ecg & amt-ii
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‘VOCATIONAL HIGHER SECONDARY
State Council of Educational Research & Training (SCERT)Vidyabhavan, Poojappura, Thriuvananthapuram-12, Kerala
Government of KeralaDepartment of Education
2006
ECG & AMTTEACHERS’ SOURCEBOOK
(Class XII)
CGovernment of Kerala
Prepared by :State Council of Educational Research and Training (SCERT)
Vidyabhavan, Poojappura, Thiruvananthapuram - 12, Kerala2006
Preface
Dear Teachers,
One of the aim of education is to help the learners to internalise to themaximum the immense possibilities of the ever-expanding body ofknowledge. The revision of curriculum and transactional strategies isaimed at changing the educational scenario. It is with this view thatthe ECG & AMT Sourcebook for Standard XII has been prepared.
This Sourcebook for teachers includes many new concepts and principlesalong with suggestions for transactional strategies. The teacher is expectedto select and use these strategies judiciously and transact them to learners.If the acquired knowledge is to contribute to the over all developmentof the learner, it has to be internalised through activities. For theeffective transaction of concepts, clarity is as important as involving inmeaningful activities.
The sourcebook has been prepared as an instrument to equip the teacherwith indication to make the activities more purposeful by specifyingwhat help is to be given at which stage and how. It is hoped that theactivities suggested in this book are suitable to the existing situation inour schools. It is also expected that the teacher has to seek help fromother sources like general reference books available in various libraries,websites, etc. Only then we can attain the objectives of learningscience practically and meaningfully.
It is report that this Sourcebook will be utilised to its maximum for theeffective transaction of the curriculum.
With regards,
Thiruvananthapuram Dr E. Valsala KumarDirector
SCERT, Kerala
Contents
Approach ............................................................... 05Subject Approach .................................................. 2 3Teaching Learning Strategies ................................... 2 5Curriculum Objectives ............................................ 3 5Syllabus ................................................................. 3 8Planning ................................................................. 4 2Evaluation ............................................................... 4 6Unit wise analysis
ECGUnit 1 Electro Cardiography ......................... 56Unit 2 Other Cardio Vascular Measurements
and equipments ................................ 72Unit 3 Cardiopulmonary resuscitation &
Medical Ethics ................................. 84
AMTUnit 1 Pure Tone and Speech Audiometry ..... 88Unit 2 Assessment of Hearing Loss ............... 94Unit 3 Hearing Aids ................................... 106Unit 4 Ear moulds ....................................... 112Unit 5 Rehabilitation Adults and Childrens
with Hearing Impairments ................... 116
References ............................................................... 118
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Significance of vocational education
The ultimate aim of education is human refinement. Education should enable the learnerto formulate a positive outlook towards life and to accept a stand which suits the wellbeing of the society and the individual as well.
The attitude and potential to work has determined the destiny, progress and culturaldevelopment of the human race. As we all are aware, the objective of education is toform a society and individuals having a positive work culture. The educational processexpected in and outside our formal schools should concentrate upon inculcatingconcepts, abilities, attitudes and values in tune with these work culture. Hencevocationalised education cannot be isolated from the main stream of education. Inanother sense, every educational process should be vocationalised. However due toour inability to utilize the resources wisely, scarcity of job opportunities is a severeissue of the present society. For overcoming this deep crisis, emergent techniqueshave to be sorted out and appropriate researches have to be seriously carried out. It isin this sense that the content and methodology of Vocational Higher SecondaryEducation have to be approached. The need for meaningful linkages between the worldof work and world of education is well recognized. The essence of therecommendations made by various commissions and committees is that thevocationalisation should be the main feature of the future system of education at thehigher secondary stage, it can be extended to school level also.
Vocational Education is the system of education which intends to prepare studentsfor identified occupations , opening several areas of activities.
The Vocational Higher Secondary course envisaged as a part of the National Policyon Education with the noble idea of securing a job along with education. The relevanceof vocational education is very great in this age of unemployment. This educationsystem, which ensures a job along with higher education stands aloof from other systemsof education.
This education imparts the life skills required by the youth to enter the world of workand assuming the responsibilities of adulthood. As per the expert meeting report(2001) of UNESCO, the life skills are grouped under 4 categories. They are
GENERAL APPROACH
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1. skills for personal fulfillment
2. skills for living in society
3. skills for dealing with changing economies
4. skills for dealing with changing work patterns.
Vocational Education ensures fulfillment of manpower requirement for nationaldevelopment and for social security for the citizens through self-employment. It alsohelps to reduce the migration of rural youth to urban areas and thus helps in ruraldevelopment.
The learners of Vocational Education get an opportunity to avail one yearapprenticeship training in industries to improve their practical skill. During the courseof study, on the Job Training (OJT) for 10 days in a year is arranged to improve theskill and efficiency of the learner. This education system motivates the attitude towardsself –employment through Production/ Service cum Training Centres. (PTC)
Objectives of vocational education
The National policy on education has accorded very high priority to the program ofvocationalisation of education, considering the following objectives.
1. To fulfill national goals of development and the removal of unemployment andpoverty.
2. To impart education relevant to increased production and productivity, economicdevelopment and individual prosperity.
3. To make available skilled work force at all levels to alleviate the ruralunemployment and for the development of nation.
4. To develop environmental awareness to ensure sustainable development.
5. To develop vocational aptitude, work culture, values and attitudes of the learnersso as to enrich the productivity of the nation.
6. To develop entrepreneurial competencies and skills of learners for self relianceand to undertake gainful self employment.
7. To facilitate the expansion of higher education and explore future opportunitiesthrough innovative guidance and programmes.
8. To develop vocational competencies, creative thinking in the related areas andfacilitate training.
9. To create awareness on mental, physical and social health.
10. To acquire awareness about different job areas and to provide background foracquiring higher level training in subjects concerned.
