First semester nursing students have a lot of stresses as they begin their journey towards becoming a registered nurse. One of the main stresses is to perform a practical examination. That is the “make believe” portion of nursing school although we try to make the situations and equipment as real as possible. These examinations are performed in make believe hospital rooms complete with hospital beds, call lights, bedside tables, and various types of mannequins used for different skill check-offs. Not only are the nursing students stressed about getting graded on a pass or fail system, they have to verbalize back to the instructor what they are doing and why they are doing it. The students are responsible for knowing basic physical assessment of all of the body systems but are accountable for two systems during their practical examination. They have to pick these systems from folded pieces of paper in a cup. The unknown can also be very stressful.
During the physical practical examination first semester nursing students needed to memorize how to examine selected body systems as well as begin to learn and pronounce medical terminology. This was always not that easy since many medical terms are quite lengthy and oddly spelled. This can make for some interesting pronunciations of medical terms as the student are performing their exams.
Kelly was a young 22-year-old who had always wanted to be a nurse. Her partner Cindy was a little older and 35-years-old with the same goal. They were going to perform their physical assessment on each other to get checked off either pass or fail. I had the cup with the folded pieces of paper in my hand. I explained to both they were responsible for two body systems. “Who wants to go first,” I said. They both looked at each other. Neither wanted to go first but knew it was a 50/50 shot. Finally after 15 seconds Cindy volunteered. “I may as well get it over with now,” she tells Kelly and me. I held the cup for her to pick out her first body system. She looked briefly at the sizes of some of the pieces of paper. Some were irregularly shaped compared to others. There were six pieces of paper. I knew the logic for some of the students would be the smaller piece of paper would be the easiest system to assess and get graded on. She picked the smaller piece of paper and opened it up to see what system she would need to assess. “I picked the respiratory system,” Cindy said with a sigh. “That is one of my least favorite,” she tells Kelly and me. I got the grading sheet ready and stood at the bedside table. “Okay. You can begin,” I told her. She looked at me like she wanted to cry.
She stood in front of Kelly. “Can you sit on the bed?” she asked Kelly. Trying to be the good partner Kelly sat on the bed with good posture. She knew it would be easier for Cindy to assess the respiratory system if she sat straight. “Okay first I am going to watch her breaths,” said Cindy. “I will watch for 30 seconds and multiply by 2,” she says. Then there was silence. Kelly was motioning downward with her eyes trying to give Cindy some clues. I knew she was stuck already. I waited a few more seconds before giving her a little push. “I will need to listen for bowel sounds,” says Cindy. “No, we are doing the respiratory system,” I told her. She slaps her hand to her head. “I know. I am nervous,” she replied. “I know. Just take your time. Think it through,” I told her. There was more silence. I knew she probably was praying to get the abdomen for one of her check-offs. The bowel sounds gave me the clue. “What are you looking for when you are watching somebody breath?” I asked. “You have to look at the systimitry,” said Cindy. “Do you mean symmetry?” I ask. “Oh yeah. Symmitry,” she replied. She was close enough. Cindy stood in front of Kelly and with her hands motioned out and in. “Ummm. Well… Abdomen?” she asks. “She liked the abdomen,” I thought to myself. I proceeded to prompt her a little more to get her to say rate, depth, accessory muscle usage but it took a while. She was not as prepared as she should have been.
It was time for Cindy to auscultate (listen) the lungs. “I am going to listen for the appacal,” said Cindy. “You mean apical?” I asked. “Oh yeah. Appical,” she replied. It wasn’t part of the check-off for respiratory but I did not want to confuse her anymore than she was. She finally started to listen to the lungs. “Tell me what sounds you are supposed to hear where,” I said. “You will have brachial sounds here,” as she puts the diaphragm on one side of Kelly’s neck. “Do you mean bronchial sounds?” I asked. “Oh yeah. Branchial,” she replied. “Close enough,” I thought to myself. Cindy put the stethoscope on Kelly’s chest. “You should hear branchialvoscular sounds here,” she said. “Do you mean bronchovesicular?” I ask. “Oh yeah. Branchoviscular.” I knew the terms would come with time.
After Cindy was done with auscultating the lungs I asked her what abnormal sounds she may hear. She stood there for a while with the ear piece of her stethoscope still in her ears. I motioned to take the ear pieces out of her ears so she could hear. She did. I asked her again what abnormal sounds she may hear. She stood there for a while. “What if you have a cold or are an asthmatic?” I prompted her. “Oh. You can hear weezles,” she said. “Do you mean wheezes?” I asked. “Oh yeah. Wheezes,” she replied. We were done. Now it was Kelly’s turn. I made a mental note. “Work on medical terms with Cindy.”
