of 6 weeks duration).
Completion of 12 distance learning modules: Participants should acquire a pass grade on the tutor
marked assignments that should be sent to the center on time at the end of each module.
Project Participants should secure a pass grade on the project outline (to be submitted at the end of the
1st month), full project plan (to be submitted at the end of the second month), two interim project reports
(to be submitted at the second and fourth month of project phase), the final project report (to be submitted
at the end of the project phase) and completion of project implementation.
The participants should perform satisfactorily in theory and practical assessments during the Con c
CThe participants are required to spend at least 7 hours every week on course related work during the
entire period of the course.
...
The participants will have to fulfill all the above requirements to be eligible for award of Fellowship m
pitidp^to^ need to meet the cost of travel and for food, accommodation and individual expenses.
.
Participants will be assisted to develop their project proposal by a faculty member A screening
committee will evaluate the project proposal. Approval of the project proposal by the screelu^
committee and completion of the contact and distance course requirements is necessary to imtiate
project implementation. The costs of project work will be borne by the institution from which the
.
By a^eSg tXoU for this course, we are building a partnership with the student and the
pitidpating institution /organization. It is assumed that the student will continue to work for
organization after the completion of the course. However, if the student resigns from the
organization or discontinues this working relationship with the organization, they would not
able to complete the course.
1
STATEMENT OF AGREEMENT BY COURSE PARTICIPANT
I,
(name of course participant) agree to:
a. attend the CC-I, CC-II, CC-III, CC-IV according to the specified schedules.
b. complete the 12 distance learning modules required for the distance course on time.
c. send in the tutor marked assignments at the end of each module.
d. complete the project work required for the course.
e. send in the project outline, full project plan, interim project reports and final
project report according to the schedules that are specified for the course.
f. spend 7 hours of study time every week towards the course requirements.
g. abide by the rules and regulations of the institution while attending
the contact courses.
h. bear the costs of travel and accommodation & food, in case my institution will
not be able to support these costs.
i. continue my work contract with the sponsoring institution / organization while
undergoing the Fellowship in HIV Medicine program.
I hereby confirm my participation in the Fellowship in HIV Medicine 2006, after having understood
the different components of the program and the course requirements. I agree to participate and
fulfill the requirements of the Contact Courses I - IV, distance courses and project work.
Signature of course participant
Designation
Participating Institution
2
AGREEMENT BY PROJECT GUIDE
To be filled in by the project guide nominated by the participant in the application form.
I hereby agree to guide(course participant) during the entire
period of die Fellowship in HIV Medicine Program from February 26, 2006 to February 2007. During
this time I will agree to:
A
a. guide the participant in conceptualizing, planning, implementing and evaluating the project work.
b. assist the participant in preparing the project outline, full project plan, interim project reports I and
II, final project report and presentation according to the course schedule.
c. meet with the participant at least once a month to discuss the progress in project work.
Signature of the project guide
Designation:
Office stamp:
3
AGREEMENT BY THE CHIEF ADMINISTRATIVE OFFICER OF THE SPONSORING
INSTITUTION
To be filled by the chief administrative officer.
Our organization agrees to provide the following support to----------------------------(name of course participant) to undertake the Fellowship in HIV Medicine 2005 at xxxxxx :
a. Meet expenditure required for the travel and cost of food &
accommodation.
b. Provide the necessary administrative and financial support to ensure
implementation of the project
c. Provide the participant with the necessary leave to attend the contact courses.
d. Arrange work schedules to allow the participant 7 hours of study time per week.
e. Meet with the participant every month to discuss the progress in the training
program and sort out any difficulties that arise.
Signature of the administrative officer
Designation:
Office stamp:
4
41
DATA BASE OF SELECTED CANDIDATES
SL#
*
Roll#
Names
Address
Contact details
Organisation
represented
State represented
FACULTY DEVELOPMENT PROGRAMME
HANDBOOK ON CONTACT COURSES
FOR
FELLOWSHIP IN HIV MEDICINE
CMC, Vellore
INDEX
SI. No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Title
Introduction
_
Aims of each contact course
Scheduling of each contact course
Schedule of student distribution__________
General instructions
Specific instructions for each contact course
Instruction sheet for CC I_______________
Instruction sheet for CC II_______________
Instruction sheet for CC III_____________ _
Case work up sheet___________ _________
Evaluation form for contact courses_______
List of sample articles___________________
Sample time tables of CC I - IV__________
Page No.
1
2
4
4
5
7
12
13
15
18
23
25
26
1
Introduction:
This hand book is a guide to planning, coordinating and conducting of the contact courses I to IV o a
total of 6 weeks duration which is a component of the Fellowship in HIV Medicine programme, t is
suggested that each regional training center modifies and adapts the process to meet their loca
needs. In the following pages you will find the details of the contact courses. Sample templates are
included.
*
2
Aims of each contact course
Contact course I (CC I)
At the end of this contact course the students would have:
• Orientation to the objectives, contents and structure of the training programme
• Developed basic clinical skills
• Developed skills in project planning
• Developed computer skills
• Orientation to distance learning
• Networked with faculty
Contact course H (CC II)
At the end of this contact course the students would have improved skills in:
• History taking, physical examination, making a clinical diagnosis, ordering and interpreting
laboratory investigations and initiating treatment for common clinical problems in HIV
infection at the level of peripheral hospital and clinic.
• Pre and post - test counseling and dealing with psychosocial issues in a patient with HIV
infection.
• Organizing clinical care set up with reference to out - patient, in - patient services, laboratory
infrastructure and community based prevention.
• Presenting a detailed project plan to the course faculty and finalizing it based on discussions
with the faculty.
Contact course III (CC III)
At the end of this contact course the students will have improved skills in:
• Independently managing patients with HIV infection presenting in asymptomatic state with
- respiratory syndromes
- gastrointestinal syndromes
- CNS syndromes
- Acute and chronic fever
- Skin problems
- STD syndromes
- Gynaecological complaints
- Pregnancy
- Psychiatric syndromes
Paediatric problems
4
•
3
Diagnosing, initiating treatment and followup management for common opportunistic
infections independently
- TB
Pneumocystis carinii
- Bacterial pneumonia
- Bacterial meningitis
- Cryptococcal meningitis
- TB meningitis
- Cerebral toxoplasmosis
- CMV infection
- Candidal infections
•
Independently handle acute emergencies occurring in HIV infection
- acute CNS infection and altered sensorium
- respiratory failure and respiratory emergencies
- SIRS and shock
Electrolyte imbalance
- Cardiac arrest
•
Independently perform the following procedures
- Lumbar puncture
- Pleural aspiration
Ascitic tap
- Bone marrow aspiration
- Lymph node aspiration
- Endotracheal intubation
- Cardiopulmonary resuscitation
Pap smear
•
Independently initiate and followup ART treatment
- diagnose and manage ART side effects
- diagnose and manage IRIS
- diagnose and manage treatment failure
.
Independently conduct pre - test, post - test and followup counseling and handle
psychological issues related to HIV infection.
Contact course IV (CCIV)
Aims of CC IV:
• Assessment and evaluation
• Networking
4
Scheduling of each contact course
While planning the dates for the contact courses keep in mind the activities / other major
programmes of the departments / institution and holidays / vacation period.
Contact course I
Contact course II
Contact course III
Contact course IV
One week
Two weeks
Two weeks
One week
First week of the programme
By the second month of the programme
By the sixth month of the programme
Last week of the programme
Schedule of student distribution
Contact course I
Contact course II
Contact course III
Contact course IV
All the students of the programme together
The students are divided into two groups. Each group attends
separately
_________________
The students are divided into four to five per group. Each group
attends separately._______________________ _______ .
All the students of the programme together
For CC II & CC III, the students are given the choice to decide which batch they would like to attend.
A fixed number of students attend CC II & CC III per batch.
*
5
General instructions for all contact courses
Meeting with faculty for session planning:
the need. Finalize the time schedule at least two weeks prior to the contact course.
Dispatch of student letters, prior reading and assignments:
material and the time table for the contact course.
Arrangement of course materials.
other additional resources as a soft copy and load it on to CDs. rovioe
student.
Logistical planning:
1 D card / badge: Arrange for and provide identification badges for each of the students
Accommodation. Arrange for accommodation well In advance. Inform the students of the same and
how to reach the venue when they come for the course.
Food: Arrange and block an area for snacks and meals for the students as available - at the site of
residence or at the venue.
iquired and when planning field trips.
Transport: Arrange for transport facilities as re<
6
Classroom: Arrange for classrooms for the theory classes during the contact course.
AV aids: Consult the faculty and confirm the AV aids required for each session. Make arrangements
for the necessary and that they are in good working condition. Ensure that the training officer or
another person is able to handle the AV aids.
Letters: Send letters of request to the concerned faculty regarding their sessions and input for the
contact course. If external faculty are involved send appropriate letters with details of the contact
course. Send letters of intimation / permission to the departments that will be involved in the contact
course - Hospital Administrator / Medical Superintendent, Nursing Service department, library,
computer lab etc.
Course evaluation and summary; dispatch to faculty:
After each theory session, give the students the evaluation form from the session. Collect the forms
before the end of the day. During the concluding session of the contact course, give the students the
overall evaluation form. Collect the forms before the students disperse. Consolidate the evaluation
remarks and circulate it among the faculty. Prepare a list of improvements required for the next
contact course.
7
Specific instructions for each contact course
Contact course I (CC I)
Preparation of schedules (draft schedule attached):
All the students come for the contact course at the same time. This contact course is of one week
duration. A tentative time schedule should be prepared and should be sent to tire selected candidates
along with information and instructions about CC I, when the participant has confirmed his / her
joining for the programme.
Dispatch of student letters, prior reading and assignments (draft letter attached):
Draft and send a letter to the students regarding details of the Fellowship programme. The details
may include information about the course in total, the requirements for course completion, contact
numbers & travel guidelines.
#
Arrangement of course materials:
The course material for CC I includes a binder with the session plans of CC I, a binder of guidelines
for project work, introduction to distance learning binder and guidelines for the final examination.
The students may be given a file, note book and pen / pencil.
Clinical sessions:
The objective of the clinical sessions is orientation to clinical aspects and attaining a common
standard among all the students towards clinical approach. The focus of the clinical session in contac
course I is on basic clinical skills in history taking, clinical examination and problem analysis for the
ThT^de^telreallotted patients from General Medicine wards the previous day of the clinical
session. Selection of patients is based on approaches to problems of different systems in the bo y.
Respiratory, cardiovascular, central nervous system, gastrointestinal system cases are a11^students work up the patients and present the same during the clinical session. This is followed y
case discussion facilitated by a faculty member.
Computer session:
XneXTsX^
update on different topics etc are initiated through the e-group.
8
Networking session:
An introduction session where students get to know each other and the faculty members is planned
on the first day of the contact course. A time slot is allotted for each student for the my hospital / my
work' session. During these sessions students make presentations about their institutions and their
work. It is an informal session towards networking. Some of the academic sessions have group
activities, which enable the students to work together. The picnic and having meals together are
informal times of networking.
Project work:
While planning the time schedule the project guides are consulted for convenient time slots to meet
with their student. During the contact course I, the students are oriented to project writing and
planning. They meet with their project guides and discuss their project outlines. The project outline
is improved according to the feedback given by the faculty guide. (See project planning guidelines).
Photography:
Arrange for a group snap to be taken sometime during CC I.
Picnic:
Plan and arrange for an outing during CC I.
Course evaluation and summary; dispatch to faculty (draft evaluation form attached):
Prepare a feedback form for each session of CC I. Provide the students with the feedback form for
each session, on completion of the session. Collect and compile the forms. Consolidate the feedback
and send a copy to the concerned faculty.
Provide the dates for CC H and request the students to fill in their names against the convenient
dates.
Contact course II (CC II)
Preparation of schedules (draft schedule attached).
The students may be divided into two batches. This contact course is of two weeks duration. The
schedule is prepared for two batches of students.
9
Dispatch of student letters^ prior reading and assignments (draft letter attached):
Draft and send a letter to the students regarding details of CC IL The details may include information
about the batch they belong to & when they need to attend the contact course.
Arrangement of course materials:
The course material for CC II includes the practical record book. The students need to fill in the case
studies and submit the practical record book on the final day of CC II (sample record book attached).
Clinical sessions:
The focus of contact course II is more in-depth clinical approach to evaluation and management of
common HIV and infectious disease problems. Students mostly observe management, though it
suggested that participation in clinical care is maximized.
The students are involved in outpatient and inpatient care. All common infection related problems
are discussed.
Respiratory: acute pneumonia, subacute respiratory illnesses, pleural effusion, empyema,
pneumothorax, respiratory failure, TB, Pneumocystis carinii pneumonia.
CNS: Meningitis, stroke, focal cerebral syndrome, myelopathy, peripheral neuropathy, dementia,
cryptococcal meningitis, cerebral toxoplasmosis
Gastrointestinal system: dysphagia, diarrheal illness, ascites, hepatitis and chronic liver disease,
pancreatitis, cholecystitis
Cardiovascular: endocarditis, pericardial effusion
ART related problems: assessment for ART, side-effects, immune reconstitution inflammatory
syndrome
The students work up the patient allotted to them using the format on the practical record and
present the same during the clinical session. This is followed by case discussion. Students are
encouraged to follow-up cases up to discharge and to observe procedures.
Field trip:
Field trip to observe prevention programmes / to participate in public health education programmes
may be planned.