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LEARNING
Learning is construction of knowledge through a continuous mental process. It is anadvancement through adding and correcting in the light of comparing the new issuewith the previously learned concepts. It is an intellectual process rather than the merememorization of facts. Learning is a conglomeration of a variety of activities likeproblem solving, finding out co-rrelations, prediction, arriving at conclusions, rationalas well as critical thinking, finding applications, grouping for other possibilities andextracting the crux when opportunities are provided for intellectual processes learningwill become effective and intellectual ability will get strengthened.
Theoretical foundations of learning
Education is the best device that can be adopted for creation of a new society. Itshould be democratic in content and process and should acknowledge the rights ofthe learner. It should also provide opportunity for better citizenship training. Theconcept of equality at all areas should get recognition in theory and practice. Thereshould be conscious programme of action to develop nationality, humanness and loveagainst the encroachment of sectarianism of caste and religion. The learner shouldbecome cognizant of the implications of privatisation, liberalisation, globalisationetc.
They should develop a discrimination to use the acquired learning as a liberative weapon.
They should be able to view education and life with the perspective of social wellbeing.
A basic awareness of all the subjects needed for life is essential for all students.
The remnants of perspectives formed in us during the colonial period still influenceour educational philosophy. The solution to the present day perplexities of the societywhich approaches education on the basis of competitions and marketisation is only acomprehensive view of life.
It is high time that education was recognized on the basis of the philosophy of humaneducation. The human approach to education has to reflect in its content, learningprocess and outlook. The perspective of ‘learning to be’ and ‘learning to live’ togetheras expressed by the UNESCO and the concepts of existential, intrapersonal andinterpersonal intelligence.
The basis of new approaches on curriculum and teaching- learning process are derivedfrom the developments tookplace in the east and west of the world.
When we begin to see the learner at the centre of the learning process, the teachingprocess has to be changed timely. It is the result of the rapid growth and development
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of Science and Technology and Pedagogy. If we want to undergo the changing process,we have to imbibe the modern hypothesis regarding learner that they have
1 Great curiosity
2 Good imagination
3 Numerous other qualities and interests
4 Independent individuality
5 Interest in free thinking and working In a fearless atmosphere.
6 Interest in enquiring and questioning.
7 Ability to reach conclusions after logical thinking.
8 Ability for manifest arid establish freely the conclusions arrived at.
9 Interest for recognition in the society.
10 Determination to face the interference of society and make componentswhich is a part of social life.
When we consider the learning system, the domains to be stressed in educationaccording to the modern development becomes relevant.
The knowledge domain consists of
1 Facts
2 Ideas
2 Laws
3 The temporary conclusions and principles used presently by scientists.
The learning is a process. The continuous procedures we undergo to reach a particulargoal is process. The skills which are parts of the process to analyze the collected ideasand proofs and come to a conclusion is called process skills. Some important processskills are, the skills;
1 To observe
2 To collect data and record
3 To classify
4 To measure and prepare charts
5 To experiment
6 To predict
7 To recognize and control the variables
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8 To raise questions
9 To generalize
10 To form a hypothesis and check.
11 To conclude
12 To communicate
13 To predict and infer
14 To use tools.
In addition to this, consider the skills related to creative domain also, they are skills:
1 To visualize
2 To connect facts and ideas in new ways.
3 To find out new and uncommon uses of objects
4 To fantasize
5 To dream
6 To develop creative isolated thoughts
Again, the following factors consisting in the Attitudinal domain are also importantas;
1 Self confidence
2 Love for scientific knowledge
3 Attitude to know and value history
4 Respect human emotions
5 Decide with reasonable present problems
6 Take logical decisions regarding personal values
As regards the application domain the important factors are the ability to:
1 observe in daily life examples of ideas acquired.
2 take the help of scientific process to solve the problems of daily life.
3 choose a scientific life style
4 connect the ideas acquired with other subjects.
5 integrate the subjects with other subjects.
Some basic stands have to be taken on the new scientific knowledge about intelligencelearning and teaching. When such basic concepts are accepted changes are required inthe following factors.
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1 The vision, approach, structure and content of the curriculum.
2 The vision, approach, structure and content of the textbooks.
3 Role of the teacher and the learner.
4 Learner atmosphere, learning materials and learning techniques.
Some scientific perspectives accepted by modem world in Educational Psychologyare given below.
Constructivism
This approach puts forward the concept that the learner constructs knowledge. Newknowledge is constructed when ideas are examined and practiced in new situationsrelating them with the previously acquired knowledge and experience. That is assimilatedinto the cognitive structure of one’s knowledge. This method which gives priority tocritical thinking and problem solving provides opportunity for self motivated learning.
Social Constructivism
Social constructivism is a branch of constructivism. Knowledge is formed, spreadand imbibed and it becomes relevant in a social environment. Interactive learning,group learning, co-operative participatory learning, all these are concepts put forwardby social constructivism.
The main propounders of constructivism are Piaget, Vygotsky and Bruner.
Discovery learning and interactive learning have prime importance. Learning takesplace as a part of the attempt for problem solving. The activities of a learner whoconfronts cognitive disequilibrium in a learning situation when he tries to overcome itleads to the renewal of cognitive structure. It is through this process construction ofnew knowledge, the assimilation of them takes place. Observation and enquiry areunavoidable factors. The learner advances towards new areas of acquisition ofknowledge where he tries to compare his new findings with the existing concepts.
Learning is a live mental process. Rather than the ability for memorization of factscognitive process has to be given emphasis. The process of problem analysis,elucidation, critical thinking, rational thinking, finding out correlation, prediction,hypothesis formation, application, probing for other possibilities, extracting the cruxand other processes are of critical importance in learning.
Constructivism gives greater predominance to co-operative learning. Social and culturalfactors influence learning. Sharing of knowledge and experience among learners,collective enquiry, assessment and improvement, group activity and collaborativelearning by sharing responsibilities with the objective of public activity, provideopportunity for effective learning.
