1. science
2. medicine

Curriculum
Development Project
GO GREEN – GROUP III
Group 3

Dr K Bhuvaneshwari

Dr V Dhanalakshmi

Dr A Moorthi

Dr S Rajesh

Dr Rashmi Jain

Dr Sudhir Babji

Dr N Vinay Kumar
Mentor – Dr Minnie Faith
A curriculum to teach comprehensive
management of Hypertension to CRRIs
Introduction

As per the World Health Statistics 2012,

57million global deaths in 2008,

36 million (63%) were due to non communicable diseases (NCDs).

The largest proportion of NCD deaths is caused by
cardiovascular diseases (48%).

Attributable deaths, raised blood pressure is one of the
leading behavioral and physiological risk factor to which
13%of global deaths are attributed.
Introduction

Hypertension (HTN) –

4th cause of premature death (developed countries)

7th cause in developing countries.

The prevalence of hypertension is rapidly increasing in developing countries and is
one of the leading causes of death and disability.

Hypertension is the most common, important preventable condition seen in
primary care and leads to Myocardial infarction, Stroke, Renal failure, and death if
not detected early and treated appropriately.

Overall prevalence for hypertension in India is 29.8%

Currently the coverage of HT management is

25% in rural and

38% in urban
What do we want to do ?
Goal
Reduce the burden/ deaths of non communicable disease
Competency
At the end of internship, the graduating doctor will have achieved proficiency in early diagnosis,
management and screening of hypertension in a comprehensive way.
Problem identification and general
needs assessment

Whom does it affect-Communities both adult and pediatric (urban & rural)
across SES

What does it affect- Quality of life ( health/finance/manpower)

Importance of problem-Early age of onset, incidence is increasing, Increase
in morbidity and mortality, changing lifestyles (work/food) Has preventable
and modifiable risk factors
General needs assessment
By Government
By Society
By Health
Professional
Current Approach
Primary healthcare ,
Gov. programs towards
NCD screening
Ideal Approach
Awareness and Health
education through
various media/health
camps
Needs based approach
Self education and
periodic health
checkups
Holistic approach
(Education for lifestyle
modification)
Retraining Health
professional already
existing in the
community
Diagnose and treat
General need
Awareness and
prevention
General needs assessment

Methods of obtaining information- Health statistics from gov and private
parties, including health experts in the local community, Study like million
death study

Pilot testing - Survey procedure in the field practice area of Medical college
Needs assessment of targeted learners

Identify learner- Interns

Identify information required for needs assessment- Previous training and
experiences

Decide on the methods to be used for needs assessment-
Survey/Knowledge, Attitude, Practice - questionnaire in Interns to identify the
gaps in learning
Goals, competencies and Specific learning
objectives and specific measureable objectives and
Educational strategies
SLO
T/l
At the end of medicine
internship, the intern
should be able to grade
blood pressure
recordings in adults
according to JNC7
guidelines
Tutorial
Small group teaching
Seminars
PBL
At end of medicine
postings, the intern
should able to
demonstrate correctly
least 3 times the steps
to measure blood
pressure in adults.
At the end of medicine
posting the intern should
be able to identify the
need and help the
hypertensive patient in
modifying dietary habits
according to API
How will you derive Who will be the experts? Timetable
the content
First week of
medicine postings
Physicians
(General and cardio)
First week of
medicine postings
Demonstration on patient
Standard medicine
and Mannequin
text books,
Hands on
International and
national guidelines
Role play
Role model (clinic
observation)
Small group teaching
(Skill of counseling)
Video
Health education
Physicians
(General and
cardio),Community
medicine, Dietary
Counselor
Continuous
process
Curriculum organization and Implementation
Evaluation & Feedback
SLO
At the end of
medicine
internship, the
intern should be
able to grade blood
pressure recordings
in adults according
to JNC7 guidelines
T/l
Tutorial
Small group
teaching
Seminars
PBL
Assessment methods
Formative
Viva
Case based
discussion
MCQ
Summative
Written test
Viva
Evaluation
questions
Indicator
1.Short terma. satisfied with
way in which
grading of HTN
was taught
b. Are the
students able to
understand the
grading of htn
80% of students Students
satisfied with
the teaching
methods
Long term- Are
the students
able to grade
htn, in patient
management
100% of students
should be able
to grade HTN
100% of students
will be able to
apply grade of
HTN
Data source
Data collection
method
Feed back
MCQ/OSCE
(Knowledge
station), problem
solving exercise
OSCE at end of
posting
Curriculum organization and Implementation Evaluation & Feedback
SLO
At end of medicine
postings, the intern
should able to
demonstrate
correctly least 3
times the steps to
measure blood
pressure in adults.
T/l
Demonstration on
patient and
Mannequin
Hands on
At the end of
Role play
medicine posting
Role model (clinic
the intern should
observation)
be able to identify
Small group
the need and help
teaching
the hypertensive (Skill of counseling)
patient in
Video
modifying dietary
Health education
habits according to
Assessment methods
Formative
OSCE
DOPS
OSCE
(history takingKnowledge
station)
Summative
OSCE
OSCE
Written exam
Evaluation
questions
Indicator
Data source
Short term- All
students able to
demonstrate the
steps to measure
blood pressure
Intermediate- All
students are
able to correctly
measure BP in
all patients
100% of students Students
are able to
correctly
measure BP
OSCE
100% of students
are able to
measure BP as
part of routine
clinical
examination
without error
Million death
study like surveys
to collect the
current trends in
hypertension/CVS
disease
Short termRecognize the
need for dietary
modification in
HTN pts
Long termDecrease in HTN
morbidities and
mortality due to
100% of students
should be able
to motivate the
community to
accept the
change in diet
50% of the
hypertensive
patients are able
Student and
HTN patients
community
Hypertensive
patients in
Data collection
method
OSCE and Survey
Community
Curriculum organization and
Implementation


Resources

Personnel- Physicians (General and cardio),Community medicine, Counselor

Time- Faculty- 2 months of medicine posting (Continuous)
Learners- Whole medicine posting


Facilities- Space- Wards/ OP (opportunistic)/ Demonstration halls/ Community
clinics
Equipment- Audio visual aids/ Mannequins/ BP apparatus and stethoscopes

Support- Support from Medical dean/ HOD/ administrators/ Colleagues, Institution
funding for the AV and charts and community visits

Anticipate and address barriers

Faculty development- Authorizations, Community leader and community doctors

Resistance from Colleagues- Students, Counselor, AV &equipment proper functioning