Networking session:
Informal networking sessions and visits to local alumni may be arranged.
10
Project work:
During CC II, the students meet their project guides and discuss the final project outline. They
present the final project outline to the group and the faculty. Written feedback is given to each
student. (See project planning guidelines).
Provide the dates for CC in and request the participants to fill in their names against the convenient
dates.
Contact course HI (CC III)
Preparation of schedules (draft schedule attached):
The group may be divided into smaller batches of 4 - 5 members each. This contact course is of two
weeks duration. The time schedule needs to be prepared in consultation with the faculty involved.
This is focused on development of clinical skills.
Meeting with faculty for session planning:
After drawing up a tentative time schedule, approach each faculty concerned and discuss the date,
time and other details of their clinical session. Finalize the time schedule at the latest one week prior
to the commencement of CC III.
Dispatch of student letters, prior reading and assignments (draft letter to the student attached).
Draft and send a letter to the participants regarding details of CC III. The details may include
instructions regarding CC III - accommodation and food arrangement, travel guidelines payment of
advance, list of things to bring and contact numbers; academic preparation for CC III and the time
schedule for CC III.
Arrangement of course materials:
Formulating, compiling and printing of course material should be completed at least within a week
prior to commencement of CC III. The course material for CC III includes the practical record book
(given at CC II) and the log book for procedures.
Studenls'pa'racipate as members of the treating team in contact course Hl at a similar level to the
11
setting they are involved in the care of patients in the HIV/ART clinic under supervision. In the
counseling area, they are involved in the counseling of patients under the supervision of trained
counselors.
Journal club/paper reading:
The objective is to enable critiquing of a journal article. The journal article is selected based on latest
updates on HIV related issues. A xerox copy of the article and related articles / cross reference
articles are sent to the students a month prior to commencement of CC III. The students are
instructed to go through the article /s, critique and prepare a power point presentation of 20 minutes
with a 10 minute discussion. During CC III, the students present the topics given to them to the rest
of the department faculty. The student presenting the article may write a summary which may be
posted on the e-group. (A list of sample articles is attached)
Contact course IV (CCIV)
Preparation of schedules:
a
*
All the students come for this contact course at the same time. This contact course is of one week
duration. The time schedule for the theory and practical assessment, picnic, networking session,
graduation ceremony and alumni meet needs to be prepared in consultation with the faculty
involved.
Theory, OSCE, clinical exam:
You will be provided detailed guidelines for running the theory, OSCE and clinical exam. The theory
and OSCE exam will be prepared at the Distance Learning Center.
Project work:
You will be provided with detailed suggestions for the poster session, graduation and alumni
meeting.
12
INSTRUCTION SHEET FOR CONTACT COURSE - I
This may include the following sections:
Accommodation
Travel
Payment
Sessions
Local transport
Food arrangement
Things to bring with you
ACADEMIC PREPARATION FOR CONTACT COURSE -1
Contact Course - I preparation:
"My Hospital / My Work"
On Monday - Friday, following dinner there will be a short 10 minute presentation by each of the
course students titled, "My hospital and my work". This is an informal presentation for the students
and faculty to learn about your background and work. The presentation need not focus only on
HIV related work. We would have the LCD projector and OHP available for you to use.
Project preparation
.
Please bring a copy of your project proposal that you have submitted m your application. During
the CC - I, you would revise this project proposal to prepare a project outline.
In addition to this we would like you to bring some data on the local HIV care need:
1. Prevalence of HIV infection in your district / state.
2. Availability of HIV prevention and care services in your area.
3. Availability of HIV services in your hospital /institution.
4. HIV patient load (in-patient, out-patient, HIV tests, counseling performed).
5. The gaps in HIV care provision at your institution and in your town / district.
13
INSTRUCTIONS FOR CONTACT COURSE II
These may include details of the following:
Accommodation
Sessions
Transport
Food arrangements
Payment
Things to bring with you
CONTACT COURSE II
Aims:
At the end of the CC-II session you will have improved skills in:
History taking, physical examination, making a clinical diagnosis, ordering and interpreting
1.
laboratory investigations and initiating treatment for common clinical problems in HIV
infection at the level of peripheral hospital and clinic.
Pre and post-test counseling and dealing with psychosocial issues in a patient with HIV
2.
infection.
Organizing
clinical care set-up with reference to out-patient, in-patient services, laboratory
3.
infrastructure, and community based prevention.
Presenting
a detailed project plan to the course faculty and finalizing it based on discussions
4.
with the faculty.
Methods:
1. Lecture/case discussions:
STD and skin, neurology, gastrointestinal system, paediatric, obstetric and gynaecological
problems, eye, respiratory and ambulatory care, psychiatry and psychosocial issues, pre and post
test counseling.
2. Clinical exposure:
I. Ward rounds
a. Case allotment
Each of you will be allotted cases every l-2days during the CC-II.
b. Case workup and presentation
You will work up cases, prepare a written record and present the case to the faculty at the
bedside clinics.
d. Case follow-up
You will follow-up the cases on a daily basis maintaining detailed case notes.
e. Log book
,
You will submit your case records at the end of the CC-II for faculty assessment.
II. Out-patient clinics
a. ID clinic
b. Case workup and discussion with supervising faculty
14
3. Other practical sessions and organization of care:
a. Microbiology
b. Clinical virology
c. Blood bank
d. Infection control
e. Radiology
f. Community based prevention
4. Project presentation:
During CC II you will prepare the full project plan. The full project plan should include all the
items in the project outline but in more detail (objectives, background, methods, evaluation,
budget, the logic model template, Gantt chart and stakeholder analysis). Please refer the
guidelines for preparation of the full project plan in the "Guidelines for project planning"
binder that has been given to you during CC I.
You will meet with your supervising faculty during week 1 to discuss your project. You would
submit your full project plan on the first day of CC I. Following this, you will present the
project plan on an afternoon to the supervising faculty and to your batch mates.
The presentation may be using OHP / LCD. The duration of your presentation should not
exceed 15 minutes.
ACADEMIC PREPARATION FOR THE CC-II
Before CC II:
a. You need to discuss your project outline with your local guide and other persons who are
critically involved in the project (eg. Administrator, head of the department).
b. Please study the full project plan guidelines.
c. Obtain necessary additional information to prepare the full project plan (eg. Needs
assessment, background, problem analysis, budget)
d. Prepare some notes to help you develop the full project plan during CC II.
e. Perform a literature review for the project and obtain necessary information.
15
INSTRUCTION SHEET FOR CONTACT COURSE III
These may include details of the following:
Accommodation
Sessions
Food Arrangements
Payment
Library
Items to bring with you
CONTACT COURSE III
&
^X.ims*
At the end of the CC-III session you will have improved skills in:
1. Being able to independently manage patients with HIV infection presenting.
In asymptomatic state
With - Respiratory syndromes
Gastrointestinal syndromes
CNS Syndromes
Acute and Chronic fever
Skin problems
STD Syndromes
Gynaecological complaints
Pregnancy
Psychiatric syndromes
Paediatric problems.
gement for common opportunistic
2. Being able to diagnose, initiate treatment and followup mana;
infections independently:
TB
Pneumocystis carinii
Bacterial pneumonia
Cryptococcal meningitis
TB meningitis
Cerebral toxoplasmosis
CMV infection
Candidal infections
16
3. Being able to independently handle acute emergencies occurring in HIV infection:
Acute CNS infection and altered sensorium
Respiratory failure and respiratory emergencies
SIRS and shock
Electrolyte imbalance
Cardiac arrest
4. Being able to independently perform the following procedures
Lumbar puncture
Pleural aspiration
Ascitic tap
Bone marrow aspiration
Lymph node aspiration
Endotracheal intubation
Cardiopulmonary resuscitation
Pap smear.
5. Being able to independently initiate and follow-up ARV treatment.
Diagnose and manage ART side-effects
Diagnose and manage IRIS
Diagnose and manage treatment failure.
6. Being able to independently conduct pre-test, post-test and follow-up counselling and handle
psychosocial issues related to HIV infection.
Methods:
The Fellowship program students will be posted to Medicine Unit as co-registrars and will have the
following responsibilities:
1. They will be given independent charge of patients in the general wards.
2. They will have to write the history sheet, problem sheet, and progress sheet and
discharge summary.
3. They would evaluate the patients twice a day and present the case on rounds.
y would\perform xprocedures; on the patients under supervision.
4. They
5. 'They would be in charge of communicating health information to the patient and
family.
They
would be allowed to participate in medical decision-making under supervision.
6.
7. They would undertake ambulatory care of HIV patients in ID clinic under
supervision.
They
would undertake casualty calls under supervision twice during their posting.
8.
They
should be involved in care of 10 patients during their posting.
9.
10. They should counsel 10 patients during their posting under supervision.
11. They should perform each of the procedures at least twice during their posting.
&
17
Other Scheduled Postings:
Dermatology
Paediatrics
O&G
Lymph node - FNAC - two sessions
Bronchoscopy - one session
Sputum Induction - one session
Counseling
Cardiopulmonary resuscitation
Radiology
Delivery and Caesarean section (optional)
18
CASE WORKUP SHEET
Name:
Age:
Sex:
HISTORY (Chief complaints, relevant details of history including details of chief complaints,
past, personal, family history and systems review) ________________________
EXAMINATION (Vitals, general examinationz significant findings on physical examination)
19
DIAGNOSIS (Differential diagnosis in order of probability)
RATIONALE FOR DIAGNOSIS (Reasons for diagnosis)
TESTS TO BE ORDERED (Appropriate tests to be ordered at the level of a peripheral hospital
20
MARKING GUIDELINES FOR CASE WORKUP
Marks_____________
HISTORY________________________________
Relevant chief complaints obtained_________
10_________________
20
Details of chief complaints obtained
(relevant positive and negative history)______
10
Relevant past, personal, family and treatment
history obtained__________________________
10
Able to summarize history_________________
5
Vital signs_______________________________
5
General examination______________________
20
Elicits positive physical signs_______________
10
Able to state relevant negative signs_________
30
Diagnosis and differential diagnosis________
10
Able to explain rationale of diagnosis________
10
Able to order appropriate laboratory tests
20
Communication skills and bedside manner
20
Presentation skills_______________________
20
Case write-up
________________________
200
TOTAL
INTERPRETING LABORATORY TESTS AND PLANNING MANAGEMENT
Marks__________________
50
______________________
Able to interpret blood tests_________
50_________ ____________
Able to interpret microbiology reports
50______________________
Able to interpret radiological tests
Writing prescription/ order sheets
100______ ________
50______________________
Explaining drugs to patient_________
300
TOTAL
21
T ABORATORY TESTS
TREATMENT
FOLLOWUP
22
PROCEDURE LOG BOOK
Name of student:
Roll No.
Procedures to be performed: Bone marrow, lumbar puncture, pleural tap, ascitic tap, fine needle
aspiration cytology of lymph node
Procedures to be observed: Sputum induction, pap smear, lymph node PNAC
No.
Name
Hospital
No.
Diagnosis
Procedure
performed
Faculty
Signature
23
CONTACT COURSE - SESSION EVALUATION FORM
TITLE OF THE SESSION:
NAME OF THE FACULTY:
1 What are two things that you liked about the session?
(1)
(2)
2. What are two things that you did not like about the session?
(1)
(2)
3. What are two things that you learnt through the session?
(1)
(2)
4. What improvements would you suggest in the session?
(1)
(2)
5. Any other comments:
24
CONTACT COURSE - OVERALL EVALUATION
With regard to the Contact Course:
1. What three things did you enjoy most?
(1)
(2)
(3)
2. What three things did you enjoy least?
(1)
(2)
(3)
3. What were the most important things you learnt?
(1)
(2)
(3)
4. What else would you like to have done during this Contact Course?
(1)
(2)
(3)
5. What improvements could be made to this Contact Course?
(1)
1
(2)
(3)
6. Any other comments:
w
SI. No
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
25
LIST OF SAMPLE ARTICLES
List of articles
Clinical Profile of HIV in India
N.Kumarasamy et al / Indian J. Med Res 121z April 2005/ pp377-394 ---------------------- ------Preventive therapy for tuberculosis in HIV infected individuals
C.Padmapriyadarshini & Sowmya Swaminathan
Indian J Med Res 121z Apr 2005 z pp 415 - 423
_
__________
Hepatitis B & Hepatitis C in HIV infection
Shyam Kottilil et al / Indian J. Med Res 121z April 2005z pp 424 - 450----------- -----------------—
Natural History of Human Immunodeficiency Virus Disease in Southern India
N.Kumarasamy et al / Clinical Infectious Diseases 2003z 36.79-85 ____________ _________
Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features.
G.E.Thwaites et al / The Lancet 2002; 360:1287 -92
_________
Does Tuberculosis Increase HIV Load
John H.Day et al / JID 2004; 190:1677 - 84
HIV/AIDS epidemic in India: An economic perspective
Ajay Mahal and Bhargavi Rao; Indian J Med Res 121z April 2003z pp 582-600------- ------------Determinants of Immune Reconstitution Inflammatory Syndrome in HIV type I Infected
patients with Tuberculosis after initiation of antiretroviral therapy.
Guillaume Breton et al / CID 2004: 39 (December) 1709 -12.
_
_
_
Outcome of HIV associated Tuberculosis in the era of Highly Active Antiretroviral Therapy
Keertan Dheda et al; The Journal of Infectious Diseases 2004;190:1670 - 6___________ _____
Effect of Cotimoxazole Prophylaxis on Morbidity, mortality, CD 4 + cell counts and Viral
Load in HIV infection in rural Uganda.