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In learning internal motivation is more important than external motivation. The learnershould have interest and initiative in learning. Learning situation should be capable offorming a sense of ownership in the learner regarding the learning process.
Learning is not a linear process. It progresses in a spiralled way advancing deeper andwider.
NEW CONCEPTS OF LEARNING
1. Discovery Learning
The teacher has to create a motivating atmosphere for the learner to discover conceptsand facts, instead of listening always. Creating occasion to progress towards discoveryis preferred. Instead of telling everything before and compelling to initiate the models,situations are to be created to help the children act models as themselves.
2. Learning by discussion
Discussion leads to learning is Burner’s theory. Here discussion is not opposing eachother. It is a sharing on the plane of ideas. New ideas are arrived at by seekingexplanations, by mutual giving and taking of ideas and by problem solving.
3. Problem solving and learning
Only when the learner feels that some thing is a problem to be solved that he takes theresponsibility of learning it. It is an inborn tendency to act to solve a problem thatcauses cognitive disequilibrium in a particular area. It is also needed to have confidencethat one is capable of doing it. The problems are to be presented in consideration ofthe ability and level of attainment of the learner.
4. Collaborative learning
This is the learning in which the responsibilities are distributed among the membersof the group keeping common learning objectives. The common responsibility of thegroup will be successful only if each member discharges his duties. All the memberswill reach a stage of sharing the result of learning, equally through the activity withmutual understanding. The teachers who arrange collaborative learning will have tomake clear the responsibilities to be discharged. This is possible through the discussionwith the learners. Collaborative learning will help to avoid the situations of one personworking for the whole group.
5. Co-operative learning
This is the learning in which the learners help one another. Those who have moreknowledge, experience and competency, will help others. By this exchange of resourcesthe learners develop a plane of social system in learning also. As there are no high upsand low ones according to status among the learners they can ask the fellow students
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doubts and for helps without any hesitation or in hesitation. Care should be taken notto lead this seeking of help to mechanical copying. It should be on the basis of actualneeds. So even while encouraging this exchange of ideas, among the members of thegroup cautious acceptance is to be observed as a convention. There should be anunderstanding that satisfactory responses should come from each member and thatthe achievement of the group will be assessed on the basis of the achievement of allthe members
6. Zone of Proximal Development
Vygotsky observes that there is a stage of achievement where a learner can reach byhimself and another higher zone where he can reach with the help of his teachers,peers and elders. Even though some of them can fulfill the learning activity bythemselves there is the possibility of a higher excellence. If appropriate help is providedevery learner can better himself.
7. Scaffolding
It is natural that the learner may not be able to complete his work if he does not getsupport at the proper time. The learner may require the help of the teacher in severallearning activities. Here helping means to make the learner complete the activity takingresponsibility by himself. The teacher has to keep in mind the objective of enablingthe learner to take the responsibility and to make it successful.
8. Learning - An active mental process
Learning being a cognitive process, the teacher needs to know cognitive processes tofacilitate the creation of learning opportunities. Learning can be made effective byproviding learning experiences involving mental processes like
1 Retrieves/recollects/retells information2 Readily makes connections to new information based on past experiences
and formulates initial ideas /concepts.
3 Detects similarities and differences4 Classifies/categories/organizes information approximately.
5 Translates/transfer knowledge or understanding and applies them in a newsituation.
6 Establishes cause-effect relationships7 Makes connections/relates prior knowledge to new information/applies
reasoning and draw inferences8 Communicates knowledge/understanding through different media.
9 Imagines/fantasies/designs/predicts based on received information
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10 Judges /appraises/evaluates the merits or demerits of an idea/developsown solutions to a problem.
9. Intrinsic Motivation
Intrinsic motivation is given more importance than extrinsic motivation. The teacherhas to arouse the internal motivation of the learner. A person internally motivatedalone can immerse in learning and own its responsibility.
10. Multiple intelligence
The Theory of Multiple Intelligence put forward by Howard Gardener has created aturning point in the field of education. The National curriculum documents hasrecommended that the curriculum is to be designed taking into consideration of thistheory.
MAIN FACTORS OF THE INTELLECT
1. Verbal/linguistic Intelligence
Ability to read and write, making linguistic creations, ability to lecture competence toeffective communication, all these come under this. This can be developed by engagingin language games and by teaching others.
2. Logical/mathematical Intelligence
Thinking rationally with causes and effect relation and finding out patterns and relationscome under this area. Finding out relations, explaining things, sequential andarithmetical calculations etc. are capable of developing this area of intelligence.
3. Visual/spatial Intelligence
In those who are able to visualize models and bringing what is in the imagination intovisual form and in philosophers, designers and sculptors this area of intelligence isdeveloped. The activities like modeling using clay and pulp, making of art equipments,sculpture, and giving illustrations to stories can help the development of this ability.
4. Bodily Kinaesthetic Intelligence
The activities using body language come under this. This area of intelligence is moredeveloped in dancers and actors who are able to express ideas through bodymovements and in experts in sports, gymnastics etc.
5. Musical Intelligence
This is an area of intelligence which is highly developed in those who are able torecognize the different elements of music in musicians and in those who can here andenjoy songs. Playing musical instruments, imitating the songs of musicians, listeningsilently to the rhythms and activities like this are capable of developing this area ofintelligence.
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6. Interpersonal Intelligence
Those in whom this area of intelligence is developed show qualities of leadership andbehave with others in a noble manner. They are capable of understanding the thoughtof others and carrying on activities like discussion successfully.
7. Intrapersonal Intelligence
This is the ability to understand oneself. These people can recognize their own abilitiesand disabilities. Writing diaries truthfully and in an analyzing way and assessing theideas and activities of others will help developing this areas of intelligence
8. Naturalistic Intelligence
A great interest in the flora and fauna of the nature, love towards fellow beings interestin spiritual and natural factors will be capable of developing this area.
