Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Letter to Editor
Year : 2010 | Month : February | Volume : 4 | Issue : 1 | Page : 2158 - 2162 Full Version

Our Experiences With ‘Sparshanam’, A Medical Humanities Module For Medical Students At KIST Medical College, Nepal


Published: February 1, 2010 | DOI: https://doi.org/10.7860/JCDR/2010/.642
SHANKAR PR*, PIRYANI RM**, THAPA TP***, KARKI BMS****

*Dept. of Medical Education,**Dept. of Medicine,***(Principal) Dept. of Medical Education,****Deputy Director Academics,Dept.of Microbiology,KIST Medical College, Imadol,Lalitpur.(Nepal)

Correspondence Address :
Dr. P. Ravi Shankar,KIST Medical College,P.O. Box 14142,Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com

Abstract

Medical Humanities (MH) uses subjects which are traditionally known as humanities in the pursuit of medical educational goals. MH programs are not common in South Asia. A voluntary module for medical students and interested faculty was previously conducted at Pokhara, Nepal.
KIST Medical College is a new medical school in Lalitpur district of Kathmandu valley. A MH module for faculty members was conducted. The first year medical students joined the MBBS course in mid-November 2008. An MH module using small group and activity-based learning was conducted for all students. Case scenarios, brainstorming sessions, role plays and paintings were used to explore various aspects of MH. In this article, the authors share their experiences of conducting the module.

Medical Humanities (MH) has been defined as ‘an interdisciplinary and increasingly international endeavour that draws on the creative and intellectual strengths of diverse disciplines including literature, art, creative writing, drama, film, music, philosophy, ethical decision making, anthropology and history in pursuit of medical educational goals’ (1). MH programs are common in developed nations but are not common in South Asia. Nepal is a small developing country in South Asia and many medical schools have opened in the country in the last fifteen years.
The first author conducted a voluntary MH module for interested students and faculty members at Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal (2).Twenty-six students from the third, fifth and sixth semesters and interested faculty members participated. The participants enjoyed being a part of the module. They had problems with certain literature excerpts and wanted more literature and art from a South Asian context. The author’s experiences while conducting the module have been mentioned in a recent article (3). Making the module interesting and informative was the main challenge faced. Keeping an open mind and employing a flexible approach were also important.

KIST Medical College
KIST Medical College (KISTMC) is a new medical school in the Lalitpur district of the Kathmandu valley which is committed to

excellence in holistic healthcare, education and research. A module was previously conducted for faculty members and medical/dental officers at KISTMC. The participant feedback on the module was positive (4). The group dynamics during the sessions were satisfactory, but certain literature excerpts were felt to be complicated. Certain respondents were uncomfortable with role plays dealing with sexual and reproductive issues.

The 75 first year medical students joined the undergraduate medical (MBBS) course in mid-November 2008. There was a week long orientation program for students where they learnt about, ‘what it means to be a doctor’ and ‘medical ethics’ and were introduced to the faculty members and different departments. There was also a session on the ‘Art of medicine’.

Can We Have An MH Module For All First Year Students?
The curriculum of Tribhuvan University (TU) to which the college is affiliated, emphasizes early clinical contact and learning of communication skills by students (5).Students attend the clinical teaching sessions every Wednesday morning from 8 am to 12.30 pm in the teaching hospital.

We wanted to introduce the students to Medical Humanities. The first task was to prepare a module outline. The module concentrated on empathy, the doctor, the patient, the doctor-patient relationship, dealing with HIV-positive patients, the family, the healthcare team, the medical student and ‘what it means to be sick in Nepal’, among other topics. There were a total of 11 topics and each topic was to be completed in two sessions. The MH sessions were held from 8 am to 9.30 am every Wednesday. We were apprehensive about involving all students in the module. Engaging the large student number (75) and creating, maintaining and sustaining their interest in MH were the major challenges faced by the organizers.