Jonathan Mermin et al / The Lancet: Oct 16 - Oct 22, 2004.Vol 364, Iss.9443; pg 1428. 7 pgs.
Low cost monitoring of HIV infected individuals on highly active antiretroviral therapy (
HAART) in developing countries
Pachamuthu Balakrishnan et al
Indian J Med Res 121, April 2005, pp 345 -355
_____________________
Utility of Tuberculosis Directly Observed Therapy Programs as sites for access to provision
of Antiretroviral Therapy in Resource Limited Countries
Gerald Friedland et al / CID 2004: (Suppl 5) S 421
Immunoadjuvant Prednisolone Therapy for HIV associated Tuberculosis. A phase 2 clinical
trial in Uganda; Harriet Mayanja - Kizza et al / JID 2005:191 (March 15)------------------------Cotrimoxazole prophylaxis reduces mortality in human immunodeficiency virus positive
tuberculosis patients in Karonga District, Malawi.
Frank B.D. Mwaungulu et al / Bulletin of the WHO/may 2004,82 (5); pg 354,102gs----------AIDS Vaccine Development: Perspectives, Challenges and hopes
Jean Louis Excler; Indian J Med Res 121, April 2005, pp 568 - 581----------------------------------Stressors and rewards for workers in AIDS services organizations
Demmer C et al / AIDS Patients Care 2002:16; 179 - 187----------------------------------------------
Time
8.00-9.00 am
9.00-10.00
am
February 28 - Monday
Venue: Norman Audi.
Meeting with the
Principal___________
State of art lecture I:
Inaugural address:
Current perspectives in
HIV medicine
Dr. Dilip Mathai_____
Group introduction
Mr. Gunasekaran /
Dr. Punitha / Ms. Sara
10 - 10.15 am
10.15 - 11.15
am
11.15- 12.15
pm
12.15
pm
1.00
Course introduction
Dr. Anand Zachariah
Dr. O C Abraham
(10.15-11.30 am)
Orientation to project
work
Dr. Mani Kaliath
(11.30 am - 1.00 pm)
________________TIME TABLE FOR CONTACT COURSE - I
March 3 - Thursday
March 2 - Wednesday
March 1 - Tuesday
Venue: Norman Audi.
Venue: Norman Audi.
Venue: Norman Audi.
State of art lecture IV:
State of art lecture III:
State of art lecture II:
HIV: Risks to the health
Current status of anti HIV epidemiology in
care worker
retroviral therapy
India: an overview
Dr. Elizabeth Mathai
Dr. O C Abraham
Dr. Anand Zachariah
March 4 - Friday
Venue: Wheeler Hall
Psychosocial issues and
basic HIV counseling
Ms. Joyce Rajan
Mr. Govindan
Mr. Peace Clarence
Mr. Gunasekaran
March 5 - Saturday
Venue: Norman Audi.
Introduction to distance
learning
Dr. Anand Zachariah
Dr. J V Punitha
Anti - retroviral therapy:
Psychosocial issues and
Bedside pharmacology
a practical approach
basic counseling for the HIV physician
Dr. Subramanian
continuation
Dr. Sujith Chandy
Mr. Rajkumar
Dr. Subramanian
Mr. Peace Clarence
Dr. Priscilla Rupali
______________ COFFEE BREAK
Venue: OG conference room
to
skin Anti - retroviral therapy - Women and HIV
Bedside pharmacology
Planning
of
HIV Approach
Dr. Jessie Lionel
manifestations of HIV continuation
for the HIV physician prevention programmes
and STD’s - continuation
Continuation
Dr. Santhidani
(10,45-12.15 pm)
(9.00- 10.30 am)
and Opportunistic infections: Children and HIV
virology
Networking
with
Planning
of
HIV Basic
an overview
Dr. Valsan Philip V
positive people
prevention programmes - immunology of HIV
Dr. O C Abraham
Dr. Rajesh K
(10.45-12 N)
continuation
Approach to ambulatory
care of HIV infection
Dr. George M Varghese
(9.00- 10.30 am)
Approach to skin
manifestations of HIV
and STD’s
Dr. Susanne Abraham
Project work up / meeting
with guide
Project work up / meeting
with guide
Opportunistic infections continuation
Project work up / meeting
with guide
Project work up I
meeting with guide
(12.N-12.30 pm)
CC - I conclusion and
feedback
(12,30-1.00 pm)
LUNCH BREAK____________
Clinics
Clinics
I
D
Clinic
Planning for projects - Clinics
(2.00-4.00
pm)
(2.00 - 4.00 pm)
(2.00-4.00
pm)
(2.00 - 5.00 pm)
2.00-5.00 pm group activity
Dr. Anand Zachariah
Project work up / meeting Dr. Priscilla /
Students depart
Dr. George M Varghese
(2.00-6.30 pm)
Dr. O C Abraham /
Project work up / meeting
with guide
Dr. Mani Kaliath
Dr. Subramanian
with guide
(4.00 pm-5.00 pm)
Dr. Anand Zachariah
Picnic
(4.00-5.00 pm)
Dr. Punitha
(5.00-9.00
pm)
Dr. Santhi Dani______
Picnic
Computer class
Computer class
Computer class
5.00 - 6.30 pm Orientation to CMC
DINNER
BREAK
Venue: Senate Hall
Venue:
Senate
Hall
Venue: CHTC
Venue: CHTC_____
7.30 - 8.00 pm
Picnic
4
Student
presentations:
4
Student
presentations:
4 Student presentations:
Introduction to CMC
My
hospital
/ my work
My
hospital
/
my
work
My
hospital
/
my
work
8.00 - 9.15 pm 3 Student presentations:
____________ My hospital / my work
__________________ i___________ _________ ______________________________ _ ___________
Venue: For classes - Norman Auditorium - 2nd Floor of OPD block, opposite Medicine For clinics - B ward and ID clinic (Cardiology OPD, 1st Floor, OPD)
For computer classes - Dodd library, ASHA bdg.
OPD, OG conference room - 6 111 Floor of ISSCC block, Wheeler
Hall-Ist Floor, ASHA bdg.________
1.00-2.00 pm
26
1
TIME TABLE FOR CC II - Week I
04. 04. 2005 Monday
Introduction to CC II
Dr. Anand Zachariah
(8.00-8.30 am)
MEU office
05. 04. 2005 Tuesday
Radiology in HIV
Dr. Rekha Cherian
(8.00-9.00 am)
CEU conf, room
06. 04. 2005 Wednesday
Clinical pharmacology
Dr. Sujith Chandy
(8.00-9.30 am)
CEU conf, room
07. 04.2005 Thursday
Neurological problems in
HIV
Dr. O C Abraham
(8.00-9.30 am)
CEU conf, room
08. 04. 2005 Friday
ART-I
Dr. Subramanian
(8.00-9.30 am)
CEU conf, room
09. 04. 2005 Saturday
ART-II
Dr. Subramanian
(8.00-9.00 am)
CEU conf. Room
Coffee break
(9.00-9.30am)
Case allotment and case
work up and project
work
(9.30-12.30 pm)
Coffee break
(10.00-10.15 am)
Prescription writing &
ARV pharmacy
(10.15-12.30 pm)
Dr. Subramanian
Dr. Priscilla and Team
CEU conf, room
TB in HIV infection
Dr. Ashish R.
(9.00 - 10.00 am)
CEU conf, room
Introduction to
immunopathogenesis in
HIV infection and
Virology practicals
Dr. Rajesh Kannagai
(8.30- 12.30 pm)
Virology classroom
TB in HIV infection
Dr. Anand Zachariah
(2.00-3.30 pm)
Wheeler hall
Case allotment and case
work up
(3.30-4.30 pm)
Ward orientation
(4.30-5.00 pm)
B ward______________
Evening clinics
(5.00 - 6.00 pm)
Dr. O C Abraham
Medical wards
Case allotment and case
work up
(10.00- 11.00 am)
Medical wards
GIT problems in HIV
infection
Dr. Ashish M
(11.00- 12.30 pm)
| CEU conf, room
DOTS clinic practicals
Dr. K R John
(2.00-5.00 pm)
CHAD
Health Education
programme
(5.30-9.00 pm)
Mr.Gunasekaran and
team
Coffee break
(9.30- 10.00am)_______
Case allotment and case
work up
(10.00- 11.00 am)
Medical wards_________
HIV and GITPracticals
Dr.Ansu, Dr.Gagandeep
(11:00- 12:30 pm)
Williams building______
Lunch break (12.30 — 2.00 pm)__________
Microbiology - practicals
Dr. Inbamalar
(2.00-4.00 pm)
Micro. Dept.
Meeting Med I faculty
(9.30- 10.00 am)
Psychosocial aspects
Ms. Joyce and team
(10.00- 12.30 pm)
CEU conf, room
ID clinic
Evening clinics
(4.30 - 6.00 pm)
Dr. Dilip Mathai
Medical wards
Evening clinics
(5.00 - 6.00 pm)
Dr. George M Varghese
Medical wards
27
Blood banking practicals
Dr. Joy Mammen
(2.00-3.30 pm)
Blood bank
Clinical Meeting
(3.30-5.00 pm)
ASHA building
Evening clinics
(5.00 - 6.00 pm)
Dr. Ashish M
W / L ward
Project work, library
work
WEEKEND
TIME TABLE FOR CC II - Week 2
11. 04. 2005 Monday
12. 04. 2005 Tuesday
13. 04. 2005 Wednesday
Community based
prevention
Dr. Kuryan George
(8.00- 12.30 pm)
CHTC
HIV and children
Dr. Valsan P Varghese
(8.00- 12.30 pm)
Child Health conf,
room
Respiratory problems in
HIV
Dr. Dilip Mathai
(8.00- 10.00 am)
CEU conf, room
14. 04. 2005 Thursday
Fever in HIV
Dr. Priscilla
(8.00- 10.00 am)
CEU conf, room
15. 04. 2005 Friday
Home based care
Dr. Punitha
(8.00-9.00 am)
MEU office
HIV and women
Dr. Jessie Lionel
(9.30- 12.30 pm)
CEU conf, room
Dermatology and STD
Dr. Susanne Abraham
(10.30- 12.30 pm)
CEU conf, room
16. 04. 2005 Saturday
Antimicrobial therapy
Dr. Anand Zachariah
(8.00-9.30 am)
CEU conf, room
Ophthalmological
problems in HIV
Dr. Sanitha
(9.30- 12.00 N)
Schell hospital
Conclusion and
feedback
(12.30-1.00 pm)
Counseling in children
Dr. Manoramma
(10.30- 12.30 pm)
CEU conf, room
Lunch break (12.30 - 2.00 pm)
Epidemiology of HIV
infection
Dr. Dilip Mathai
(2.00-3.00 pm)
CEU conf, room
Case allotment and case
work up
(3.00-4.00 pm)
Evening clinics
(4.30-6.00 pm)
Dr. O C Abraham
Medical wards
Infection control
Ms. Sara Oommen
(2.00 - 4.00 pm)
MEU office
Case allotment and case
work up
(3.00-4.00 pm)
Evening clinics
(4.30-6.00 pm)
Dr. Anand Zachariah
Medical wards
Project presentation
(1.30-5.30 pm)
Seminar room
ID clinic
Case allotment and case
work up
(2.00-4.00 pm)
Evening clinics
(4.30 - 6.00 pm)
Dr. Anand Zachariah
Medical wards
Evening clinics
(5.00-6.00 pm)
Dr. George M Varghese
Medical wards
28
Students depart
TIME TABLE FOR CC HI
5? SI 5C 2ro
IU\ Ho
ui 5 ?
/'/• /
X
791$
Week one_____
Monday
22.8.05_______
Devotion
M-I office
8:00 - 8:30
Journal Reading
(M-I)
(8:30- 10:30)
Split
Ward Rounds
(10:30- 1:00)
Tuesday
23.8.05
Dermatology
OPD
(8:00- 12:00)
Wednesday
24.8.05_______
Journal Club
(FHM)
Dr.Geetha
Dr.Divya
(8:00- 10:00)
Surgery OPD
FNAC
(12:00- 1:00)
Bronchoscopy
(10:00- 1:00)
Lunch
(1:00-2:00)
Case Work up
Procedures
(2:00 - 4:00)
Tea Break
Lunch
(1:00-2:00)
VCTC
Medicine OPD
(2:00-4:00)
Tea Break
Lunch
(1:00-2:00)
ID Clinic
(2:00-4:30)
Bedside Clinics
Dr.O.C.A
(4:30-5:30)
Evening Rounds
Case Work ups
Library
(6:00 - 8:30)
Bedside Clinics
Dr. D.M
(4:30-5:30)
Case Work ups
Procedures
(6:00 - 7:30)
Casualty Rounds
(7:30-8:30)
C ? \>A
□-■ to
• \' ■< V.
?
Thursday
25.8.05
Grand Rounds
(8:00- 1:00)
Friday
26.8.05______
PPTCT
Counseling
Sessions
(8:00-11:00)
Review x-rays etc
(11:00-1:00)
Saturday
27.8.05_________
Debriefing
Week 1
(8:00-8:30)
CPR
Dr.VCT
(8:30-9:00)
Radiology
U/S - scanning and
procedures.