9. Existential Intelligence
The ability to see and distinguish our own existence as a part of the universe, ability todistinguish the meaning and meaninglessness of life, the ability to realize the ultimatenature of mental and physical existences, all these are the peculiarities of this faculty ofintelligence.
EMOTIONAL QUOTIENT
The concept of emotional intelligence put forward by Daniel Golman is used in framingthe new curriculum. The fact that one’s Emotional Quotient (E.Q) is the greatest factoraffecting success in life is now widely accepted. The teacher who aims to focus onimproving the emotional intelligence of students need to concentrate on the following.
i) Ability to take decisions
Rather than imposing decision on students while planning and executing activities, thestudents may be allowed to take part in the decision making process. Taking decisionsthrough open discussion in the class, inviting students suggestions on commonproblems etc. are habits to be cultivated.
ii) Ability to reach consensus
• When different opinions, ideas and positions arise, the students may begiven the responsibility to reach a consensus.
• Imagining what would be the course of action in some situtations, allowingto intervene in a healthy way in problems between individuals.
iii) Problem solving
• Developing the idea that there is reason and solution to any problem.
• Training in finding reasons for problems.
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• Suggesting solutions through individual or group efforts.
• Discussing social problems.
• Analyzing the shortcomings in methods to solve problems.
Whether plastic can be banned within school premises can be given as a problem.Group discussion will provide reasons and solutions. Problems, which can influenceclassroom learning and for which the learner can actively contribute solution needs tobe posed
1 Self criticism, evaluation
2 Ability to face problem-situation in life
3 Thinking what one would do if placed in the situation of others, how one wouldrespond to certain experiences of others - All these foster the growth of emotionalintelligence.
iv) Life skills
Life skills need to be given a prominent place in education. W.H.O. has listed : skillsrequired for-success in life.
1 Self awareness
2 Empathy3 Inter personal relations
4 Communication5 Critical thinking
6 Creative thinking7 Decision making8 Problem solving
9 Coping with emotion10 Coping with stress
THE NEW CURRICULUM ADDRESSES THESE AREAS.
Knowing the characteristics of the learner, role of the teacher and how to use theteachers handbook help the teacher to plan and effectively implement learning activities.
Role of a Teacher
In the earlier approach the teacher was mainly depending on the lecture method forteaching. But in the new method of education the student centered approach is givenmore importance than the teacher centered approach. Under this changed scenariothe teacher has to perform the following roles in the classroom.
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The teacher should be
1 A facilitator of learning
2 A guide to the overall development of the student
3 A good observer and motivator
4 Able to consider the activities, needs, special features and age group of studentsat higher secondary level.
5 Able to understand the limitations of learner and their learning problems.
6 An instructional material developer
7 A good communicator
8 An innovator
9 Able to raise leadership qualities and self confidence of the learner
10 An authoritarian in the concerned subject
11 Able to arrest and sustain the attention of the learner
12 Able to bring out and encourage the inborn talents.
13 A resource manger to ensure the optimum utilization of resources.
14 A systematic record keeper
15 A controller to issue guidance to the students
16 A person with high level of practical competency
17 Able to correlate area of study with familiar environmental situations
18 A self evaluator and good listener
19 Able to create awareness in social problems
20 A person with democratic and humanitarian approach
21 A professionalist as well as philosopher
22 A good evaluator
23 A good organizer and a friend.24 A co-learner as well as co-researcher
25 Able to give assistance and advice in placement needs and self employment bygiving moral and technical support
26 Able to keep moral values27 A person equipped with skill for using new techniques of learning
28 Optimistic and impartial
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Child friendly Class Room Atmosphere
Learning can be effective and enjoyable only when the class atmosphere is accordingto the new conception of learning and the characteristics of vocational higher secondaryteacher.
1 Class and seating are arranged in an attractive way
2 Democratic nature is upheld
3 Always active
4 Students interact with teachers without fear
5 Opportunity for a variety of activities
6 Students allowed to involve interesting group activities
7 Learning speed, learning style and different levels of attitudes are considered.Help is extended whenever needed.
8 Sufficient instructional materials are available
9 There is freedom of expression, students share their ideas and experiences
10 Students are given acceptance and encouragement
11 Healthy atmosphere
12 Needs of each student is given consideration. Happy and energetic atmosphere
13 Teachers work considering the rights of students
14 Prtoblems handled in a patient way
15 Teachers work at all events from the students view point
There will be students of various ability levels in any class because of learning style,learning speed, varying exposure to language experiences, physical ad psychologicalproblems and varying socio-cultural background.
The learning experiences provided must help to bring the low activities to an expectedlevel and extended the breadth and depth of the skills of the high activities.
By repeating experiences, introducing variations in a learning experience to suit differentlevels and if needed, formulating additional experiences the problem of varying abilitylevels can be tackled.
Role of Learner
The learner in second year VHSE has undergone a learner centered and process orientedlearning experience up to first year. The learner at this age is in awakening stage and heis enthusiastic about environment. He needs recognition and encouragement from
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environment and also recognize as a grown up man. He is adequately competent toselect vocational subjects according to his aptitude and interact and to acquire highereducation and profession as he wishes. The aspirations about future life is framed inthis particular age for seeing national and international job opportunities. Some of thepeculiarities of learner at this stage are
1 Physical, intellectual and emotional plans have intensive changes during the ageand their reflections can be observed
2 Ability to enquire discover and establish cause effect relationship betweenphenomena
3 Readiness to undertake challenges
4 Capacity to shoulder leadership roles
5 Attempt to interpret oneself
6 Susceptibility to different pressures
7 Doubts, anxieties and eagerness about sex
8 Imaging for social recognition
Needs of Learner
1 To make acquaintance with a job or self employment through vocationaleducation
2 To acquire more knowledge in the concerned area through higher education
3 To recognize and encourage the peculiar personality of the later adolescentperiod
4 To enable him to defend against the unfavorable circumstances without anyhelp
Role of learner
1 Active participant in the learning process
2 Act as a researcher
3 Sharer of information
4 Sharer of responsibilities
5 Collect information
6 Takes leadership
7 Involves in group work
8 Act as a co-participant
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9 Observes his environment
10 Experiments and realises
11 Make interpretations and draw inferences
12 Mould himself in to an active contributor for the welfare of the society
Evaluation
In vocational higher secondary education, a new approach to education and evaluationshould be made. Evaluation must be a systematic and continuous process. As thecurriculum is based on vocational stream, capacity building is a most important partand it should be evaluated accordingly. The technical skills, interest in the particularfield, communication skill, analysis organizing and presentation skills etc have to beevaluated. The personal and social qualities also have to be evaluated. Therefore,evaluation should be transparent, continuous and comprehensive.
