Exchange report - incoming teachers
Home university: Pravara Institute of Medical Sciences
Study programme: Medicine
Exchange programme: Linnaeus-Palme
Semester: Autumn semester 2018/2019
Duration: 22
Name: Gokul Jorwekar
Email address: jorwekarg@gmail.com

Accommendation

Accommodation facility is really wonderful specially individual accommodation in an apartment which is strategically located and well connected by commuter and bus services round the clock.&nbsp;<div>Apartment is really spacious with privacy, security with ample space for relaxation and studies and computer work with adequate electrical outlets and most importantly warmers in all the rooms.</div><div>Bathroom has all necessary accessories.</div><div>Bed is a spring bed which led to backache so I used floor mattress.</div><div>Kitchen is very modular with burner, coffee maker, utensils, washing accessories, oven, microwave, toaster etc. .</div><div>Really loved the accommodation.&nbsp;</div>

Language and Culture

Most of the teaching sessions were conducted in English. One or two occasions when students were not conversant with English, Swedish language was used. Language barrier was found with one nursing and one medical students particularly Swedish students.&nbsp;

Leisure time

<div>&nbsp;I had a dinner party with Dr. Carina, Aida, Mini and Emma.Thanks a lot.&nbsp;</div>

Miscellaneous

During teacher exchange program, I had ample opportunity to do sightseeing in and around Stockholm which is one of the scenic and beautiful city.

Other activities

<p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">I visited ultra modern patient care facilities created at both KI Solna and Huddinge, Flemingsburg the centers spread over a large area with fantastic provisions like individual patient rooms, well equipped nursing station with electronic support, central cabinet for discussion about plan of management, recreation area for patient’s relatives, ample play area for children including cafeteria. Especially, all the patient care premises are strictly controlled by security with only access by cards. </p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">I am really lucky to be visiting worldwide center of excellence of ECMO, services of which are extended to most of part of Europe. </p> <p class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">CAMST at Huddinge, Flemingsburg is one of its kinds of simulation center with high fidelity facility, upper GI scopy, hysteroscopy, TURP, Cystoscopy, URS, and Arthroscopy etc. <u style=""><b>I am very thankful especially to Dr Lars Henningshon, Urologist, Huddinge, Flemingsburg who toured me all throughout the CAMST and showed with lots of enthusiasm. Definitely, I would like to take some tips for interactive teaching from him.&nbsp;<span style="white-space:pre"> </span>I am also thankful to Dr. Hanna, Metilda, Johan and S/N Hanna for involving me in the hands on seminars on upper GI scopy and ABCDE.&nbsp;</b></u></p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">I could visit library facility provided at KI, Solna which really is an impressive and excellent resource materials with preserved dissertations of various PhD awarded. </p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">All emergency facilities at the both the campuses are directly connected by electronic modes with alarm facility where ambulance can reach outside the door of emergency trauma room where life saving surgery can be performed. A typical trauma team consists of general surgeon, orthopedic surgeon, nurse, paramedics, physiotherapist, radiologist, pediatrician, anesthetist and physician. Most importantly, all emergency OR are present right in the emergency unit with immediate connection with CT scan unit if it is required for patient evaluation. </p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">All the patient care record is maintained electronically with unique identification number for each patient that can be used to request pathological, biochemical, microbiological and radiological investigation, interdepartmental consultation, medications, operative details etc. Information access to health care workers is only available by card access provided to doctors and nurses.&nbsp; </p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">Hybrid OR is another major availability at KI, Solna especially designed for highly specialized unit of vascular surgery. Each patient care area is provided with individual hand held Doppler, portable radiography, ultrasonography, vein detectors for easy venous access which is really found to impressive by me. Intensive and emergency care unit has highly technologically advanced laboratory devices like ABG machines and one of most recommended FAST USG. </p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">I had presentation about Pravara-An example to follow and a short presentation about work done by department of surgery which was really well appreciated by the surgery faculties, Huddinge, Flemingsburg. </p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">Followed by I had a very fruitful meeting with Dr. Joy Roy who is a eminent vascular surgeon at KI, Solna about possibility of implementing a ‘<b><u>Global Surgery Program’</u></b> already run at Uganda in which undergraduate students from KI participate. </p> <p class="MsoNormal" style="font-weight: normal; margin-bottom: 0.0001pt; text-align: justify; line-height: normal;">Research is found to be at the most important at KI as dedicated Dean of Research which is headed by Dr. Anders Gustafsson who appreciated Pravara model and expressed possibility to collaborate for research with PIMS-DU. Dr. Vinod Diwan who is a retired Head and Professor, Department of Public health who is presently looking after Global Health Research, KI shared his view about research and confirmed that year 2019 will be Sweden India Health Collaboration for which PIMS-DU can lead by hosting an international meet. He further confirmed that Karolinska Institute is positively interested in collaborating with PIMS-DU.&nbsp;</p>

