Dr Srivastava's Report
Evaluation Report on Dr. Kuldeep Srivastava’s observership training funded by the MHMF in 2006
From 3rd April to 26th May 2006, Dr. Kuldeep Srivastava undertook an observership at Moorfields Eye Hospital in London, UK. The area of the observership was in strabismus (squint) and paediatrics. The observership was under the guidance of mentor Mr. John Lee, who is also a member of the ORBIS Volunteer Faculty cadre. In order to assess the impact of the observership almost a year after the training had taken place, we asked Dr. Srivastava to take part in a post observership training evaluation.
The report will be divided into three sections and will look at:
1) How the training has affected the way the fellow approaches their work
2) The wider impact of the training
3) Whether there have been any difficulties encountered in applying the training
4) Plans for follow up training
1) How the training has affected the way the fellow approaches their work
The objective of the observership was to improve Dr. Srivastava’s skills in the field of Strabismus & Pediatric Ophthalmology, and these objectives were fully achieved. The observership has greatly improved Dr. Srivastava’s confidence in managing complicated strabismus disorders. His technical skills have improved, as he is applying adjustable sutures and fixation sutures for III Nerve palsy on his patients. Mentioned below are specific areas that Dr. Srivastava was able to learn from Mr. Lee’s experience.
a) Adjustable suture in strabismus – strabismus surgery is performed with temporary suture knots and finer adjustment is done after surgery while patient is awake.
b) Fixation suture for III N palsy – the management of total III N palsy is a challenge to a strabismologist and Mr. Lee has developed an effective technique to treat these cases.
c) Botulinum toxin in strabismus management – certain types of strabismus that are not amenable to surgical correction can be managed with this modality of treatment. An injection of Botulinum toxin into specific extra ocular muscle improves strabismus. This modality is also used to assess the possibility of diplopia following strabismus surgery. Mr. Lee has more than 20 years experience in this technique and successfully managed over 6,000 patients during last 24 years of practice.
d) Dr. Srivastava mentioned a specific case where he was able to treat a patient with a condition that he would not have been able to treat before the observership:
“A 60 years old gentleman presented to me with complaint of double vision for distance since last one year. He was not able to drive his motorbike. On examination, he was found to have left VI nerve paresis with esotropia more for distance than near. I performed strabismus surgery on him with adjustable suture technique, which I learnt during observership at Moorfields. Following surgery, his strabismus improved and he is diplopia free.”
2) The wider impact of the training
Following his observership training, Dr. Srivastava has had the opportunity to train three other colleagues in his department. The names of the colleagues and the length of time Dr. Srivastava has spent training them is outlined below:
a) Dr. Gauri: 9 months
b) Dr. Pradhnya: 9 months
c) Dr. Pragati: 4 months
3) Any problems encountered in applying the training
In response to questions about challenges encountered in applying the training, Dr. Srivastava reported that he had not encountered any problems. Similarly, Dr. Srivastava did not suggest any ways that the observership programme could have been improved, as he was satisfied with the training he received.
4) Plans for follow up training
Dr. Srivastava’s mentor, Mr. John Lee will be visiting SNC, Chitrakoot in October 2007 to participate in a hospital based programme (HBP) in strabismus. As Dr. Srivastava is the Head of the Children’s Eye Care Centre, SNC and ORBIS India both felt that the HBP would greatly benefit if Dr. Srivastava takes responsibility for coordinating the training for the HBP. Dr. Srivastava has therefore played an instrumental role in outlining the training needs and selecting three more junior ophthalmologists who will benefit from the hands on training with Mr. Lee.
Two of the trainees participating in the HBP are the same trainees that Dr. Srivastava trained following his observership at Moorfields. These trainees are Dr. Pradhnya and Dr. Pragati, and the third trainee for the HBP is Dr. Lokesh Arora. The HBP will therefore provide an excellent opportunity to both strengthen the skills of these trainees and facilitate further interaction between Dr. Srivastava and Mr. John Lee. This is an example of how ORBIS’s training activities have a wider impact of improving the capacity of our partner, SNC, through strengthening the skills and expertise of individuals who are able to share their skills with others, contributing to long-term capacity building.
Thursday 17-May-2007