Supporting System
In learner centered vocational education, a learning methodology has to be organizedand a proper learning atmosphere is to be provided. Many organizations can supportthe learning activity. They are:-
1. School Resource Group (SRG)
Comprising all teachers (vocational and non vocational) instructors, and lab assistantswith academic head as the group leader.
2. School Support Group (SSG)
Comprising PTA president, members of local bodies, members of social clubs, subjectexperts etc who can contribute guidance /technology /infrastructure /financialassistance etc.
3. Parent Teacher Association (PTA)
Can provide adequate funds for field trips, Production/ Service cum Training Centers(PTC), Vocational Exhibition, On the Job training (OJT) etc.
4. Local bodies
Grama Panchayat, District Panchayat and Block Panchayat can provide infrastructureie, class rooms, laboratory, library, seminar hall, audiovisual equipments etc.
5. Subject club
All vocational teachers handling same vocational subjects should form a subject clubat regional level or district level. This will helps to share the knowledge and practicalfacilities, production and marketing of materials, service etc.
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6. Nodal Schools
Based on the excellency, district wise nodal schools may be selected to providefacilities like central library, museums, video conferencing etc.
7. Institution Industry Interaction Project (III P)
This should be implemented in every institution to update knowledge. This also helpsfor OJT , PTC and field visit.
Monitoring system
Education is a sort of journey from darkness to light satisfying the needs and thewants of the individual and the society. The modernization of education through activityoriented system enhances free thinking and working in a fearless atmosphere. It is aqualitative process not a quantitative one. This necessitates a proper monitoring system.The system of monitoring should have the following features.
1) It must be transparent.
2) It must enrich the ideas of the facilitator through innovative process.
3) It must be time bound and rational.
4) It must motive the facilitator to adopt new strategies.
5) It must be recordable and ensure effective feedback for the effective monitoringof the system, three levels of the mechanism should be setup.
1. School level monitoring group.
2. Regional level monitoring group.
3. State level monitoring group
Moreover a social auditing system is advisable to achieve the objective effectively.
FEATURES OF LEARNING PROCESS IN THE NEW SYSTEMOF EDUCATION
In the new system of education the learning process should be modified in such a way
as to enable the learner to construct the knowledge of his own through observation,
co-operation, problem solving, social interaction etc. The learning process should
consider the nature ability, social setup, inborn talents and subject selected by the
learner. Therefore the learning process should be:
1 A continuous mental process
2 Simple learner must feel that he is able to undertake the task
3 Enable the learner to attain the curriculum objective
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4 Interesting
5 Suitable to the age and attitude of the learner
6 Future possibilities
7 Enable group activity
8 Challenging
9 Time bound
10 Constructive and curiosity developing
11 Possibilities for evaluation
12 Capacity to generate independent thinking
13 Ability to enquire discover and establish cause effect relationship betweenphenomena.
Learning Aids
To make the teaching and learning process simple and effective , certain learning aidsand necessary use of such aids for transacting a complex idea make the class room liveand students get more and more involved. The advances in science and technologymay be effectively utilized for this purpose. Some of the learning aids listed below.
1 Multimedia
2 Over Head Projector
3 Computer
4 Internet
5 Liquid Crystal display Projector
6 TV, VCD, DVD and tape recorders
7 Working models
8 Charts
9 Slides
10 Video Conferencing facility
11 Library
12 Text book
13 Source book
Society
The new educational policy uplifts the social commitment of the learner. Thereforethe society can also give some valuable contributions in this changing situation. The
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new system also ensures that the learner can perform certain useful services for thebetterment of society. The social obligations can be illustrated as follows.
1 To enrich social values, aptitude and ability in learner
2 To develop entrepreneurial aptitude and ability which helps social welfare andself employment
3 New system of education adopts OJT, PTC etc or part of vocational curriculumwhich helps to make close contact with the society.
4 The resources available from our society can be positively utilized to conveneseminars, interview etc.
5 Social organizations can help learners to make their education socially committed.
6 The social clubs like NSS, Tourism Club, CDO Club, Energy Club etc functioningin schools can make direct link with the society.
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SUBJECT APPROACH
Electrocardiography and Audiometry is one of the paramedical courses included in the sciencegroup of VHSE. The curriculum emphasises two important diagnostic measures- ECG &Audiometry.The risk of heart diseases increases now a days due to the change in life style and social setup. In these circumstancesECG & Other Cardiovascular measurement techniques included inthe curriculum are essential for proper diagnosis. The purpose of this course is to createskilled technicians to meet the heath needs of society.Despite the appearence over the last decades of the large number of novel instrumentaltechniques for the diagnosis of cardiovascular diseases, electrocardiography remains the mostimportant and commonly used single diagnostic procedure, in this field. Millions of ECGs arerecorded annually and then often help the physicians to make the correct diagnosis, evaluatemyocardial functions and monitor the efficiency of treatment. It has been demonstrated bymany authorities that the adequate clinical diagnosis is now a days virtually impossible withoutECG. As a result electrocardiography found wide spread application not only in cardiologybut also in pulmonology. Internal therapy, endocrinology, heamatology, survey, sports medicine,regular checkup and for screening purpose.Audiology is a scientific subect which is continually developing and changing. A firm knowledgeof audiology is essential for all those working in audiology laboratories and with hearing impairedpupils. The aim of the course curriculum is to create an awareness about clinical audiologicalprocedures and there by assists the audiologist. Rehabilation of hearing impaired is also included.Aims• To obtain job as ECG technician.