Kelly looked at the cup with the remaining pieces of paper. There were five left. I knew she was thinking if Cindy picked a small piece and got what she did not want, she would pick one of the larger ones. She slowly opened up the paper and looked. I looked over her shoulder. She picked head and skin. I heard a small sigh. I prepared another grading sheet. “Okay. Begin,” I said. “Can you sit on the bed?” she asked Cindy. Cindy complied and was happy she was done with one of her assessments. “Well, you look at the face sysmetry and the color,” she said as she placed her hands on Cindy’s face feeling her skin. “Do you mean symmetry? I asked. “Oh. I made the same mistake as Cindy huh?” she replied. “That’s okay. Just keep going. You’re doing well,” I responded. She continued to look at Cindy’s face. “I need to check her popples,” she said. “Do you mean pupils?” I asked. “Yeah. Popples,” she replied. Kelly had a little of an accent. Maybe that was as close as she could get. “She’s not paler,” said Kelly. I stood there for a while. “Do you mean pale?” I asked. “Yes. Pale. She’s not,” she responded.
Kelly continued to work her way down Cindy’s face and skin on her body. “What are you looking for when you are looking at the skin?” I asked. I knew she was stuck. “Well, you would look for cuts and bumps and migules,” she responded. “It’s okay if you called them moles for now until you get used to the term. They are called macules if they are flat and papules if they are raised,” I said. “Ok.” She continued feeling Cindy’s skin and naming every little bump and moles she had on her legs. Then we were done. Now it was time for Cindy to assess her second system and repeat it with Kelly. There were 26 students left. It was going to be a long morning. Cindy picked neuro for her next assessment.
Tuesday, October 28, 2008
Medical Assistants Learning Medical Terminology
As with anything in life, persistent study and practice is what makes your knowledge of medical terms stronger. There are various methods, which can be utilised, and all are successful in their own way. The more methods you can use to learn medical terminology, the better understanding you will have. Below are various methods, which can be used.
Aural
There are many software programs, which you can use to study medical terms via the aural method. These programs will have most terms on a CD, which are played with an interval, which allows you to repeat the term. It then gives you the definition of that term. Over time, you will benefit by this study method as it allows you to leave the books and concentrate on the terms, their correct pronunciation, and their meanings.
Internet
The Internet has many online medical terminology dictionaries and resources. The majority of these are free which will allow you to practice effectively. These resources will usually cover all of medical terminology reviews consisting of:
· Prefixes
· Suffixes
· Root Words
· Medical Terms
· Medical Abbreviations
· Medical Definitions
· Surgical Abbreviations
· Diagnostic Abbreviations
Medical Dictionaries
Dictionaries such as the Mosby’s Medical, Nursing, and Allied Health have a dedicated section on Medical terminology. It assists with the breaking down of combining forms, roots or stems, prefixes and suffixes of a term. There is also the option of online medical dictionaries found on the Internet.
Mosby’s Medical terminology is categorised under:
Prefixes Suffixes Roots and combining forms in external anatomy Roots and combining forms in internal anatomy Greek and Latin verbal derivatives Greek and Latin adjectival derivatives Miscellaneous words and combining forms.
Flash/Cue Cards
One of the best methods of learning terminology is to use Flash cards, which has the term on one side and the definition on the other side. There is software, which will allow you to enter your own terms and definitions and will work based on random selections.
Writing the term down
After some time, the student will be able to recognise enough terms and their definitions to begin writing them down. Another person calling out either the term or the definition can assist via this method. The student is then able to recall their medical terminology knowledge. This is one of the best methods as it allows tests to take place.
Anatomical specific
Another method is to select an anatomical part of the body and write down or verbalise as many terms pertaining to that part of the body. This will enhance your body specific knowledge greatly.
Aural
There are many software programs, which you can use to study medical terms via the aural method. These programs will have most terms on a CD, which are played with an interval, which allows you to repeat the term. It then gives you the definition of that term. Over time, you will benefit by this study method as it allows you to leave the books and concentrate on the terms, their correct pronunciation, and their meanings.
Internet
The Internet has many online medical terminology dictionaries and resources. The majority of these are free which will allow you to practice effectively. These resources will usually cover all of medical terminology reviews consisting of:
· Prefixes
· Suffixes
· Root Words
· Medical Terms
· Medical Abbreviations
· Medical Definitions
· Surgical Abbreviations
· Diagnostic Abbreviations
Medical Dictionaries
Dictionaries such as the Mosby’s Medical, Nursing, and Allied Health have a dedicated section on Medical terminology. It assists with the breaking down of combining forms, roots or stems, prefixes and suffixes of a term. There is also the option of online medical dictionaries found on the Internet.