(9:30- 1:00)
Bedside Clinics
Dr.AZ
(4:30-5:30)
Tea Break
Evening Rounds
Case Work ups
Library
(6:00 - 8:30)
Lunch
(1:00-2:00)
Case Work up
Procedures
(2:00-4:00
Tea Break
Bedside Clinics
Dr.S.S
(4:30-5:30)
Evening Rounds
Case Work ups
Library
(6:00 - 8:30)
! _ ii
29
Lunch
(1:00-2:00)
X-rays Discussion
Dr.RC
(2:00-3:00)
Clinical Meeting
(Med -1)
(3:30-4:30)
Bedside Clinics
AM
(4:30-5:30)
Tea Break
Casualty Rounds
Case Work ups
Library
(6:00-8:30)
Holiday
TIME TABLE FOR CC III
Week two
Monday
29.8.05
Devotions
M-I office
(8:00-8:30)
Review Article
(FHM)
Dr.Kala
(8:30- 10:30)
Split
Ward Rounds
(10:30- 1:00)
Lunch
(1:00-2:00)
Case Work up
Procedures
(2:00-4:00)
Bedside Clinics
Dr.O.C.A
(4:30-5:30)
Evening Rounds
Case Work ups
Library
(6:00-8:00)
Tuesday
30.8.05
Dermatology
OPD
(8:00-12:00)
Surgery OPD
FNAC
(12:00- 1:00)
Lunch
(1:00-2:00)
VCTC
Medicine OPD
(2:00-4:00)
Bedside Clinic
Dr. D.M
(4:30-5:30)
Case Work ups
Procedures
(6:00-7:30)
Evening Rounds
(7:30-8:30)
Wednesday
31.8.05_________
Journal Club
(FHM)
Dr.Shoba
(8:00-10:30)
Split ward Rounds
Case Presentation
And
Discussions
Procedures
(10:30- 1:00)
Thursday
1.9.05______
Grand Rounds
(8:00- 1:00)
Lunch
(1:00-2:00)
ID Clinic
(2:00 -4:30)
Lunch
(1:00-2:00)
Case Work up
(2:00-4:00)
Bedside Clinic
Dr.A.Z
(4:30-5:30)
Evening Rounds
Case Work ups
Library
(6:00- 8:30)
Bedside Clinics
Dr.S.S
(4:30-5:30)
Evening Rounds
Case Work ups
Library
(6:00-8:30)
Friday
2.9.05________
Induced Sputum
Pulm Fn Lab
(8:00- 10:00)
Saturday
3.9.05__________
Split Ward Rounds
(8:00- 11:00)
Project Work
Up date
(11:00- 12:00)
Dermatology OPD
(10:00- 1:00)
30
Lunch
(1:00-2:00)
Preparatory Time
for clinical meeting
(2:00-3:30)
Clinical Meeting
(FHM)
(3:30-4:30)
Bedside Clinics
VP
(4:30-5:30)
Evening Rounds
Case Work ups
Library
(6:00-8:30)
Conclusion
And
Feedback
(12:00- 1:00)
Students
Finish and go back
home
10.01.2005
_____ Monday
Theory - Part I
(10.00- 12.00 N)
Wheeler Hall
11.01.2005
Tuesday
OSCE - Part I
(10.00- 12.00 N)
Wheeler Hall
________ TIME TABLE FOR CC IV
13.01.2005
12.01.2005
______
Thursday
_____ Wednesday
Poster presentation
Bedside clinical case
(8.00-4.00 pm)
presentation
CHTC
(8.00- 12.00 N)
Wards
Theory - Part II
(2.00 - 4.00 pm)
Wheeler Hall
OSCE - Part II
(2.00-4.00 pm)
Wheeler Hall
Preparation for poster
presentation
(2.00 - 4.00 pm)
CHTC
Graduation ceremony
(6.00-8.00 pm)
CHTC Auditorium
31
14.01.2005
_____ Friday
Picnic &
Networking session
(8.00 - 4.00 pm)
Karigiri
15.01.2005
_____ Saturday
Alumni meet
CME
Networking session
(8.00- 1.00 pm)
Wheeler Hall
FACULTY DEVELOPMENT
PROGRAMME
HANDBOOK ON DISTANCE
LEARNING COURSE
FOR
FELLOWSHIP IN HIV MEDICINE
CMC, Vellore
3
1
INDEX
SI. No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
V
M*
7
10.
11.
12.
13.
14.
15.
16.
17.
Title
Introduction_____________
__
Modulepreparation
Formulation of a time schedule for the DLC
Briefing of faculty
______________
Orientation to distance learning course________
Dispatch of modules to the students___________
Receipt of tutor marked assignments (TMA),
module evaluation questionnaires and feedback
forms_____________________________________
Dispatch to concerned faculty________________
Collection of tutor marked assignments after
marking by the faculty______________________
Entry of marks of the TMAs
_______________
Dispatch of the marked TMAs to the students
Consolidation of distance learning course scores
Feedback of distance learning modules
Sample time schedule_______________ _______
Session plan for CCI
_______________
Guidelines for distance learning - handbook
Template for tracking file
_________________
Page No.
1
2
2
2
2
2
2
3
3
3
3
3
3
4
_5
6
9
1
Introduction:
This hand book is a guide to coordinating of the distance learning course which
is a component of the Fellowship in HIV Medicine programme. It is suggested
that each regional training center modifies and adapts the process to meet their
local needs. In the following pages you will find the details of the coordinating of
the distance learning course. Sample templates are included.
Steps in the process
Module preparation
Printing of the module
Xeroxing and binding of the module
Receipt of the module for dispatch
_____________________
Formulation of a time schedule for the DLC_______________________________
Briefing of faculty_________________ ______________________ _______________
Dispatch of modules to the students______________________ ________ _____ ___
Receipt of tutor marked assignments (TMA), module evaluation questionnaires
and feedback forms____________________________________ ________________
Dispatch to concerned faculty
Collection of tutor marked assignments after marking by the faculty--------------Entry of marks of the TMAs------------- ------------------ - -----------------------------------Dispatch of the marked TMAs to the students--------------------------------------------Consolidation of distance learning course scores
Feedback of distance learning modules___________________________________
2
Module preparation
1. Proof read the documents.
2. Print the modules.
3. Arrange according to order.
as required for the respective modules.
4. Arrange for photographs and X-rays
5. Xerox and bind the modules.
6. Collect the modules and keep them ready for dispatching.
Formulation of a time schedule for the DEC
The distance learning course starts during the later half of CC I. It takes a total of
I mon £ to complete the 12 modules of the distance learning course. A week
ime?smven for each module to completed. The second contact^course may fall
to between the distance learning course. The dates need to be adjusted
accordingly. For a sample of the time schedule given to the students and the
schedule used at the office see page 4.
Briefing; of faculty
each TMA.
Orientation to distance learning course
The students are oriented to the distance course during Contact Course I (Session
plan on page 5). They are briefed regarding the "Guidelines for distance
learning" handbook (Page 6).
Dispatch of modules to the students
The first few modules may Wi^ento^“XuXd"o'uner
SX^XXof^^ouV^Xies Uld be sen. in such a way
that they reach the student on time.
Hereipt of tutor marked assignments (TMA). evaluation and feedback forms
3
evaluation questionnaire and feedback form. Remind the students who have not
submitted the TMA by the specified date. Maintain a tracking file (Page 9).
Dispatch to concerned faculty
Take a xerox copy of each of the TMAs received and file them. Send the original
copy of the TMA to the concerned faculty for marking. When sending the TMA
to the faculty, attach the common scoring sheet to the file (Page 9). Take a xerox
copy of the feedback form and send it also to the concerned faculty. Maintain a
tracking file for each module (Page 10).
Collection of tutor marked assignments after marking by the faculty
Receive the marked TMA's from the concerned faculty. Maintain a tracking file
for each module (Page 10).
Entry of marks of the TMAs
Enter the marks against each student's name and module number, on to the
master sheet (Page 10).
Dispatch of the marked TMAs to the students
Xerox the marked TMAs. Send the original copy of the marked TMA to the
respective student. File the xeroxed copy of the TMA.
Consolidation of distance learning course scores
At the end of the distance learning course, when all the 12 modules are
completed and the TMAs are scored, counter check the entry of all TMA scores
against each student. Calculate the total score and the percentage (Page 10).
Obtain the final result.
Feedback of distance learning modules
Compile the feedback and comments of each modules. Discuss issues of revision
of modules with the concerned faculty and send the completed feedback and
scores to the Distance Learning Centre (DEC).
4
TIME SCHEDULE GIVEN TO THE STUDENTS
________ 12 MODULES
Module #
1
2
3
4
5
6
7
8
9
10
11
12
Dispatch date
16/7/05
01/8/05
27/8/05
(Oct 3-11 FDW II)
08/10/05
JULY - OCTOBER, 2005_________
Start Module on (Mon)
Complete Module on (Sat)
18/7/05
25/7/05
01/8/05
08/8/05
15/8/05
22/8/05
29/8/05
05/9/05
19/9/05
26/9/05
10/10/05
17/10/05
23/7/05
30/7/05
06/8/05
13/8/05
20/8/05
27/8/05
03/9/05
10/9/05
24/9/05
01/10/05
15/10/05
22/10/05
Mail Back TMA
(Mon)
25/7/05
01/8/05
08/8/05
15/8/05
22/8/05
29/8/05
05/9/05
19/9/05
26/9/05
03/10/05
17/10/05
24/10/05
TIME SCHEDULE FOR THE OFFICE
Module
#
1
2
3
4
5
6
7
8
9
10
11
12
Dispatch
date
16/7/05
1/8/05
27/8/05
8/10/05
Start
Module
on
(Mon)
18/7/05
25/7/05
1/8/05
8/8/05
15/8/05
22/8/05
29/8/05
5/9/05
19/9/05
26/9/05
10/10/05
17/10/05
Distance Learning Course - Time Schedule______
Send
copy to
Faculty
Collect
Complete
Mail
Receive
for
TMA
Module
Back
TMA
Xerox
on
TMA
(1 week and File marking
(2
(Wed)
weeks)
(Sat)
(Mon)
-Fri)
(Mon)
17/8/05
3/8/05
23/7/05
25/7/05
29/7/05
1/8/05
24/8/05
8/8/05
10/8/05
30/7/05
1/8/05
5/8/05
31/8/05
15/8/05
17/8/05
6/8/05
8/8/05
12/8/05
24/8/05
7/9/05
15/8/05
19/8/05
22/8/05
13/8/05
31/8/05
14/9/05
26/8/05
29/8/05
20/8/05
22/8/05
7/9/05
21/9/05
2/9/05
5/9/05
27/8/05
29/8/05
28/9/05
14/9/05
9/9/05
12/9/05
3/9/05
5/9/05
12/10/05
26/9/05
28/9/05
23/9/05
10/9/05
19/9/05
19/10/05
5/10/05
3/10/05
30/9/05
24/9/05
26/9/05
12/10/05
26/10/05
10/10/05
7/10/05
1/10/05
3/10/05
9/11/05
21/10/05 24/10/05 26/10/05
15/10/05
17/10/05
2/11/05
16/11/05
28/10/05 31/10/05
24/10/05
22/10/05
Enter
marks
of TMA
(Fri)
19/8/05
26/8/05
2/9/05
9/9/05
16/9/05
23/9/05
30/9/05
14/10/05
21/10/05
28/10/05
11/11/05
18/11/05
Dispatch
Marks to
Students
(Sat)
20/8/05
27/8/05
3/9/05
10/9/05
17/9/05
24/9/05
1/10/05
15/10/05
22/10/05
29/10/05
12/11/05
19/11/05
5
SESSION PLAN FOR CC I
INTRODUCTION TO DISTANCE LEARNING
Date:
Time:
Faculty:
Objectives:
At the end of this session the students should know:
1. Why distance learning is being used in this course.
2. The differences between distance learning and classroom learning.
3. How to study within a distance learning course.
4. The aims, methods, structure, schedules and work requirement of the
distance learning program.
5. How to start working on the first distance learning module.
6. How to fill in a tutor marked assignment and the schedule for sending the
tutor marked assignment to CMC, Vellore.
7. The importance of maintaining communication with fellow students and
schedules for e-group communication.
Methods:
Lecture
Discussion
Individual work on the first module
Handouts:
1. First four distance learning modules
2. Introductory guide for distance learning course
6
GUIDELINES FOR DISTANCE LEARNING - HANDBOOK
HIV DISTANCE LEARNING COURSE
INTRODUCTION TO THE COURSE
Introduction:
.
.
Welcome to the Distance Learning Course. We hope that you will enjoy studying
the distance learning modules. We also hope that they will help you in
developing HIV care in your set up.
The distance-learning component of the HIV Physician Training Course aims to.
1. Improve your knowledge in the practice of HIV medicine.
2. Enable you to learn from your own hospital situation and patient population.
3. Apply the knowledge that you gain to your own practice situation.
4. Support learning from other components of course namely the contact
courses and project work.
How were they prepared:
These modules were carefully prepared by the course faculty keeping in mmd
the local situation of your work. They were written with the specific aim of
improving your practical knowledge. Dr. Janet Grant from the Open University
Centre for Medical Education assisted the faculty in developing the modules
through workshop training and constant guidance. Other experts m the field
evaluated the modules. Each module was then pilot tested by two doctors
working in peripheral hospitals to make sure the material was clear and relevant.