• To assist the audiologist.
• To acquire self employment.
• To undergo higher education.
• To develop skills for self learning, continuous learning and communicating the ideas aboutthe subject.
• To develop skills in various learning activities in a co-operative, collective and creativeway.
• To develop an idea about the opperation of advanced cardiovascular measurementtechniques and equipments.
• To develop an idea about routine and special audiological investigations.The learner shoud be exposed to activities like projects, assignments, seminar, discussion,debates, symposium, field visit, camps, clinical practice and experiments. To develop their
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vocational skill, OJT and hospital visit are necessary. The above learning activities help thestudents to enhance their opportunity in higher studies.The learning of ECG should also be through activities. The content based approach should bereplaced by the process approach which gives adequate emphasis to develop their vocationalskill.Learning of ECG needs to be• Activity oriented
• Process oriented
• Learner centered
• Environmental based
• Life orientedThe new approach gives emphasis to• Multiple intelligence
• Co-operative learning
• Constructivism
• Emotional quotientContentThe course content in second year ECG includes ECG, other cardiovascular measurementsand equipments, cardio pulmonary resuscitation and medical ethics.The course content in second year AMT includes pure tone and speech audiometry, assessmentof hearing loss, hearing aids, ear moulds and rehabilitation of children and adults with hearingimpairment.
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In the modern era of globalization the introduction of new technologies ensureonly the survival of the fittest. So it becomes a necessity to equip the learners toface the growing challenges in the competitive world. Hence the traditionalapproach to learning is no more relevant in the present context. The teachershould use instructional techniques that motivate the students to construct hisown knowledge. Now the learners are not passive listeners, but they are theactive participants in the construction of knowledge. Here the teacher – studentinteraction should be given much importance.
In the new instructional strategy while selecting the methods of teaching, thesocial and psychological aspects of the learner is to be taken into consideration.The given activities for learning are only suggested ones. It can be altered accordingto the discretion of the teacher.
To obtain the objectives, the new system of education is introduced in theVocational Higher Secondary Education for attaining the objectives of the coursesin this system, we can adopt the following strategies.
I. Assignment
Assignment is some specific work assigned to the students as a part of their academicenrichment. There are learning activities undertaken as a continuation of class room activitiesto realize the curriculum objectives to a broader extent . They should be completed in timebound manner. They help to lead learner to higher level of learning from the present status.Challenging assignment can motivate the students to involve in group dynamics and achievefruitful results. The teachers may at as a guide.
Assignment may be given on individuals or group basis. Assignment includes preparationof notes, preparation of charts, models, collection of materials from institutions etc. Assignmentsdevelop skills of reference, observation, enquire reporting etc. It ensures the effective utilizationof leisure time of the students.
II. Seminar
Seminar is a learning strategy involving an in-depth analysis of specific topic, preparation of apaper and presentation . The paper is presented by either one student or a group of students.After the presentation, there will be a discussion/ interaction in which all the students canparticipate. The students get an opportunity to clear their doubts and make clarification. Seminarhelps to develop communication skill and overcome stage fright.
LEARNING STRATEGIES
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Stages
1. Selection of Topic: The topic of seminar should be relevant to the subject ofstudy
2. Assignment of topic to individuals students or team: The topic may be assignedto one student or to a group of students.
3. Collection of relevant information: Information required for seminar can becollected from various sources namely books, magazines, internet, institutions,place and persons.
4. Preparation of draft paper: Based on the information collected the studentmay prepare a draft paper and submit it to the teachers for comments. Revisethe draft paper based on the comments of the teachers. The refined draft issubmitted for approval.
5. Program scheduling: The date, time and venue of the seminar is fixed. A seminarleader may be selected from the students
6. Seminar paper presentation: The student/ students shall present the paper inthe seminar. The teacher may function as the moderator during the initial stages.
7. Discussion / Interaction: A number of respondents from the students makecomments on the topic. This will be followed by a general discussion. All thegroup members should actively participate in discussion.
8. Summing up deliberation: The moderator sums up the deliberation
9. Evaluation / Feed back: Both teachers and students evaluate theprogramme.
10. Preparation of final report: A final seminar report is prepared covering all theadditional points discussed and consolidated.
III. Panel Discussion
It is a learning strategy in which a panel of experts are allowed to discuss a specific subjectunder the control and direction of a moderator. Subjects can be divided according to thenumber of panel members. Number of panel members are fixed according to subdivision ofpoints in the subject. Relevant materials and handout may be given in advance to the learners.The monitor or moderator introduces the subject of discussion and invites a panel member tostart the discussion. Each panel member is invited for discussion afterwards. After briefing bythe panel members the questions are raised from the audience and the panel members givesuitable answer to them. A report should be submitted by each learner to the moderator.
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IV. Project
Project is a self-learning strategy which can exert great influence on the overall developmentof the learner. Project as learning strategy is to be selected where a problem arises in any partof the curriculum. The students may be divided into groups and assigned different aspects ofthe problem. Each group works independently .Specific aspects of the problem such as datacollection, classification, analysis, report preparation and presentation is to be undertaken byeach of the members. Even though the work is divided among the members, it must be ensuredthat the execution of each and every activity is done with the active participation of all. Afteranalyzing data collected from different sources, the learner arrives at a conclusion that canhelp to solve the problem. Thereby learner learns the topic though his own activity. The otheradvantage of this learning activities is that it helps the learner to scientifically handle anyproblematic situation. It helps in the development of scientific thinking and thereby builds upthe students aptitude for the subject.
Stages of the project
1. Selection of a topic
The project selected should be related to the curriculum and it should not be a project forprojects sake. The topic or problem should arise from the curriculum.