Mosby’s Medical terminology is categorised under:
Prefixes Suffixes Roots and combining forms in external anatomy Roots and combining forms in internal anatomy Greek and Latin verbal derivatives Greek and Latin adjectival derivatives Miscellaneous words and combining forms.
Flash/Cue Cards
One of the best methods of learning terminology is to use Flash cards, which has the term on one side and the definition on the other side. There is software, which will allow you to enter your own terms and definitions and will work based on random selections.
Writing the term down
After some time, the student will be able to recognise enough terms and their definitions to begin writing them down. Another person calling out either the term or the definition can assist via this method. The student is then able to recall their medical terminology knowledge. This is one of the best methods as it allows tests to take place.
Anatomical specific
Another method is to select an anatomical part of the body and write down or verbalise as many terms pertaining to that part of the body. This will enhance your body specific knowledge greatly.
Medical words of the moment
Over the past few months I’ve been steadily collecting medical terms that I like. To make them last longer I’ll try to dole them out across a few posts. Also, I’m sure I’ll continue to identify other cool ones as time goes on, so watch for updates.
hyperammonemia - the presence of an excess of ammonia in the blood [This one holds a special place in my heart because I encountered it on my first day as a medical editor. Terms like that proved the new job would definitely be a change from editing elementary school math textbooks.]
[Actually, I kind of like all -emia words. Some examples:]
hypercalcemia - the presence of an excess of calcium in the blood
hyponatremia - deficiency of sodium in the blood
Note: Although AMA and my work both use Stedman’s as the preferred medical dictionary of reference, I plan to use slightly abridged definitions from the online Merriam-Webster’s Medical Dictionary for their broad appeal (you don’t have to look up another definition for a word that’s describing the definition you actually want to know - that’s always a turnoff).
hyperammonemia - the presence of an excess of ammonia in the blood [This one holds a special place in my heart because I encountered it on my first day as a medical editor. Terms like that proved the new job would definitely be a change from editing elementary school math textbooks.]
[Actually, I kind of like all -emia words. Some examples:]
hypercalcemia - the presence of an excess of calcium in the blood
hyponatremia - deficiency of sodium in the blood
Note: Although AMA and my work both use Stedman’s as the preferred medical dictionary of reference, I plan to use slightly abridged definitions from the online Merriam-Webster’s Medical Dictionary for their broad appeal (you don’t have to look up another definition for a word that’s describing the definition you actually want to know - that’s always a turnoff).
Cool brain and drug words
At work recently we’ve been editing materials about sleep disorders and their treatments, especially in elderly patients. Last week a set of slides on that topic netted lots of cool-sounding medical words:
suprachiasmatic nuclei - A pair of neuron clusters in the hypothalamus [in the brain] that receive light input from the retina via the optic nerve and that regulate the body’s circadian rhythms.
alpha synucleinopathies - A class of neurodegenerative disorders (such as Parkinson’s disease, certain types of dementia, and multiple system atrophy) that are caused by alpha-synuclein (alpha-SN) accumulating on vulnerable neurons.
fluoxetine - An antidepressant drug that enhances serotonin activity (better known as Prozac).
mirtazapine - A tetracyclic antidepressant (better known as Remeron).
venlafaxine - An antidepressant drug that acts by inhibiting the reuptake of serotonin and norepinephrine by neurons (better known as Effexor).
pramipexole - A dopamine agonist used treat the symptoms of Parkinson’s disease (better known as Mirapex).
anticholinesterase inhibitors - A class of drugs that decrease breakdown of the acetylcholine (a chemical messenger in the brain) and can be used in conditions where there is an apparent lack of this messenger transmission, such as in Alzheimer’s disease.
suprachiasmatic nuclei - A pair of neuron clusters in the hypothalamus [in the brain] that receive light input from the retina via the optic nerve and that regulate the body’s circadian rhythms.
alpha synucleinopathies - A class of neurodegenerative disorders (such as Parkinson’s disease, certain types of dementia, and multiple system atrophy) that are caused by alpha-synuclein (alpha-SN) accumulating on vulnerable neurons.
fluoxetine - An antidepressant drug that enhances serotonin activity (better known as Prozac).
mirtazapine - A tetracyclic antidepressant (better known as Remeron).
venlafaxine - An antidepressant drug that acts by inhibiting the reuptake of serotonin and norepinephrine by neurons (better known as Effexor).
pramipexole - A dopamine agonist used treat the symptoms of Parkinson’s disease (better known as Mirapex).
anticholinesterase inhibitors - A class of drugs that decrease breakdown of the acetylcholine (a chemical messenger in the brain) and can be used in conditions where there is an apparent lack of this messenger transmission, such as in Alzheimer’s disease.