We have also made sure that the modules do not exceed the time available to
you. We have therefore completed the pilot testing and validation of the
modules. One batch of students have completed the modules and we have
modified them based on their feedback.
What they cover?
The sixteen modules of the course cover the major areas of------HIV care: at the level
The
modules
do not aim to be
of secondary hospitals and primary care. ---- ------comprehensive like a textbook. They are very
y practically oriented focusing on the
information and principles required for HIV clinical work. They direct you to
more comprehensive resources.
These modules will be supplemented by the sessions in the contact course where you will be given skills training and provided additional knowledge.
Please feel free to request for more information.
Structure of the module
Each module is a specially designed integrated learning material.
It consists of:
, ,
1. Overview: provides a summary and overview of the module
2. Objectives: list of objectives that you will achieve by the end of the module.
3. Contents page: List of activities, readings and time required for each.
4. Activities with feedback answers:
The module consists of a series of activities that need to be attempted in
sequence. They are specially designed active learning exercises. These provide
you opportunity to think about, apply and understand more fully the topics you
are learning about.
Perform the modules according to the following instructions:
a. Read the overview, objectives and contents.
b. Following this proceed to the instruction preceding the first activity.
c. You will be asked to read a short section in the reader.
d. Following your reading you can start the activity. The time allotted for the
activity is specified and is usually in excess of the time that you may
require.
e. Write the answers to the questions in the activity in the boxes on the page.
After you have finished the activity you can read the feedback for the
f.
activity that is on the following page.
After completing one activity you can move on to the next one. Complete
gone activity after the next till you reach the end of the module.
The activities are critically important to your learning. Try not to skip them, even
if time seems ipressing. If you just read the feedback without actually doing the
activity, you may’ lose a lot of the educational benefit of the module. In
particular, you will miss many opportunities to apply your studies to your own
practice situation.
5, Tutor marked assignment
The tutor marked assignment aims to help you apply your new knowledge you
into your practice situation. Each tutor marked assignment will take about 1
hour. Following completion of the tutor marked assignment you should tear
the page and insert it into the addressed envelop and send it to the course
office by the date specified.
The faculty who prepared the module will evaluate the tutor marked
assignment and the marks and feedback will be sent back to you in about 4
weeks after we receive your tutor-marked assignment.
6. Reader:
.
The reader consists of short sections, which you have to study as you work
through the activities.
7, References and further reading:
Study of the references is not essential to completion of the module. They point
to further study materials. If the references are not available to you, they can be
accessed from the course library when you come for the second contact course.
After yoif complete the module fill in the short feedback form at the back of the
module. Tear it out and insert it into the envelope and mail it back to the course
office along with the tutor marked assignment.
Organising time for the Distance Learning Course
We have tried to make this course as straightforward as possible for you to use.
You will simply need to set aside a maximum of 6 hours per week to study each
module (about 1 hour every day).
Evaluation of the course
The TMA marks contribute to 20% of your total assessment. To pass the course
you need to score a minimum of 50% overall in all the 12 modules together. You
should not score not less than 50% in more than 4 modules out of the 12.
Module Order
1. Fever in HIV infection
2. HIV and respiratory system
3. HIV and the GI system
4. Infection control and exposure
prevention
5. HIV and nervous system
6. HIV and women
7. HIV and children
8. HIV, STI's and RTFs
9. Anti-retroviral treatment
10. HIV and psychiatry
11. Basic science of HIV infection
12. Safe blood banking
This course and you
So, what are you expecting to gain from this course?
We hope that you will gain a good, practical grounding in HIV care in your
practice. If you already provide such a service, we hope that this course will help
you develop it further. We hope also, that the course will help you to involve
other members of your team in making constructive plans for the development
of HIV care in your setup.
Evaluation of the course
As part of our evaluation of the course we would like you to provide feedback
for each module. This evaluation questionnaire is placed on the last page of
every module. Please fill it when you have finished and send it along with the
TMA to the project office. This will help us improve the module in the next
course.
Distance Learning Course Schedule
This schedule explains to you the detailed time schedule for you to start each
module and send each TMA. You will receive modules in sets of four. The
marking of the TMA will be sent back to you one month after we receive it from
you.
Module No.
Module to be started
TMA to be sent
9
TRACKING SHEET FOR TMAs, MODULE EVALUATION QUESTIONNAIRES & FEEDBACK
FORMS
SI
No.
Roll No.
TMA received
Name of students
Module
evaluation qs
received
Feedback form
recieved
COMMON SCORING SHEET FOR TUTOR MARKED ASSIGNMENTS - FACULTY
w
MODULE NO:
TITLE:
SI. No.
Date:
Roll No.
Name of students
Marks scored
Signature of the faculty:
10
TUTOR MARKED ASSIGNMENT TRACKING SHEET
Module No:
Title:
Name of faculty:
Date of giving TMA to faculty for marking:
Date of collecting from faculty after marking:
Marks entered on & by;
Date of sending TMA back to students:
SI
No.
Roll
No.
Name of students
TMA
received
TMA sent
TMA
TMA
TMA
TMA
xeroxed back to
mark
sent for marking
student
marking completed entered
w
MASTER SHEET OF TUTOR MARKED ASSIGNMENT SCORES
SI
No
Roll
No
Scores of each module
Name of
students
1
2 3
4 5
6 7 8 9 10 11 12
Entered
by
Total
Score
%
Counter
checked
by
e
FACULTY DEVELOPMENT PROGRAMME
HANDBOOK ON PROJECT WORK
I
I
I
I
I
I
I
I
I
FOR
(PROJECT GUIDES, COURSE ORGANISER AND CORE
TEAM)
FELLOWSHIP IN HIV MEDICINE
I
CMC, Vellore
INDEX
SI. No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
Title
Introduction_______________ _____________________
Objectives____________________ __________________
Prior to Contact Course I__________________________
During Contact Course I___________ _______________
Inter phase period (CC I - CC II)
________________
During Contact Course II____ _____________________
Inter phase period (CC II- CC III)___________________
During Contact Course III_________________________
Inter phase period (CC III- CC IV)__________________
During Contact Course IV________ _________________
Guidelines for project planning____________________
Session plan for CC I__________________________
Hypothetical case scenario__________ ______________
Session plan for CC II_____________________________
Draft letter to guide for marking of full project plan
Guidelines for assessment of full project plan________
Guidelines for assessment of budget________________
Draft letter indicating project approval______________
Draft letter requesting resubmission of full project plan
Draft format for administrative approval & account
head information________ ________ ________________
Draft letter while sending seed grant amount________
Receipt of seed grant___________ _________________
Format for project interim report___________________
Draft letter for planning site visit
______________
Outline of final project report
________________
Guidelines for poster presentation
Page No.
1
2
3
3
3
3
4
4
5
5____
7
16
18
19
20
21
23
24
25
26
27
28
29
30
31
32
1
Introduction:
This hand book is a guide for the faculty guiding the FHM student through the project work. It is
suggested that each regional training center modifies and adapts the process to meet their local
needs. Sample templates and guidelines are included.
CC-I (Month 1):
CC-II:
CC-II + 1 month:
Month 6:
Month 6-11:
CC-III:
Month 8:
I Month 10:
CC-IV:
__________________ Steps in the process___________________
Training in project planning and preparation of project outline;
Presentation of full project plan;
Submission of revised full project plan;
Project review and grant sanction;
Project implementation;
Update on project work;
Project interim report I;
Project interim report II;
Submission of final project report and poster presentation.
Based on the schedule of the contact courses, prepare a detailed schedule of the project planning and
put it up on the year planner in the course office.
2
Objectives of project work in the FHM programme
To strengthen HIV care services in the students' hospitals. By the end of the course it is aimed that:
(a) the student would be able to independently plan and implement a project tailored to the specific
local needs;
(b) basic components of HIV care would become available in each of the institutions (outpatient
clinic; inpatient care; HIV testing; infection control and exposure prevention system; counseling and
staff education);
(c) services would become more accessible
(d) quality of services would improve.
c
3
Prior to Contact Course I
The course organizer and core team should divide the students among the project guides. The project
guides should be selected based on expertise and interest in undertaking project work. It would be
preferable for the project guides to be members of the core team who have undergone training in
project planning. Each project guide would supervise a maximum of two students. A meeting should
be conducted with the project guides before the beginning of the course, to orient them adequately to
their roles.
The details of the student and the proposed project (according to the application form) should be
given to the project guide. The project guides need to be briefed regarding their roles. They are
requested to study the project proposal.
The course organizer and core team should carefully select the faculty who would be undertaking
training in project planning. Prior discussion is necessary with the concerned faculty in planning the
training for project work (guidelines for training in project planning session in CC I attached). The
mock exercise for training in project planning needs to be designed and appropriate facilitators for
this exercise should be chosen.
During Contact Course I
During CC I the students are trained in project planning (sample of session plan for CC I attached).
The students undertake a needs assessment based on a hypothetical scenario (attached). Through
group activity they are taken through the steps of project planning to address the aspects of the needs
identified.
Time slots are planned in the time table for students to meet their guides. The student meets the
project guide at least twice during CC I. During these meetings the guide and student discuss the
project outline. The project outline is improved (rewritten) according to the feedback given by the
project guide. At the end of CC I the students should submit a revised project outline, retaining a
copy for themselves.
Inter phase period (CC I - CC II)
The student works on the project proposal outline in consultation with the local guide and guide at
the regional training institutions. The guide keeps in touch with the student through e-mail / phone.
The guide may contact the student's local guide and discuss the project outline with him / her. The
student prepares the final project plan based on the guidelines for the full project plan. Depending on
the time between CC I and CC II, the students may submit the full project plan 1-2 weeks before the
CC II. If the time interval is short, it may be submitted at the beginning of CC II.
During Contact Course II
During CC II, plan one afternoon session for presentations of the full project plans (a draft session
plan is attached). The students should submit the full project plan at the beginning of CC II. This
should be sent to their project guide. Arrange meetings of the respective students with the guides to
4
revise the full project plan. Based on these discussions, the students plan their presentations as
overhead or power point projections. This presentation is attended by the project guide.
A combined feedback is provided by the core team and the project guide in written format. A copy of
the feedback is retained along with the full project plan. A date for resubmission of the revised full
project plan is given to the student at the end of CC II.
Inter phase period (CC II - CC III beginning of the project phase)
The student on return to their institution revises the full project plan, based on the feedback from the
project guides during contact course II, in consultation with their local project guide and the
institution administration. The revised full project plan is sent to the office by the specified date.
If the full project plans are not received by the specified dates, reminders are sent to the students. The
full project plan is copied and sent to the project guide and one other faculty member who
independently mark it (sample letters attached). The revised full project plan is graded by the project
guide and one other faculty member based on the guidelines for assessment (sample attached) and
full project plan marking format. A minimum grade of 50% is required in the full project plan. The
project guide provides feedback for further revision. Summarize the feedback of the project guide
and the other faculty member and send it to the student indicating whether the project has been
approved or not and the revisions required (sample letter attached). If the student has not received
the pass grade, the student is requested to resubmit based on the feedback for fresh assessment
(sample letter attached). After the student has passed in the grading of the full project plan, the
budget is reviewed by two members of the core team based on the guidelines for assessment of the
budget (attached).
Once the project has been approved, the administrator from the institution should send a letter
indicating their approval of the project and the budget. They should also indicate the institutional
account head on which the seed grant draft should be made (sample format attached).
Once all the full project plans are approved, send the set of full project plans along with the budget
and the letters from the administrators to RCSHA for release of the project seed grant. RCSHA will
release 80% of the budget at this time. Drafts are to be prepared by the accounts department to the
specified account heads of the student's institutions (sample letter attached). The drafts are sent to the
student's institutions with receipt forms (sample attached). Follow up to ensure that the amounts
have been received; the receipts sent back and filed.
During Contact Course III
Arrange time for the students to meet with the project guide and also the course organizer. The
student presents an update of his / her work regarding the project.
5
Inter phase period (CC III— CC IV)
Project interim reports
Two months after commencement of the project, the student submits the first interim report and four
months into the project the second interim report is submitted (sample format attached). Follow up
with the students regarding receipt of the project interim reports depending on the due dates.
These need to be sent to the project guides for review and comments. The guide provides feedback on
the interim reports to the student.
Site visit 1 (before or 1 month into the beginning of project work)
At the end of the contact course II, start planning the dates of the site visits with the project guides
(sample letter attached). The project guides need to be briefed regarding the site visits (site visit tool
attached as a separate document). They are given a file with the site visit tool and full project plan.
The training officer prepares the travel arrangements and contacts the students to check their
availability. The site visit is generally of one day. Training sessions for the hospital staff may be
arranged based on the request of the student and the expertise of the faculty. At the end of the site
visit, the course organizer debriefs with the faculty. The narrative report is sent to the student and
their administrator with some suggestions for improvement. On return from the first site visit, the
scores are transferred into the excel format.
Site visit II (last month of project work or after completion of the course)
The dates for second site visit are arranged with the students and project guides in the same way as
the first site visit. On return from the second site visit, the scores are transferred into the excel format.
Submission of final project report
By six months the student concludes the project or if it is an ongoing project, concludes this phase of
the project. The student writes the final project report (outline of project report attached) and
prepares posters for the project presentation (guidelines for poster presentation attached) during
contact course IV. The final project report is sent by the end of December for review by the project
guide.