2. Planning of the Project
(a) Hypothesizing: Hypothesizing means making assumptions based on the availableprimary information.
(b) Methods and Technique : The methods and Technique should be based on theaim and Hypothesizing of the Project. The nature of the project, suitability of thetools, and the methods of learning should be related to each other.
3. Collection and Tabulation of Data
The data may be primary, secondary or tertiary. Either census or sampling method can beused based on the objective of the project. Suitable questionnaires are to be prepared forthe collection of primary data.
The collected data is to be classified and tabulated so as to make it easily understandable.
4. Analysis of data and formulation of conclusion
By analyzing the data, the reliability of the hypothesis can be examined. Preparation of graphsand diagrams and maps will positively help the analysis. The similarities, relations and differencesgathered from the analyzed information would tell whether the hypothesis should be acceptedor rejected.
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5. Preparation of Report
The cover page should have the title of the project, the period of study, name (s) of investigator/group, and the address of the school. The report should be structured in the following order.
1. Title
2. Preface
3. Hypothesis and aim
4. Methodology
5. Sources of data
6. Analysis and conclusion
7. Suggestions (if any)
8. References
9. Appendices (Questionnaire, Observation schedule, check list Etc.)
6. Presentation of the Project
When the project is presented , the learner is being evaluated and accepted. It is through thispresentation that ideas are shared with others in the class and society.
The project methods promotes scientific self learning and makes him capable of solving theproblem arising in real life situations.
V. Debate
Debate is a hot and interesting learning activities. A debate can be organized only on a topicon which there is difference of opinion. Therefore a topic suitable for debate has to be chosen.
Debate can be on relevant topic that is different and interesting to the students and relevant tosociety. Students with different opinions have to be identified for discussion. Those who havesimilar opinion should join together to form a side . Those who hold the opposite view withform the other side. It would be ideal to write down the topic of the debate and displayed inadvance. There should also a person to control debate.
Students should be given opportunity to absorb the ideas obtained from discussion and debate,develop the idea through reading and study, and to express them through writing or othermeans
Stage of Debate
1. Topic Selection
2. Selection of panels keeping in balance with intelligence, gender etc.
3. Selection of moderator
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4. Collection of information guided by the teacher
5. Conducting the debate under the control of moderator by avoiding any sort ofpersonal conflicts
6. Conclusion by the moderator expressing his final version or verdict.
VI. Case Study
A case may be a person, institution or a community case study is an in-depth analysis of anactual event or situation. It presents real pictures of situation with facts, objective informationor data. Learners analyses the case to interpret, predict and resolve issues associated with it.The case study provides the learner an opportunity to analyse and apply concepts, data andtheory taught from the class. Learners can work individually or in groups.
By studying realistic cases in the classroom, students develop new insights into the solution ofspecific on – the – job problem and also acquire knowledge of the latest concepts andprinciples used in problem solving.
Case may be presented by the teachers or may be provided in print form.
A simple case study may have the following steps
1. Collection of data
2. Conversion of data into information
3. Analysis of the case in groups
4. Presentation of the finding by each group leader.
5. Evaluation
In addition to the above mentioned learning strategy there are many other learning strategieswhich can be used in appropriate situations to enrich leaning process such as problem solving,Role play, brain storming, debate etc.
VII. Brain Storming
This is the best method for solving creative problems. It facilitates generation of ideas quickly.Rules for conducting Brain storming.
1. No response is wrong. So welcome every response.
2. Welcome as many responses as possible
3. No criticism is allowed
4. Allow to work on others idea
Steps in Brain storming
1. Presentation of the problem
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2. Provide relevant information
3. Record the ideas put forth by the participants
4. Combine similar ideas
5. Evaluate each idea and solution
6. Selection of the best solution
If brainstorming is used as an instruction strategy, the last step is not essential
VIII. Discussion
Discussion is essential for the student to share new finding, idea and conclusion at each stageof learning with fellow students and teachers. In general discussion the teachers should guidethe discussion through questioning and summarizing. The major steps involved are
1. Introduction initiated by the teacher
2. Development of discussion by giving lead points and follow up interactions
3. Transaction stage in which the key points are reviewed by the teacher and
4. Summarizing stage in which teacher provides additional support materials to ensurethe achievement of the objectives
IX. Group Discussion
Group discussion is an ideal method to develop cooperation, democratic attitude, friendlinessand compromising attitude which are the ultimate aims of education. During group discussionthe teacher may observe each group and it needed help them to channel the discussion towardsthe common objectives. All students may be given opportunity to take part and express theirideas within a time limit. The conclusion reached may be entered by each student. A grouprepresentative must present this during consolidation in which the teacher may correct or addinformations to ensure that all the relevant ideas have been covered
X. Collection
Collection is a continuous learning activity, which ensures complete participation of students.The collected item may be materials, pictures, charts, ideas, data etc. Collection providesdirect experience to learn. An exhibition of collected materials will help to strengthen theconcept.
XI. Practical works
Experimentation contains the process skill in an integrated way. In the new approach ofcurriculum the student forms idea and comes to conclusion through process. The term ‘Practical‘when associated with a science subject usually means an experiment. The objective of doingan experiment is to explore new ideas through investigation only. Its main purpose is to verify
31
some principles associated with theory. The subjects end here. But this is not the case with‘Vocational Practical’
The ultimate goal of Vocational Education is to generate skill through continuous practicealong with investigation and invention. Continuous practice transforms the unskilled to theskilled. This is the significance and importance of practical in the Vocational stream. Hence itis very crucial that Vocational teachers as well as instructor should understand the importanceof vocational practical and act accordingly.
XII. Quiz
Quiz programmes can be used as an interesting class room tool for transaction of curriculumobjectives as well as to evaluate the effectiveness of transaction and achievement of students.