Monday, October 27, 2008
5 yr degree program in pharmacy
Recently, the Pharmacy Council of India (PCI) has proposed a plan to start a 5-year PharmD program in India. The PCI has selected 20 pharmacy institutions in India and submitted the proposal to the Indian Ministry of Health and Family Welfare for their review and approval. The idea is to educate and train pharmacy students in India to meet the shortage of pharmacists in Indian hospitals and also to match the entry-level PharmD curriculum in the United States. The National Association of Boards of Pharmacy (NABP) new requirement that a foreign pharmacy graduate have 5 years of pharmacy education before applying to take the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) in order to then take the North American Pharmacist Licensure Examination (NAPLEX) and finally obtain a license to practice pharmacy in the United States is the key reason for this change in pharmacy education in India.1-4 The movement towards a clinically oriented curriculum is already afoot and we believe more countries in the Indian subcontinent and around the world will soon follow the PCI decision.5 In fact, many pharmacy institutions in India, like Jadavpur University have started offering a master of science (MS) course in clinical pharmacy to expand upon the basic pharmaceutical courses in the 4-year curriculum. Dr. Dutta, a Jadavpur University alum, was invited to his alma mater to provide a workshop for the faculty in teaching clinical courses to pharmacy students. We believe that students with advanced training in clinical courses meet the 5-year pharmacy requirement for taking the FPGE. Currently, Jadavpur University is identifying us universities to establish collaborative faculty and student exchange programs in pharmacy whereby faculty members from both institutions can visit the host institution to gain valuable experience in teaching and research. Jamia Hamdard (Hamdard University), Dr Ghilzai's alma mater, has also started an MS course in pharmacy practice at the Faculty of Pharmacy.
The course is sponsored by Faculty of Pharmacy with Hamdard's Hospital and will be of 2 years duration, out of which 2 semesters will cover course work and another 2 semesters will be devoted to a research project and practice experiences to be undertaken in the Hospital. The new course has been established in Hamdard Hospital and the facility of Drug Information Services, which also publishes a bimonthly newsletter on the current drug information, has already been developed. Besides pharmacy faculty members, 2 clinicians from Hamdard's Hospital are associated with this course.
We really appreciate the PCI decision, which came after a visit by the Accreditation Council for Pharmacy Education (ACPE) delegation to India to meet with the PCI. Although this bold decision came very late, it is a positive step in the right direction to popularize pharmacy education and to graduate skilled and knowledgeable pharmacist who can work in clinical settings and counsel and manage drug therapy and improve patient's health care.
Until now, Indian pharmacy graduates have been mainly trained to work in the pharmaceutical industry as product and formulation scientists. Pharmacy education in India has mainly focused on pharmaceutical sciences courses, while clinical or pharmacotherapeutic courses have received far less coverage in the curriculum and no students have ever undergone pharmacy practice experiences. According to one article, there are over 600 pharmacy colleges and schools in India producing over 13,000 pharmacy graduates yearly.
In the last few years, the issue was hotly debated and discussed throughout India to get a consensus to revamp the pharmacy curriculum. It is suggested that the new pharmacy curriculum will entail courses in pharmacogenomics and biotechnology and a significant portion of the curriculum will focus on pathphysiology, pharmcotherpaeutics, and practice experiences.
According to one article, there are over 600 pharmacy colleges and schools in India producing over 13,000 pharmacy graduates yearly.
In the last few years, the issue was hotly debated and discussed throughout India to get a consensus to revamp the pharmacy curriculum. It is suggested that the new pharmacy curriculum will entail courses in pharmacogenomics and biotechnology and a significant portion of the curriculum will focus on pathphysiology, pharmcotherpaeutics, and practice experiences.
The All India Council for Technical Education (AICTE) is a statutory regulatory body for technical education in the country that had been limited to overseeing technical education. However, in 2003, the AICTE announced that it will constitute a National Engineers Registration and Licensing Board (NERLB) to provide registration and licenses for practice of engineering in India. We would suggest that the PCI should work in close association with the AICTE to introduce and mandate a similar national board examination for pharmacy graduates to qualify to practice pharmacy in India.
We have contributed twice here in the past to raise the issue of pharmacy education in India and in those letters we suggested that pharmacy education in India needed to be more clinically oriented. We personally appreciate the PCI's decision to explore and involve an international accreditation agency and also congratulate the ACPE for supporting the PCI.