During Contact Course IV
Poster presentation: The projects of the students are grouped under various themes like ART,
hospital / clinic based care, counseling, screening & home based care, infection control & staff
education, prevention etc. Each theme group may have 4-5 projects. On the day prior to the poster
presentation the posters are put up and a rehearsal is organized. The project guide is present while
the students rehearse the poster presentations.
6
On the day of project presentation: The poster presentation session starts off with a welcome and
explanation of the schedule for the day. Time is allotted for all participants to study all the posters.
After this the participants break into theme groups and students make an oral presentation (10
minutes) to the group. Each group has a chairperson (could be the guide). This is followed by a
discussion for 20 minutes. This is based on a set of discussion questions:
a) What was the project trying to do?
b) How did the trainers approach the problems?
c) To what extent was the approach successful?
d) What were the difficulties they experienced and how were they tackled?
e) What general lessons can be drawn from the project?
f) What are the next steps or the future of the project?
Following the group presentations a plenary presentation of poster themes is organized with a senior
guest / guide chairing it. Each group is given 10 minutes to present the projects and 15 minutes for
discussion.
7
GUIDELINES FOR PROJECT PLANNING
GUIDELINES FOR PROJECT WORK
Meeting with faculty guide during CC-I:
a. You need to take a completed project outline, logic model template, Gantt chart
and stakeholder analysis for discussion with the faculty guide.
b. Your guide will go through the project outline and comment on it and give you
suggestions for improving project outline.
c. You should aim to improve the project outline and bring a final copy when you
meet your guide at the end of the week.
Role of the project guide at the regional training institution:
To assist and guide you in developing a project plan, implementing and evaluating the project. These
include:
a. Assistance in writing project reports
b. Academic support for the project work
c. Discuss progress and sort out problems
d. Evaluating project reports
e. Visiting your hospital / institution
Role of the local project guide:
a. Sort out local administrative problems
b. Sustain the motivation of the student.
8
GUIDELINES FOR IMPROVING PROJECT WRITE UPS
Project Outline:
1. Background to the problem:
What is the size of the HIV problem locally (figures for prevalence in your district/state)? What
are the available HIV prevention and care services in your area? What are the available HIV
services in your hospital/institution? What is the HIV patient load (in-patient, out-patient, HIV
tests performed)? What are the gaps in HIV care provision at your institution? How will the
project help in addressing these gaps?
2. Goals and objectives:
The goals may state the long-term outcomes that need to be achieved. The objectives need to
relate to what can be achieved during the project period.
Are the objectives specific? Are they measurable? Are they achievable in the time period? Are the
objectives realistic? Are they time bound? (SMART)
Do the objectives relate to improvement in care provision (availability of components of care) or
health outcomes (or reduction in OIs, increased survival, decreased mortality)?
3. Methods:
Who are the targets (health professionals, staff, PLHAs, their families)?
What are the activities (seeing outpatients, conducting training etc.)?
What are the instruments required (questionnaires, evaluation instruments)?
What are the resources required (time, manpower, infrastructure, instruments, consumables)? Are
all the activities mentioned in the logic model template?
4. Evaluation:
Use the logic model template for outcomes, indicators and instruments. Does it describe who will
be conducting the evaluation?
5. Budget:
Are all the items on the inputs of the logic model template included in the budget? Where are the
resources going to be generated from?
LOGIC MODEL TEMPLATE
1. Outcomes: Check the outcomes against the project objectives (in the project outline). Are they
achievable? Will they contribute to the overall goal of the project?
2. Inputs: Do the inputs describe resources such as staff, facilities, equipment and money and not
activities? Are all the inputs required for the project included?
3. Activities: Are all the activities described adequately?
4. Outputs: Check that they are products of program activities and not the activities themselves.
5. Indicators: Check that the indicators are specific, observable and measurable and the level of
achievement is also stated. Make sure there is one indicator for every outcome.
6. Instrument: Check that there is an appropriate instrument to measure each indicator.
Timeline:
Check that all the inputs, activities and measurement of indicators are included in the time line.
9
PROJECT OUTLINE TEMPLATE
Title of Project
Background (Statement of problem, needs assessment, rationale of project)
Goals and objectives of project
10
Methods
Evaluation (outcomes, indicators and instruments)
Budget
11
LOGIC MODEL TEMPLATE FOR PROGRAM PLANNING
INPUTS
ACTIVITIES
OUTPUTS
OUTCOMES
Initial
12
PROGRAM OUTCOMES AND INDICATORS
NO.
OUTCOME
INDICATOR
DATA COLLECTION
INSTRUMENT
1
2
3
4
5
I
I
I
13
LOGIC MODEL OF PROGRAM PLANNING
1. Inputs: are resources a program uses to achieve program outcomes
- Staff, facilities, equipment, money.
2. Activities: are what the program does with the inputs - the services it provides - in order to
achieve its objectives.
3. Outputs: are the products of the program's activities - number of patients seen, facility set up,
number of classes taken
4. Outcomes: are the benefits of the program - improvement in care, better knowledge and
attitudes.
Outcomes may be short term, intermediate or long term. Look at the objectives of your project
to help you think about the outcomes. Then list out all outcomes that you think are important.
When you state the outcome, ask yourself: "Is it reasonable to think that the project will
influence the outcome? Will the measurement of the outcome help to identify the success of
the program? Will my peers accept this as a valid outcome of the program?"
5. Indicators: are specific items of information that help track the achievement of the outcomes.
The indicators should be specific, observable and measurable characteristics or changes that
will represent achievement of the outcome. It should include a specific number or percentage
(statistics) that the program will calculate to summarize the level of achievement of the
program. Each outcome should have one or more indicators.
6. Data sources: are sources from which you will obtain data regarding your indicators.
7. Data collection instruments: are instruments to collect data regarding indicators. If you do not
have these already, they may need to be designed and tested.
INPUTS
>
ACTIVITIES
> OUTPUTS
> OUTCOMES
In preparation of the logic model, include all inputs, activities, outputs and outcomes that you
think are important. Make the appropriate linkages between the inputs, activities, outputs and
outcomes.
14
GANTT CHART FOR PROJECT TIMETABLE
2
1
Months__________
Organization of
inputs/preparation
for projects
3
4
5
7
6
9
8
10
11
12
Activities
Indicator
assessment
Reports__________
Project outline____
Full project plan
Revised full project
plan_____________
Project Interim
reports___________
Final project report
Project presentation
x
X
X
X
X
X
X
X
X
15
STAKEHOLDER IDENTIFICATION SHEET
Person
What do you want
them to do on
your project?
What would their
interest be in your
project?
How will you convince
them regarding your
project?
16
SESSION PLAN FOR TRAINING IN PROTECT WORK - CC I
Faculty:
Date:
Time:
Description:
The students will be taken through the steps of planning of projects and using the project outline
template and logic model template through group work.
Objectives:
At the end of this session the students should be able to:
1. List the steps of project planning.
2. Use the logic model template of project planning.
3. Develop a project plan.
4. Write out a project outline using the project outline template.
5. Appreciate the usefulness of logic template in developing the project.
6. Prepare a Gantt chart and perform a stakeholder analysis.
Methods:
Lecture/discussion:
.
Steps of project planning - project outline template, logic model of program planning
Handouts:
1. List of project guides
2. Guidelines for project work
> Project outline template
> Logic model template
> Gantt chart
> Stakeholder analysis
Abstracts
of past projects and model thematic projects.
3.
FO111OWprepar°er^project outline and logic model for program planning by xxxxxx for discussion with
2. Submit the^roject outline and logic model to faculty guide during the 'project work up /
meeting with guide7 sessions by xxxxxxx .
17
PROJECT PLANNING - GROUP WORK - CC I
Date:
Time:
Faculty:
Objectives:
As per the project planning session.
Methods:
The students will be divided into four groups.
Students will develop project plans on project ideas that they are provided with.
Students will go through the steps of needs assessment, statement of objectives, methodology, using
logic model for project evaluation.
Students will get a feedback from the facilitators at the completion of each step.
Students will make a short presentation of the logic model at the plenary session and any issues faced
in the planning process will be discussed.
Instructions to the group:
Students in small groups will work with the project outline template to:
> Perform a needs assessment
> Define the objectives
> Define the methods
> Write out a logic model template evaluation form
> Fill up the Gantt chart
> Fill up the stakeholder analysis
The group along with the facilitators will stop at every step and discuss what they have done.
At the end of the session, the groups will share their logic model templates and discuss general issues
with regard to project work.___________ ___________ ________________________ i
Names of facilitators
Names of group members
Group No.
______ I
______ II
______ III
IV
18
HYPOTHETICAL CASE SCENARIO
CASE STUDY FOR THE PROJECT PLANNING SESSION
Background of the community
X is a provincial town of two lakhs population. An important occupation in the locality is the
trucking industry noted to be prone to high risk sexual behavior. Over the recent years there has been
a dramatic increase in the HIV prevalence. Available statistics show an ante-natal HIV seroprevalence
of 3.4% and voluntary blood donor seroprevalence of 2%.
Institutional background
You are a physician working in a charitable secondary hospital in this town. The hospital has 100
beds and handles about 200 out-patients every day. About 50 HIV positive persons are seen on an
average monthly in the various OPDs and 5-10 HIV positive persons are admitted monthly mostly in
the Medicine wards. However there are no uniform guidelines for patient management and there are
concerns about the quality of services. There is no designated counselor as the doctors themselves are
giving counseling. There is concern about the lack of availability of gloves, hepatitis B immunization
and post-exposure prophylaxis. Staff feel inadequately trained to look after HIV patients. The
obstetric clinic handles a large obstetric load but there is no prevention of parent to child
transmission programme. Surgeons are anxious about operating on HIV positive patients. There are
apprehensions that a sizable group of HIV patients do not get followed up. There are a few interested
doctors, but the administration has not taken a clear policy on HIV care.
Community care and prevention
The district administration aware of the priority of the problem has initiated prevention and
promotive activities through a few NGOs. PLHA networks are raising the problem of poor quality
and expensive health care and the need for ART.
Task
The hospital administration has sent you for the Fellowship in HIV Medicine to strengthen the HIV
care in your institution. As part of the project you are trying to develop a systematic plan to address
the existing problems.
Your task is to develop a project plan through the following steps:
1. Problem identification (gaps)- Use the flipboard sheet to identify the gaps in care (30 minutes).
2. State your goals and objectives (30 minutes).
3. Develop a logic model template for programme planning and an evaluation framework on the
flip chart (45 minutes).
4. Plan a 5 minute presentation to the rest of the groups.
19
SESSION PLAN FOR CC II
PROJECT PRESENTATION
Date:
Time:
Venue:
Faculty: Project guides
Objectives:
1. To review the full project proposals prepared by the students.
2. To discuss ways of improving the project plans.
3. To finalize the full project plans based on the review process.
Prior preparation:
1. Project plans should be submitted to project guide and office on the first day of CC II.
2. The final project outline should be submitted on the first day of the second week of CC II.
3. Kindly make appointments with your project guides for discussion of full project
plan before the project presentation during CC-II.
Project presentation:
1. Each student should make a 15-minute presentation of his or her project plan.
4. The presentation should include:
Statement of the problem and local need; aims and objectives; methods; logic model template of
program evaluation (inputs, activities, outputs, outcomes, indicators, instruments); Gantt chart;
stakeholder analysis; budget and how the project is going to be sustained.
5. The presentation will be followed by 5 minutes of discussions and comments on the
project by the faculty and students. These discussions should focus on suggestions
for improvement of the projects.
Ending time
Starting time
Guide
Student
Follow up:
The students should finalize the project proposal based on the suggestions made at the project
presentation and submit the finalized full project plan in printed and electronic format within one
month of completion of CC-II.
20
DRAFT LETTER TO GUIDE FOR MARKING OF THE FULL PROTECT PLAN
To:
Dear Sir/ Madam,
I would request you to mark the full project plan of the students whose projects you are guiding.
The guidelines for the preparation of the full project plan and the marking scheme are enclosed.
Please could you send the marked full project plan by xxxxxxx. The students require a pass
requirement of 50% in the full project plan.
With regards,
Yours sincerely.
PS: I hope you have received the project outline of your student. If not, kindly let us know so that we
can forward a copy to you.
21
GUIDELINES FOR ASSESSMENT OF FULL PROJECT PLAN
CRITERIA FOR MARKING FULL PROJECT PLAN
1. Local Need Defined - 2 marks
2. Aims and objectives stated clearly and realistically - 2 marks
3. People involved and stakeholders clearly described - 2 marks
4. Methods and activities - clearly described and logical- 2 marks
5. Project evaluation - logical and feasible - 2 marks
6. Assessment of project cost - Are the budget items justified
7. Is the time plan clearly defined?
Total score - 10 marks
GUIDELINES FOR PREPARATION OF FULL PROJECT PLAN
1. Needs to be about 8 pages
2. Running text for the different sections and not just points.
3. Background:
Should have clear statement of problemWhat services are already available; number of patients; what are the present lacunae, which
aspect is trying to be addressed through the project.
4. Methodology:
Each of the steps need to be written in detail. For example:
For an education program- Objective, methods, curriculum, number of sessions, session plans
a.
etc.
For a questionnaire - the draft questionnaire should be included
b.
For staff or team- the number of persons, their role etc. need to be stated in detail.
c.
For referral system- the tiers, the role at different levels, number of persons need to be clearly
d.
stated.
Home based care- how many visits, what are the functions of each visit, who is visiting etc.
e.
5. Evaluation:
Needs to be detailed; indicator should include what measurement will be considered a positive
outcome.