What Was Covered?
The topics selected for the module were based on those covered in other MH modules worldwide, discussions with other MH educators, our experiences with various topics during previous MH sessions and feedback obtained from participants of previous modules. Topics like empathy, the doctor-patient relationship, the family, the doctor and ‘breaking bad news’ were covered in previous sessions. The new topics introduced during the present module were the healthcare team, the medical student, individuals who are victims of deprivation and ‘what it means to be sick in Nepal’. We felt these were topics of particular interest to medical students in the context of Nepal. The two home assignments were ‘Death of the family doctor’ and ‘Your friendly neighborhood medical representative’. There is a trend towards increasing specialization and super specialization in Nepal, especially in urban areas and the trend towards being ‘the general practitioner or family doctor who could treat most conditions and was a friend and counselor to the family’ is becoming increasingly uncommon. Aggressive pharmaceutical promotion is common in urban Nepal and has a major impact on the prescribing behaviour. We wanted the students to reflect on these two phenomena.

Name Of The Module
The next major challenge was naming the module. We wanted a name which reflected the module contents and objectives and that which was rooted in Nepalese culture. We ultimately settled on ‘Sparshanam’, which means ‘touch’ in Sanskrit. Many languages of South Asia including ‘Nepali’, the national language of Nepal, are derived from Sanskrit. Touch is a powerful gesture and can always comfort the patient. In many instances, touch can be therapeutic also. We wanted to emphasize the importance of touch in the doctor-patient relationship, in relationships between the patient and other health professionals and in the care and support given by the family and other care givers.

Teaching-Learning Methodologies And Activities Used
Like in previous modules, we used small-group and activity-based learning strategies. The challenge which we faced, was to adapt these methodologies for a large number of students. Case scenarios, role-plays, paintings and literature excerpts were used previously and participants had problems with certain literature excerpts. We decided not to use literature in the present module.

We started each session with a brief introduction by the facilitators and then had a brainstorming session, followed by two activities. Towards the end of the session, there was a ‘Khula Manch’ (open forum) where participants could talk about various aspects of the module or interpret MH through songs and music, followed by a ‘Take home’ message by a student and conclusion by a facilitator. Power Point slides were used to link together various activities and to keep the session on track. Students identified major issues in each case scenario and interpreted it using role-plays. The activities with regard to paintings were, ‘What do you see’ and ‘What do you feel’, to create a story or around 100 words about the scene depicted in the painting, to create and sing a song or poem about the scene depicted and to interpret the issues covered in the painting using role-plays (6).

Cofacilitators
We decided to have cofacilitators for the module, considering the large student body. The first two authors of the article acted as facilitators, while six other faculty members acted as cofacilitators. The cofacilitators were from the departments of Medicine, Surgery, OB-GYN, Paediatrics, Pathology and Family Medicine. The 75 students were divided into six groups of 12 or 13 students each and each small group was under a particular cofacilitator. The aims of having cofacilitators were, to involve more faculty members in the module, to facilitate small group dynamics and to train cofacilitators to act as facilitators in future sessions.

The first author had met Dr. Huw Morgan at Patan Hospital where he had delivered a talk on MH. Dr. Morgan is a family physician and medical educator from the United Kingdom, with a keen interest in MH. Dr. Morgan was interested in the KISTMC MH module and promised to help and facilitate sessions whenever he was able to manage time from his responsibilities at Patan Hospital. Dr. Morgan attended four sessions at KISTMC, acted as a facilitator, shared his experience with the students and brought an international perspective to the sessions.

Where To Hold The Sessions And Forming Student Groups
The next challenge was to find a suitable location to conduct the sessions. The place had to be large to accommodate 75 students comfortably, suitable for conducting activity-based sessions and with facilities for LCD projection. The college auditorium on the top floor of the hospital fulfilled these criteria and it was used. We arranged the seating of the auditorium before each session to suit our requirements. Students were seated on chairs around a worktable. Group presentations were conducted using flip charts and white boards. A microphone system was available. Arranging the groups so that the participants could see the white boards, flip charts and the projection area and in such a way that they could work together comfortably in small groups, was a challenge.

Each group was named after a famous worker in the field of MH. One of the first assignments given to each group, was to submit a short write up about the person after whom their group was named. Each group had to select a group leader, a time keeper, a recorder and a presenter. These roles were rotated during each session. Our aim was to develop qualities of leadership and problem solving among students.

Creating And Maintaining Interest
At the beginning of the module, each participant was given a curriculum outline mentioning the topics to be covered and a topic description giving a brief outline of each topic. Lesson plans were prepared for all sessions and were discussed with the cofacilitators. We relied on activities to create and maintain interest. The case scenarios covered issues of importance to medical practice in Nepal.