We would like to thank AJPE for promoting the cause of pharmacy education in foreign countries. Many foreign pharmacy graduates are employed as pharmacy educators in US colleges and schools of pharmacy. Also, foreign pharmacy graduates constitute a large and growing number of the total pharmacist workforce in some US states.
REFERENCES
1.
Ghilzai NK. In response to the letter entitled, “Pharmacy Graduates from Foreign Countries Flooding US Job Market” [letter]. Am J Pharm Educ. 2004;68(1) Article 23.
2.
Dutta A. In response to the letter entitled, “Pharmacy Graduates from Foreign Countries Flooding US Job Market” [letter]. Am J Pharm Educ. 2004;68(1) Article 23.
3.
Dutta A. The FPGEE Curriculum Requirement: An Insurmountable Hurdle? [letter]. Am J Pharm Educ. 2005;69(5) Article 105.
4.
Ghilzai NK. New FPGEE Guideline [letter]. Am J Pharm Educ. 2006;70(2) Article 46.
5.
Babar ZU. Pharmacy Education and Practice in Pakistan [letter]. Am J Pharm Educ. 2005;69(5) Article 105.
Future of Indian Pharmacy!
Guys i jus wann we people to discuss our thoughts on why pharmacy proffesion is lagging behind in india?
why dont we have respectable oppurtunities like engineering,Medicine.(lack of funds in univ to run reaserch)
We all have been listening to word GLOBALISATION for a long time.How it can benifit we students..
I wish our students to open our minds and make some thing good to our profession!
he Educational Infrastructure will continue to churn out Pharmacy Graduates as it has been doing successfully since maybe forever, in regards to the Profession of Pharmacy and the career as such, Pharmacy graduates at least in India need to create a niche for the Pharmacy profession. The Pharmaceutical industry seems to be indifferent to the Pharmacy graduates, folks I am not complaining here, myself an average or possibly a below average graduate, can't think of competing for a satisfactory career in India, glad to know that few multinationals are outsourcing the clinical trials, and generics production to India. Individuals who decided to work in India are doing well. The world is rethinking its approach to Globalization. Globalization as far as i know is the use of resources in an optimal way to create wealth. Developing nations and "Third world" are finding themselves at the short end of the bargain, the evidence is the complications in the WTO talks, well "complications" is just an euphemism the word is FAILURE. Traditional economics emphasize Globalization is a good thing, Nuclear Physicist turned activist Ms. Vandana Shiva argues otherwise. hey am i talking philosophy here, got to stop!
comments and critics appreciated.
why dont we have respectable oppurtunities like engineering,Medicine.(lack of funds in univ to run reaserch)
We all have been listening to word GLOBALISATION for a long time.How it can benifit we students..
I wish our students to open our minds and make some thing good to our profession!
he Educational Infrastructure will continue to churn out Pharmacy Graduates as it has been doing successfully since maybe forever, in regards to the Profession of Pharmacy and the career as such, Pharmacy graduates at least in India need to create a niche for the Pharmacy profession. The Pharmaceutical industry seems to be indifferent to the Pharmacy graduates, folks I am not complaining here, myself an average or possibly a below average graduate, can't think of competing for a satisfactory career in India, glad to know that few multinationals are outsourcing the clinical trials, and generics production to India. Individuals who decided to work in India are doing well. The world is rethinking its approach to Globalization. Globalization as far as i know is the use of resources in an optimal way to create wealth. Developing nations and "Third world" are finding themselves at the short end of the bargain, the evidence is the complications in the WTO talks, well "complications" is just an euphemism the word is FAILURE. Traditional economics emphasize Globalization is a good thing, Nuclear Physicist turned activist Ms. Vandana Shiva argues otherwise. hey am i talking philosophy here, got to stop!
comments and critics appreciated.
Sunday, June 15, 2008
Future of Pharmacy Informatics
Pharmacy informatics will likely continue to grow in its scope and importance for some time. When, in 1999, the Institute of Medicine (IOM) published the report To Err is Human, the pharmacy community was at once called out for allowing unsafe medication management practices to preponderate and called upon to dramatically improve the safety of medication use in the United States. The Institute for Safe Medication Practices (ISMP, [4]), a leading patient safety organization, is well positioned to advance medication safety efforts. ISMP continues to focus on pharmacy informatics and patient information management as key areas of both promise and concern, promise that the application of new information technologies will improve patient safety and concern that the diffusion, adoption and best-practice use of medication management technologies is happening too slowly. Time will tell if pharmacy informatics, as an area of applied information sciences and as a sub-discipline of health informatics, will indeed positively transform medication use so that patients benefit from improved safety and efficacy with respect to the medications they require.
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