Draft of evaluation instruments need to be included.
6. Budget:
Items:
Staff, training courses, equipment and consumables, travel, office expenses, contingencies.
Should include justification for each item (each item should have a detailed justification).
7. Sustainability of project: A short section should state how this project is going to be
sustained.
22
PROJECT OUTLINE PLAN MARKING SCHEDULE
STUDENT NAME:
ROLL NO.
SCORE ASSESSOR'S
COMMENTS
0-2
CRITERION
Local need defined (2)
Aims / outcomes stated
Clearly and realistically (2)
People involved and stakeholders described(2)
Methods / activities clearly described and logical (2)
Project evaluation - logical and feasible (2)
Assessment of project costs - are the budget items justified
completed)
Is the time plan clearly defined ((^ if completed)
Total (10 marks)
Maximum mark - 10 marks
Minimum pass mark - 5 marks
Signature of faculty:
if
23
GUIDELINES FOR ASSESSMENT OF BUDGET
Name:
Roll No:
Satisfactory (*)
Unsatisfactory
Comments:
__________
1
2
3
4
5
Full project plan sufficiently
prepared for budget sanction
Budget line items are
appropriately listed____________
Each budget item sufficiently
justified______________________
Each of the activities have been
budgeted_________________
Budget sufficient to undertake the
project._______________________
6.Does the full project plan require any major revision before sanctioning the seed grant?
Yes/No.
If yes, Please state what revisions are required:
7.Does the budget require any major revision before sanctioning of the seed grant?
Yes/No
If yes, please state what revisions are required:
I would recommend the sanction of the seed grant to the student based on full project plan
submitted:
Recommended /Not Recommended/ Pending
Signature:
24
DRAFT LETTER INDICATING PROTECT APPROVAL
To:
Dear
Sub: Project review process
I would like to congratulate you on successful completion of the full project plan.
Your full project plan has been marked by two independent faculty members and your score is
(total maximum mark - 20).
The project review committee has approved your project and the budget pending the below
modification:
1. Please could you modify the budget to include only the items that will be paid for by the seed grant
from the course office.
Please could consult your institution administration and inform me on whose name the draft should
be addressed to. Please could you send these to me as soon as possible by e-mail so that we ca n
process the grant transfer.
We would require a receipt from your office once the grant money has been transferred.
Prior to completion of the course, you would need to submit a statement of accounts of the
expenditures on the seed grant.
With regards,
Yours sincerely.
Course Organiser
25
DRAFT LETTER REQUESTING RESUBMISSION OF FULL PROJECT PLAN
To:
Dear
Sub: Project review process
The project review committee consisting of three faculty members has studied your full project plan.
They have raised the following concerns regarding your project:
Budget
We would like you to resubmit the full project plan with these modifications. The project will be
approved after you have completed these modifications.
Please could consult your institution administration and inform me on whose name the draft should
be addressed to.
I would be happy to answer any questions or be of assistance in helping with the modifications.
With regards,
Yours sincerely.
Course Organiser
26
DRAFT FORMAT FOR ADMINISTRATIVE APPROVAL & ACCOUNT HEAD INFORMATION
To
Course organiser
Dear Sir / Madam,
I have gone through the final project plan of:
Student name:
Name of hospital:
Project title:
Seed grant to be made in favour of (institutional account):
I have found that the project is a practical project that would benefit our institution.
We would provide all administrative and practical support to ensuring that the project is
implemented and according to the timeline.
We would be able to provide a detailed statement of expenditures with original vouchers at the end
of the project signed by our accounts officer.
With regards,
Yours sincerely.
Administrative officer
Institution:
Seal:
Date:
T1
DRAFT LETTER WHILE SENDING SEED GRANT AMOUNT
Dear
Enclosed with this letter is a demand draft
Demand draft:
Name of project:
Institution:
DD Number:
Please obtain the appropriate signatures and send it back to our office by registered post at the
earliest.
I have also attached a copy of the project budget in your finalized proposal. At the end of the project
your institution will have to submit a statement of expenditures signed by your administrative head
and accounts officer.
With regards,
Yours sincerely.
Course Organiser
28
RECEIPT OF SEED GRANT FOR PROJECT WORK
The following grant has been received by our institution towards seed grant for project work for the
HIV Physician training program:
Demand draft:
Name of project:
Institution:
Student name:
Signature of student
Date:
Signature of administrative
officer
Signature of accounts head
29
FORMAT FOR PROJECT INTERIM REPORT
The project interim report should include:
1. Logic model template (should indicate the inputs, activities, outputs and outcomes completed)
2. Gantt chart (time line that has been completed)
3. FIR template (completed one)
PROJECT INTERIM REPORT TEMPLATE
Problems experienced:
Methods nsed to tackle these problems:
Lessons learnt:
30
DRAFT LETTER FOR PLANNING SITE VISITS
To
Project Guides
Dear Friends,
Please could you sign below to:
1. Indicate whether you will be able to visit your students at
■for one day
2. Indicate the approximate dates of the site visits.
With regards,
Yours sincerely.
Course organizer
Name of
faculty
Place
Name of
student and site
Able to
visit sites
Approximate
date of site visits
Signature
31
OUTLINE OF THE FINAL PROJECT REPORT
The final project report should be submitted to the office two weeks prior to CC IV.
jes at the maximum) should assume knowledge of the full
The student's final project report (12 pag<
* I not repeat the content. The final project report should include:
project plan and need
1. 1Logic model template (include indicators that were met)
2. Gantt chart completed
3. Details of each project step undertaken (what was done; who was involved; problems
encountered; solutions found).
4. Project evaluation
5. Achievement of project aims - aims that were achieved / partially achieved / not achieved
6. Outstanding problems
7. Overall evaluation
8. An abstract of the project (not exceeding 1000 words)
32
GUIDELINES FOR PREPARATION OF PROTECT POSTERS
1. You will be provided a board of area 3 feet width and 3 feet height (S'xS"). This will accommodate
about 12 A 4 sheets of paper.
2. The poster should include the following sections:
a. Title - Title, authors, hospital
b. Background - statement of needs
c. Methods
d. Evaluation framework
z
e. Results
f. Discussion
g. Problems encountered
h. How they were tackled
i. Lessons learnt
j. Conclusion and future directions
The poster needs to cover all the above sections. However, you may arrange the poster layout,
title of sections and their order according to your preference.
3. You are advised to prepare your poster panels printed on A 4 or on poster size paper. The panels
may be prepared using power point program, Microsoft word or any other program.
4. We will provide you thump tacks to put up your poster.
You will have to bring the printed poster with you when you come for the CCIV. We will not be able to
assist you in taking print outs during the contact course.
FELLOWSHIP IN HIV MEDICINE - SITE VISIT TOOL
The aim of the HIV Physician training course is to establish the provision of HIV clinical services and
improve their quality and accessibility in the institutions where the students work. The
improvements in clinical services are being developed through carefully planned project work. The
essential HIV clinical services that the projects aim to develop are: (a) out-patient; (b) in-patient
services; (c) counseling; (d) infection control and (e) staff education. Other additional components
that may be established are: (i) HIV policy and practice guidelines; (ii) HIV team; (c) patient support
group; (d) networking with NGOs and GPs; and (e) home based care. In hospitals and institutions
where components of care exist, the project will aim to improve the quality of existing services.
The changes in HIV care at these institutions will be assessed at the beginning and at the end of the
project phase through two site visits using the site visit tool. This tool is specially designed to
measure improvements in HIV clinical care provided at the hospitals and projects of the HIV
Physician Training Course students.
The aims of the site visits are to:
1. obtain a first hand understanding of the institution where the student works. These would
assist in project guidance and improvement in course content.
2. develop linkages with the institutions.
3. measure improvements in care during the project phase.
4. provide suggestions to the institution on how it may improve the care to HIV patients.
The course faculty will visit the student's institution at the beginning of the project (April-May) and
at the end of the project (September). Each visit will be of one day duration. The students will be
informed of the purpose of the visit.
The tool assesses the following:
1. Establishment of the basic components of HIV clinical services
2. Utilization of the HIV clinical services
3. Score of overall HIV care and its different components
During the site visit the faculty will:
1. Meet with the student, the hospital administration, other members of the HIV team, kev
members involved in HIV care, and other staff (junior doctors, nurses, attenders).
2. Visit the outpatient, in-patient, laboratory, counseling areas and observe the infection control
system. A home based care area may be visited based on feasibility.
3. 1Review patient records of persons with HIV infection, laboratory records of HIV testing.
counseling records and hospital policy and guidelines.
4. Observe patient care in out-patient, in-patient area, counseling and laboratory testing as
appropriate.
The visit should focus on all aspects of HIV care and not just on the components of the project that
the student is working on.
INSTRUCTIONS FOR SITE VISITS AND USE OF THE SITE EVALUATION TOOL
1. Introduction to the hospital administration:
Introduce yourself to the chief administrative officer to explain:
a. The purpose of the visit- "The visit aims for the course teachers to get a better idea of how to meet
your training needs, to be able to guide the student better and provide some suggestions of how care
may be improved."
b. What you intend to do during the visit- "The visit would involve talking to the staff involved in
HIV care; visiting the areas where care is provided; observing care activities; and reviewing records C
related to patient care (patient, counseling and laboratory records)".
c. Request permission for performing the above activities- "With your permission, we would like to
do these things".
2, Performing the activities of the site visits
It is suggested that you first have a detailed discussion with the student on the different activities in
the hospital. After completing this, you may visit the patient care and laboratory areas making
observations and asking more questions.
Specific activities:
a. Discussions with student, members of the HIV team, other persons involved in HIV care.
b. To visit areas where HIV is provided- out-patient area, wards, laboratory, counseling room.
c. Observe patient care activities taking place- out-patient clinic, ward rounds, counseling, laboratory
tests and infection control.
d. Review records related to patient care, counseling, lab testing and guidelines for treatment and
hospital policy.
General instructions:
a. The specific activities need not be performed in sequence. You would try not to inconvenience on
going patient care activities in undertaking your evaluation.
b. Keep a mental list of all the questions asked in the tool for site visits. You may wish to keep the
question tool with you during your visit.
c. Use a note-pad to record the information of your discussions and observations of care provision.
d. Introduce yourself and explain the purpose of your visit as you meet each team member.
3. Style of questioning
Use open ended questions in your interview. As you proceed obtain more information through
probing questions. The question guide is a check list of information to be obtained. Questions need
not be asked in the exact format in the question guide.
J
2-
SITE VISIT I
Date of visit:
Name of hospital:
Name of the student:
Name of faculty visiting hospital:
Are you the project guide for the student: Yes/No
Persons whom you met during the visit:
Services that you visited and observed:
Records that you reviewed:
.-1
Other activities that you were involved with during your visit:
Problems that you encountered during your visit:
4
ESTABLISHMENT OF COMPONENTS OF HIV SERVICES IN THE HOSPITAL OR
INSTITUTION
Service already
existing at the time
of joining the
course
(before December
2005)
BASIC
COMPONENTS
OF CARE________
HIV testing______
Counselling
services_________
Out-patient care of
HIV patients_____
In-patient care of
HIV patients_____
Regular staff
education
programs on HIV
care and infection
control__________
ADDITIONAL
COMPONENTS
HIV team________
HIV policy and
guidelines________
HIV patient
support group in
hospital or linkage
with a patient
support group
Networking with
NGO/s private
practitioners and
other hospitals In
HIV care_________
Home based care
If service is newly
established after the SITE VISIT I
beginning of the
Date of initiation
course
of the component
(after December
2005)
SITE VISIT II
Date of initiation
of the component
UTLILISATION OF SERVICES
SITE VISIT I
SITE VISIT I
July-November
2005
December 2005April 2006
SITE VISIT II
May 2006 September 2006
HIV testing
(No. of tests
performed,
No, of positive tests)
Counselling
(no. of counseling
session)
Out-patient visit
(No. of HIV out
patient visits)
In-patient visit
(No. of HIV patients
admitted)
Staff education
programs
(No. of staff
education programs
conducted)
The details of utilization of services in the periods July-November 2005 and December 2005 -April
2006 need to be filled according to the availability of figures. Where figures for the precise time
periods are not available, record the data that is available. Approximate data may be noted with
''approximate" written in brackets.
6
SCORING OF CLINICAL SERVICES
1. COUNSELLING___________________
Question________________________ Answer
Score
Score
1 Do patients receive pre-test and No
0
post-test counseling?
If yes proceed below:______________
2 Is there a designated person who Regular staff 1
gives the HIV counseling?
provide
What formal training has the person counseling
received?
without
training
Trained
2
counselor
3
Is there a written format for
counseling?_____________________
4 Is there a method of recording of the
counseling session?_______________
5 Is there a system of auditing or
checking the counseling session?
Total score______________________
COMMENTS
Yes
1
Yes
1
Yes
1
__
%
-7
2. OUT-PATIENT HIV CARE__________
Question________________________
1 Are patients with HIV infection seen
as out-patients?
If yes proceed below.______________
2 Are they seen in the regular out
patient clinic?
Or is there a designated clinic, time
or person who sees HIV patients?
Answer
No
Score
0
Patients are
seen in a
general OP
Dedicated
HIV out
patient
system
Yes
1
Is there a written protocol for
evaluation of the patient or proforma
that has to be filled?_______________
Yes
4 Are the charts properly
documented?____________________
Yes
5 Is there an audit system or other
mechanism of assessing the quality
of out-patient services?____________
Total
______________________
COMMENTS
3
Score
2
1
1
1
<9
3. IN-PATIENT CARE________________
Question________________________ Answer
1 Are patients with HIV infection No______
admitted?
