Halfway done in the blink of an eye

(Can’t stop won’t stop with the punny titles)

Since my CASI internship is approximately halfway over, I suppose I should at least talk about the reason I came to India in the first place: to pet elephants my project! I’ve been spending excessive amounts of time with Hepsiba, Nithya, and Sakthipriya in the Aurosiksha office. Aurosiksha is Aravind’s online resource that offers courses for eye care professionals of varying education levels. In particular, it contains the streams of course materials for the MLOPs, or Aravind’s equivalent of specially trained ophthalmic nurses. I have been focusing on the basic training modules-the courses that all incoming MLOPs are required to take.

Aravind is attempting to rework this curriculum by converting the lessons into a “Learning Module Framework.” This is a standardized set of criteria for each lesson that includes teachers’ guides, assessments, activities, relevant resources, etc. The MLOP training division hopes that this coursework development will set clear expectations for learning while creating a more interactive classroom experience. The ultimate goal is to optimize the academic and technical preparation of the MLOPs, aiming to give them confidence when they interact with and treat the thousands of patients that visit Aravind everyday. If the preparation work is comprehensive and solid, they will make fewer errors and be able to correctly make critical decisions in the clinical setting.

My current task list involves the following items:

  1. Clearly define each set (and correlating subset) of modules within the stream
  2. Identify the materials that are missing from each module
  3. Modify the current modules to fit within the Learning Module Framework by correcting presentations, locating additional resources, creating activities or handouts, writing teachers’ guides, etc.
  4. Create new modules to cover topics that are currently not included in Aurosiksha
  5. Receive verification from experts in the field on each module (for example, the module that I created about Strabismus was verified by a senior sister in the pediatric department)
  6. Force either Sakthipriya or Nithya to get married before I leave so I can help plan/attend a wedding (this one has proved to be the most challenging)

Recently, I’ve also discovered an area for improvement in the training for MLOP surgical assistants. As I described in a previous blog post, the MLOPs originate from rural areas in Tamil Nadu, generally with little exposure to the medical field. Going into the operating theatre for the first time can be daunting for anyone, and given the expedited pace of work at Aravind, it could be quite intimidating for the new trainees. I am proposing a small, introductory course (similar to an orientation pre-requisite) to the operating theatre at Aravind that would occur before formal training. This would at least provide exposure to the field and serve as a glimpse into the environment that they will be training and working in for the next few years.

Yesterday I went to meet with one of the senior sisters from the surgical department in order to discuss this idea. As usual, I was not disappointed with Aravind’s execution of high capacity care, as the OTs are meticulously organized despite running four operating beds simultaneously. I arrived as a retinal injury surgery was occurring, allowing me to watch a specialty procedure. I watched cataract surgeries this morning, by far Aravind’s most common procedure, and I will be focusing on cataract operations in the lessons that I create.

While investigating Aravind’s practices of confirming that the sisters are prepared for clinical work, I learned that the MLOP stream lacks a formal certification process. Though there are exams and skill assessments that occur along the timeline of the training process, the division lacks consistent criteria in some areas. One proposal would be to “certify” the girls as a first phase MLOP before they advance to specialty training in each department. This would be accomplished by an exam that reflects nursing licensure testing in the United States. This provides more structure in the form of benchmarks through the first year and could additionally serve as a diagnostic tool for specialty placement if it is completed after the initial four months of training. We are meeting with professors and training supervisors next week to discuss the feasibility of this idea.

We are currently trying to introduce the “new and improved” lessons for the incoming group of trainees. The first module that I created was entitled “Introduction to Basic Microbiology” accompanied by a course in “Advanced Microbiology Techniques”. The introduction will be presented to all incoming MLOPs, as it focuses on fundamental biological principles (with an emphasis on pathogens), and it reinforces the practical knowledge of practicing proper hygiene around patients. We’re hoping to present the lesson as a “pilot course” at another branch hospital (likely Pondicherry) in order to evaluate the success of our lesson planning and classroom strategies.

Over the past few weeks, we met elephants, were attacked by hundreds of leeches in the rainforest, raced through gorgeous Western Ghats, found ourselves in a field of butterflies, ate parottas, explored a tea plantation, played in the Indian Ocean and the Bay of Bengal, received Ayurveda massages (@Busra), witnessed the amazing night sky of Thekkady, wandered around a palace from the 1600s, celebrated Vivek’s 22nd birthday (cue T-Swift), and, most importantly, consumed multiple pizzas from Dominos. About 5 seconds ago I looked out of our window to see a temple elephant strolling down the street. India continues to surprise me everyday, yet it has become my new standard of normal. I still can’t wrap my head around the fact that we’ve been here for over 5 weeks, but luckily we still have plenty of time to sightsee, eat weird foods, and (maybe, just maybe) make progress with our projects.

Connemara tea plantation in Kerala

Connemara tea plantation in Kerala

I still get way too excited over the presence of cows everywhere

I still get way too excited over the presence of cows everywhere

Blustery day on the Pamban bridge

Blustery day on the Pamban bridge

Thirumalai Nayak Palace

Thirumalai Nayak Palace

Dhanuskodi Beach

Dhanuskodi Beach



One thought on “Halfway done in the blink of an eye

  1. What amazing experiences you are having while truly improving lives and saving sight. So very proud of you and grateful for U of PA for believing in Olivia’s capacity to give herself totally to a project. You go gal!

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About oliviamhess

I interned at Aravind Eye Hospital-Madurai as a CASI Student Programs Intern in 2015, and I am returning to Aravind in Pondicherry to conduct research using CASI Summer Travel Funds, the Association of Alumnae Rosemary D. Mazzatenta Scholars Award, and the Gelfman International Summer Fund.