Preparation

I got the information first from the Dean Office Rural Medical College, PIMS-DU, Loni BK. Dean sir called me to his office for further briefing. During discussion, Dean sir told me about the teacher exchange program at Karolinska Institute, Sweden, He shared details about the possible benefits to me and my institute by undergoing the teacher exchange program. He also clarified my doubts about the proposed program. Then, I am allowed to have some time to take my decision, After 3 days, I conveyed my affirmation for the program. Then, further I met Dr. Sanjeev Kulkarni, Directorate of International relations, PIMS-DU who was constantly in touch with me and giving all required updates about necessary preparation and prerequisites.&nbsp;<div>I received detailed program of exchange visit spread over period of three weeks. Victoria and Emma kept me in constant touch about updates. Subsequently, Dr. Hanna Ribbing and Dr Magnus Nilsson helped me in getting the required program beforehand. All the required resource material was shared with me by e-mail. well in advance. I went through the material and found to be suitable as It was in the English language, Since, I use English for all my daily teaching assignments, my stress was relieved. Then I prepared my own format which I carried with me while in the program.&nbsp;</div>

Reflections

i am indeed very satisfied by the teacher exchange program at KI. Through the present three weekly program, I could witness huge amount of changes KI campus has brought in medical curriculum. Such a beautiful use of Pedagogy I have not particularly witnessed before in reality.&nbsp;<div>Definitely, I would like to change the teaching methodology at my place by applying certain observed practices at KI.&nbsp;</div><div>What was good or best was teacher at KI is totally in facilitator role whereas students are really self motivated.</div><div>What needs improvement is patient contact or more stress on clinical examination in detail which I found lacking and more stress is given on technological imaging rather than simple clinical examination. Off-course, this is my observation of short duration so I might have done over reading...so no personal intent.</div>

Teaching

Teaching at KI really deserves more than 100 percent marks as curriculum is totally pedagogy stimulating students for highest level of interaction, peer assisted learning, learning by doing, use of simulations, integration at all levels and mostly small group activities using various scenarios.&nbsp;<div>At my place., still more of lecture are used which is a large group activity mostly disadvantageous as learners are passive and uninterested. Group discussion is done but there is lack of integration and mostly knowledge driven than scenario or problem based.</div><div>In KI, student learning is quite paced and relaxed and student centered where a teacher is absolutely in facilitator role. Students are mostly thorough learners and self directed and motivated. They are punctual and attentive and obedient.&nbsp;</div><div>I appreciate curriculum planners of KI who have really done a great job to implement a curriculum which is following most of the aspects recommended by Harden et al in SPICE MODEL.&nbsp;</div><div><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph;line-height:normal">During my extensive 3 week program, I have actively participated in teaching learning activities like group discussion, seminars, outpatient clinics with minor surgical procedures, seminars with use of simulation like UGI Scopy, basic life support at state of art simulation center at CAMST, Huddinge, Flemingsburg.&nbsp; I got opportunity to interact with faculties of various surgical disciplines like emergency surgery, urology, pediatric surgery, vascular surgery and upper GI surgery. Most of the teaching assignments are done in the form of small groups of 4-5 students. </p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph;line-height:normal">One of the main focuses of KI curriculum is utmost use of pedagogy for major portion of teaching learning activities. To accomplish that they stress on small group discussion, peer assisted learning, simulation, hands on sessions for skill development, use of problem based MCQs, integrated seminars and case presentations. Assessment and evaluation mainly includes work place based assessment and OSCE combined for general surgery, urology, and orthopedics.&nbsp;&nbsp;</p></div><div>Really.I am moved by the learning atmosphere present everywhere in KI campus.</div><div><br></div>

Teaching hours

Most of the teaching activity at KI is based on small group discussion with use of scenario where traditional lectures are mostly not used.<div>Students spent 50-60 percent of time in seminars, 30-20 percent bedside teachings and patient are and rounds and remaining 20 percent in other activities approximately like hands on or performing surgery or observing surgery</div>