Restricted
admission
2
All patients
who require
admission
Yes
Is there a written protocol or
proforma for evaluation of patients?
3 Is the patient documentation proper? Yes
4 Is there a system of monitoring or
Yes
checking the quality of in-patient
care?________
Total score_______________________
COMMENTS
Score
0___
1
2
1
1
1
Score
' 4. OBSTETRIC CARE_________________
Question________________________
1 Are deliveries conducted for HIV
positive patients?
Are they delivered rarely or
frequently? Is there any restriction
on the deliveries for HIV positive
women?
Answer
No________
Restricted
delivery
Score
0____
1
Delivery of
all patients
who require
it_________
Yes
2
1
Is there a written protocol for
evaluation of a HIV positive
pregnant mother?_________________
ART without 1
Is
there an MTCT program with
3
regular provision of ART for positive elective
LSCS
mothers?
2
ART with
elective
LSCS
Total score
COMMENTS
2
Score
5. PROCEDURES AND SURGERIES
Question________________________ Answer
1 Are procedures performed for HIV No_______
Restricted
positive patients?
procedures
Performed
on all
patients
No
_______
Are
minor
surgeries
performed
for
2
Restricted
HIV positive patients?
minor
surgeries
Performed
on all
patients
Yes
3 Are major surgeries performed on
HIV positive patients___________
Total score
_______________
COMMENTS
Score
0___
1
Score
2
0
1
2
1
7
6. HIV TESTING_________ ___________
Question_______ _________________ Answer
Score
Score
1 Is HIV testing performed
No
0
If performed go below.____________
2 What is the training of the person Trained lab
1
who performs the test? (Lab technician
technician training with exposure to
HIV testing)__________________ ___
3 Is there a testing protocol? (2 or 3 test Yes
1
protocol)_______
4 Is there a register for entry of HIV
Register
1
reports? What is the quality of
maintained
maintenance of the register? If
well;
confidentiality maintained in the
confidentiality
reports?_________________________ appropriate
5 Are there facilities for ELISA,
Yes
1
Western blot ?____________________
6 Is there a system of quality control?
Yes
U
Total
Other observations to make: infection control in the laboratory; storage of kits; expiry date of kits
COMMENTS
Bi
7. INFECTION CONTROL_____________
Question_________________________ Answer
1 Is universal precautions the policy No
for infection control in the hospital?
2 Are barriers widely available? Yes
(gloves, masks, eye wear, gown)
3
Are universal precautions widely Yes
implemented?
Score
0
Score
1
1
3
Appropriate waste disposal,
Most of the
1
segregation, incineration, needle
components
disposal container_________________ are present
4 Majority of staff immunized against Yes
1
hepatitis B infection or policy of
hospital to have all staff immunized
against Hepatitis B.________________
6 Reporting system and post-exposure Yes
1
prophylaxis for Hepatitis B and HIV. |
Total_____________________________
(Other observations to make: methods of segregation, transport, waste disposal, observations of
procedure performance)
COMMENTS
/3>
8. STAFF EDUCATION
1
Answer
Is there staff education on HIV No________
Occassional
infection and infection control?
staff
education
Regular staff
education
2
Who are the staff who receive
education
3
Is there a feedback system on the
training or knowledge assessment of
the staff after the training?_________
Total
COMMENTS
Doctors
Doctors and
other staff
Yes
Score
0___
1
2
1_
2
1
Score
9. HIV TEAM________________________
Questions________________________ Answer
1 Who are all the persons involved in Only
yourself
HIV care
Informal
HIV group
2
3
4
Team coordinates HIV care________
Team meets regularly to discuss HIV
care____________________________
Are there any documents of team
activities________________________
Total
Score
0
Score
1
Formal HIV
group
2
Yes
Yes
1
1
Yes
1
COMMENTS
/6"
10. HIV Policy and Guidelines_________
Questions_______________________
1 Are there any written policies and
guidelines regarding HIV care?
Is this informal or does it have
administrative approval?
4
Written policy that is implemented
Total
COMMENTS
Answer_____
No_________
Informal HIV
policy
Score
0___
1
Written policy
and
guidelines
Written
guidelines
with
administrative
approval_____
Written
guidelines
with
administrative
approval,
widely
circulated
Written policy
which is
implemented
2
3
4
1
Score
11. PATIENT SUPPORT GROUP
Answer
No____
Yes
1
Is there a patient support group
2
3
Regular meeting of support group
Yes
Activities at the meeting are well
Yes
organized_______________________
Are there positive perceptions
Yes
regarding effect of the support group
on the quality of patient care?
Support groups initiate their own
Yes
activities_______________
Total
4
5
COMMENTS
Score
0____
1
1
1
1
1
Score
12. NETWORKING WITH NGO AND HOSPITALS
Answer
1 Do you obtain occassional or None_____
frequent referrals from NGOs, GPs In-frequent
and other hospitals?
Frequent
2
3
4
Provide informal education and
Yes
advise for NGOs and other hospitals.
Conduct education programs and
Yes
clinics for NGOs and other hospitals.
Formal linkages between hospital
Yes
and other NGOs or hospitals in HIV
care,____________________________
Total
Score
0____
1
Score
2
1
1
1
COMMENTS
/c
13. HOME BASED CARE
1
2
3
4
Answer
Do you visit homes? If so how None_____
In-frequent
regularly?
Is there a formal system of
procedures for provision of care at
home_________________________
Is there a system of documentation
of home visits__________________
Is there any mechanism for
monitoring quality______________
Total
Score
0____
1
Frequent
2
Yes
1
Yes
1
Yes
1
Score
COMMENTS
19
1
2
3
4
5
14, DISCRIMINATION AND STIGMA
Questions______________________ Answer
Does your hospital offer treatment No
Yes
to all HIV positive patients?
No labels on slips, charts and beds
indicating HIV diagnosis.________
No separate beds or isolation for
HIV patients.__________________
All staff look after HIV patients.
All patients with HIV infection are
treated in the same way as other
patients_______________________
Total
Score
0___
1
Yes
1
Yes
1
Yes
Yes
1
1
Score
COMMENTS
V
1
2
3
15. DRUG AVAILABILITY AND ACCESS TO TREATMENT
Questions______________________ Answer_____ Score
Are common drugs required for Bactrim, Anti- 1
treatment
of
HIV
infection TB treatment,
antibiotics
available?
Bactrim, Anti- 2
TB treatment,
antibiotics
Fluconazole,
Acyclovir
2
Yes
Are you able to provide drugs for
treatment and prevention of
opportunistic infection to patients
who cannot afford the treatment?
1
Are anti-retroviral drugs provided To patients
who can
for treatment of HIV infection?
afford it.
2
Both to
patients who
can and
cannot pay
Score
Total
COMMENTS
24
SCORING SHEET FOR CLINIAL SERVICES
SITE VISIT I
Score
1
Counseling
2
Out-patient HIV care
3
Medical care
4
Obstetric care
5
Surgical care
6
HIV testing
7
Infection control
8
Staff education
9
HIV team
10
HIV policy and guidelines
11
Organisation of positive
SITE VISIT II
Score
people/community organization
12
Networking with NGO/s private
practitioners and other hospitals
13
Home based care
14
Discrimination/stigma
15
Drug availability and access
TOTAL (Maximum score 75)
X2-
DEFINITION OF COMPONENTS OF HIV CARE
HIV testing: Availability of serological testing facilities in the hospital for diagnosis of HIV infection
by rapid tests, ELISA or Western blot test
Counseling: Provision of pre-test, post-test counseling and follow-up counseling by a trained
counselor.
Out-patient care: Provision of out-patient care to HIV patients either in a general clinic or special
clinic for HIV patients.
In-patient care: Provision of in-patient care for patients with HIV infection.
Regular staff education programs on HIV infection and Infection Control: Periodic staff training
programs related to relevant aspects of HIV care and infection control.
HIV team: A formal or informal team of persons who work together to coordinate HIV care activities.
HIV policy and guidelines: A written set of guidelines based on which care of HIV infection is
planned.
HIV patient support group: The presence of a functioning HIV peer support group linked to the
hospital.
Networking with NGO/s private practitioners and other hospitals in HIV care: The hospital
supports NGOs who are involved in HIV prevention and care; or forms a referral center for HIV care
for local GPs or other hospitals; or as training resource for HIV related issues for local GPs or other
hospitals; or provides clinical consultation for NGO's, clinics or hospitals.
Home based care: A program or a set of activities to provide care and support at home.
4
Definition of terms in scoring tool
1.
Counseling:
Trained counselor- Counsellor has undergone some formal training in general counseling or HIV
counseling.
Written counseling format- Check list for pre-test and post-test counseling or counseling proforma.
Documentation of counseling- Counselling register or patient case file.
Mechanism of monitoring of quality- System of checking register or case file, or observation of
counseling by senior.
2.
Out-patient HIV care:
General out-patient- common out-patient clinic where general patients are seen.
Dedicated out-patient system- HIV clinic runs regularly.
Written protocol for outpatient evaluation- Protocol for patient evaluation (history taking,
examination, laboratory testing).
Proforma- Proforma case documentation.
3. and 4. Medical Care and Obstetric care:
Restricted medical care, obstetric care- Admit and provide care for a few patients and refuse others.
Written protocol for evaluation of patients- Proforma for patient documentation; protocols for
evaluation of common symptoms and treatment of common conditions.
Proper patient documentation- review patient records to assess appropriateness of patient
documentation.
Mechanism of monitoring quality of medical care- cases discussed with senior persons; charts
reviewed or audited.
Protocol for care of pregnant women with HIV infection- Guidelines for ante-natal, obstetric and
post-natal care for women with HIV infection.
MTCT program with provision of ART- includes counseling and testing, regular ante-natal care,
provision of ART (AZT from 34 weeks or Nevirapine during delivery), delivery facilities with
precautions for HIV positive women, advise on breast feeding, ART for new born child. Elective
Caeserian section- Elective LSCS at 38 weeks to reduce risk of MTCT.
5. Procedures and surgeries:
Procedures- Procedures such as pleural aspiration, bone marrow, lumbar puncture, etc.
Minor surgeries- Surgeries done under local anesthesia eg. Lymph node biopsy, MTP, incision and
drainage
Major surgeries- laprotomy, thoracotomy
6. HIV testing:
Training of laboratory technician - technician has some formal training in HIV testing
Full protocol for testing- specifies the tests and the sequence (two step or three step protocol)
Register for maintenance of lab reports -Register where test reports are maintained; system of
maintaining confidentiality of test reports.
Quality control of lab testing- System of sending positive or negative samples to reference laboratory
or performing tests on samples from reference laboratory.
7. Infection control..
Universal precautions are the policy of the hospital- hospital policy refers to universal precauhons
with clear guidelines for implementation of universal precautions.
Barriers- gloves, masks, eye wear, apron
'w
Waste segregation and appropriate disposal- segregation of infectious and non-infectious waste;
incineration of infectious waste.
Needle disposal container- any system for safe disposal of needles
Evidence of compliance to universal precautions and waste disposal- system of checking on
implementation of the above.
8. Staff education - includes education on infection control and HIV care, confidentiality issues
Regular staff education- at least once a year
Education for all levels of staff- includes attenders, sweepers, laboratory workers.
Feedback system on the education- system for assessing training needs of staff and adequacy of
knowledge after training.
10. HIV Policy - Written policy which includes hospital's policy on different aspects of HIV care
including provision of treatment,counseling, testing, infection control, staff education etc.
HIV Guidelines- Include guidelines for investigation, treatment and management of patients with
HIV infection.
HIV policy with administrative approval- administrative officer, body or infection control committee
has approved the policy.
Policy widely circulated- Policy has been disseminated to all department or staff.
Written policy has been implemented- Perception that policy has been translated into action.
11. Support group- A peer support group of HIV positive persons who meet together.
Meeting activities for support group- Testimonies, sharing, discussion, education program.
Support group has improved the quality of care- Perception of team that the support group has
contributed positively to the provision of care.
Support group initiates its own activities- Support group initiates its own project activities which
further the interests of the group.
12 Networking with NGOs, private practitioners and other hospitals:
Organised steps to strengthen linkages- formal linkages and programs organized between the
institution and other organizations.
13. Home based care:
‘ ; or patient record
System of documentation of home visits- Register of home visits
Senior
checking on activities, reviewing register
Mechanism of checking quality of home-based care- >
etc.
14. Discrimination/stigma:
record of HIV written on slips and reports; HIV reports informed only
Confidentaility of reports- no
No^abXoncharteVnTbe5^
indicating HIV positive status on charts or beds
All staff take care of HIV patients- All staff willing to take care of HIV patients
Equal care given to HIV patients- no discrimination of care for HIV positive patients.
REPORT
Date of visit:
Background to HIV care (when it started,, how many patients etc.)
Persons you met
Areas that you visited
Patient care that you observed
Strengths of the HIV care
Counselling
Laboratory testing
Out-patient care
In-patient care
Obstetric care
Procedures and surgery
HIV team
Hospital policy and guidelines of care
Infection control
Staff education
Patient support group
Home based care
Networking with NGO's, GPzs and other hospitals
Addressing stigma and discrimination
Drug availability and access to treatment
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