The participants explored issues using role-plays. The facilitators gave frequent constructive feedback to the students. ‘Khula Manch’ was especially popular. The participants used it to explore various issues through songs and music. Initially, the emphasis was on romantic film music, but under our guidance, songs exploring other issues were also performed. Some participants composed their own songs or recited their own poems. Formative assessment of small groups was carried out frequently and participant feedback was taken at the end of each session. The facilitators concentrated on creating a safe and non-threatening environment for the participants.

Student Facilitators
To develop leadership and facilitation skills among students, we decided to have student facilitators for certain sessions. There was a certain amount of apprehension among the facilitators about the idea. Some felt that students would not be able to facilitate the session satisfactorily and that it may affect their learning. We decided to give it a trial.

The feedback from the student facilitators was positive. The students discussed and worked with the facilitators to develop the lesson plan for the session. Then they conducted the sessions, invited help and contributions from faculty facilitators where required and facilitated group dynamics. We felt that the student facilitators did a good job and were energetic and committed. The students facilitated five sessions. Most of the student participants felt that the ‘student facilitators’ had done a good job. Somehowever, felt that the student facilitators were a bad idea and that the concept should be reexamined for future sessions.

Problems Of Attendance
Student attendance was an occasional problem, especially if there were assessments of ‘Basic Science’ subjects. We were flexible regarding the attendance and usually anywhere between 55 to 70 students attended each session. We aimed to make the sessions interesting and informative. We also made the attendance of group members a criterion during the formative assessment of groups. The students were given two multiple choice examinations during the module, to gauge their understanding of topics discussed.

Paintings
The paintings used in the module were works by western artists. These were obtained from the literature, art and medicine database maintained by New York University. The database gives detailed annotations and interpretations of the paintings. The students had no problem relating to the scenes depicted in the paintings. Among the artists whose paintings were used in the module were Vincent van Gogh, Pablo Picasso, Alice Neel and Frieda Kahlo among others (6). The paintings were projected using the LCD projector so that students could appreciate them in colour. We had tried photocopies of paintings during the module at Pokhara, but colour photocopies were not available and black and white reproductions led to the loss of a large amount of information. Colour plays an important role in paintings. The groups carried out their activities and presented their findings, which were followed by discussion and comments by other groups. The facilitators then presented the annotations. Interpreting the scene depicted in the paintings using role-plays was extremely popular.

Lessons For Educators In Developing Countries Which Are Starting With MH Modules
Careful planning and preparation are necessary before starting an MH module. MH modules are not common in developing countries. Feedback and support can be obtained from educators in developed nations, but the responsibility of adapting and modifying topics to suit local requirements is that of the faculty member/s. Maintaining participant interest was a challenge. We would recommend around 8 or 9 topics for a new module. We had difficulty in sustaining the interest of the students for all the 11 topics. As we explored each topic in two sessions, we had a total of 22 sessions. We used small group and activity-based learning strategies. We obtained regular participant feedback and feedback from other facilitators to ensure that we were on the right track.

Future Sessions
We plan to continue with MH sessions for students in future. We are considering using paintings by Nepalese artists if possible, for certain topics. We plan to use literature excerpts from South Asia if we can get easily understandable excerpts which are relevant to our topics.

References

Royal free and University College Medical School, London, England. Acad Med 2003; 78:1048-53.

2.
Shankar PR. A Voluntary Medical Humanities Module in a Medical College in Western Nepal: Participant feedback. Teaching and Learning in Medicine 2009; 21:248-53.
3.
Shankar PR. Conducting a voluntary module – Personal experiences. Journal of Medical Sciences Research 2007; 2:55-58.
4.
Shankar PR, Piryani RM, Karki BMS. A Medical Humanities module for faculty members and medical/dental officers at the KIST Medical College, Imadol, Nepal. Souvenir, Research Day celebrations, Institute of Medicine, Kathmandu, 2009. Page 70.
5.
Medical Education Department. Curriculum for Bachelor of Medicine and Bachelor of Surgery (MBBS). Kathmandu: 2009.
6.
Shankar PR, Piryani RM. Using paintings to explore the Medical Humanities in a Nepalese medical school. BMJ Medical Humanities 2009; 35:121-2.

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