For conducting a quiz programme a topic should be selected based on the above objective
The students are asked to prepare questions based on the topic individually. The next day /next hour the students are grouped into 3-4 groups randomly. A question is raised by aparticular team and the other teams to answer them if they can answer the question they getpoints for that if all other teams fail to answer the question raised by the 1St team the 1st
team answer the question and explain the background if necessary. All the teams get equalnumber of chances to ask the question . Time limit is also prescribed for the conduction of theprogramme. The team who scores maximum points wins
All the participants can make notes on the questions asked, answers and their explanationswhich help them in learning
XIII. Models
Models are used in learning process. It enhance the leaning experience. This is based on the‘seeing is believing”. It helps the learner a chance to see feel the model presented . Still modelsand working models help the students to understand the structure, working principles, actualoperation etc.
Several steps are involved
1. Locating the problem
2. The teacher should plan the type of model according to CO’s
3. Grouping the students
4. Briefing the tasks
l Aim
l Need
l Material required
l Source & Materials
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l Cost of materials
l Division of Labour
l Guidance
l Fixing of a time limit
5. Presentation by each group about
l How the models were prepared
l Details of - Expenses
l Working and principles
l Finally documentation of the process
6. Evaluation
l By the other groups
l Later a consolidation by teachers are to be done.
XIV. Games
Class rooms can be made attractive by introducing different types of games. Games shouldbe interesting as well as informative. Some of suitable games are
1. Odd man out
2. Cross word puzzles
3. Match the following
4. Aswamedham
5. Link game – Answer using clues.
XV. Survey
This strategy involves collection of data from the group under study (book, person, materialsetc.) It develops the social interaction and communication ability of the learner. It also providesa scope for discovery learning.
Step involved in survey
1 Objective of survey
2 Selection of area for survey/sampling frame
3 Selection of survey method
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Direct method
With help of questionnaire/schedule
1 Tabulation and analysis
2 Consolidation and Presentation
XVI. Exhibition
It is a learning strategy by which the learner can get a chance to show the skill developed. Itprovides the intrinsic motivation and exposure.
Exhibition item can be conducted either individually or as a group task. It can be conducted atschool / Regional/State/National level. Necessary publicity and other arrangements can beprovided. Presentation, documentation, participation and innovative skills of the learner canbe evaluated.
XVII. Interview
Interview is one of the important learning strategies taking the help of a resource person.Interview is an inner view. It provides opinion and information about a topic.
An interview is conducted by the following steps
1. How to introduce a problem?
2. Invite a resource person
3. Decide the questions by learners
4. Decide the time, place etc.
5. How to discuss?
6. How many students to participate?
7. Implementation of the interview
8. Conclusion (Facilitator)
Items required
1 Interview Schedule
2 List of questions prepared by learners Selection of students, selected namessequence of question
XVIII. Field Visit
Field visit is an inevitable vocational tool to be implemented in Vocational Higher SecondaryEducation. This helps the students to familarise with the modern technologies and new situationin a different atmosphere. It provides learning though viewing. It is based on the principle thatseeing is better than having. It enables the learning to retain the learned information longer and
34
to make the subject more interesting. It motivates and give more confidence in his/her particularvocation.
The facilitator should identify suitable center/ institution/site. Get prior permission from theauthorities before conducting the field visit. Give instructions to the learners for collectiondata/information/materials/specimens. Teacher may assign different duties to learners byworking them different groups.
Each learner should take utmost care and interest during the visit. He/She should observe andinteract at the center/ institution where the field visit is conducted
After the visit, learner should acquire the ability to apply the ideas/concepts in his futurecarrier. Each learner should submit a detailed report about the field visit.
XIX. Demonstration
Though demonstration we can present an item/product and emphasis its features very effectively.
Eg:- To understand the functioning of a computer
1. Material/Item/Process
2. Demonstration
3. Venue
4. Additional requirements depending upon the nature of the item
Demonstration Process
1. Introduction about the item/Material
2. Principles – Working
3. Operation
4. Components
5. Merits of the item
XX. Chart display
It is also one of the important teaching aids. It can be used in every activities of a learningprocess.
Chart display is a written or pictorial representation of idea or concept. It is abbreviate, briefand clear. It is prepared by study
Benefits
1. A learner gets clear idea about the concept
2. The leaner can retain the ideas in his mind for longer periods
3. A complicated idea can be simplified though a chart
Cheap method of teaching aid.
353535
CURRICULUM OBJECTIVES
UNIT 1 Electrocardiography
1.1 To understand the history of ECG through brain storming and group discussion. Preparenotes.
1.2 To understand the basic principles of ECG recording through brainstorming, practicals,observation, group discussion. Prepare notes.
1.3 To understand the various lead system used for ECG recording through chart preparation,discussion and practicals.
1.4 To identify the parts of ECG machine and its working through brainstorming, discussion,chart preparation, demonstration of dismantled specimens and operation manuals. Preparenotes and draw diagrams in chart.
1.5 To develop an idea about standardization of ECG machine through brainstorming, discussion,demonstration and practical experiments. Prepare notes.
1.6 To get an idea about the need of critically damped and the concepts of over damping andunder damping through observation, discussion and practicals. Prepare a chart demonstratingthe damped condition.
1.7 To understand the precautions and patient preparation before recording ECG throughdiscussion, demonstration and practical. Prepare an assignment.
1.8 To acquire practical skill in recording ECG through group discussion, observation, practicals,field visit and OJT. Prepare a report.
1.9 To understand the normal ECG waveform pattern through brainstorming, chart preparation,observation and group discussion. Prepare charts and notes
1.10 To understand the ECG measurement parameters through discussion, data collection andobservation. Prepare a note
1.11 To get an idea about abnormal ECG waveforms associated with certain diseases throughinterview, seminar, reference materials, IT support and group discussion. Present theseminar report.
1.12 To understand the common artifacts occurring in ECG recording and able to minimizethose artifacts through observation, discussion. Prepare an assignment.
1.13 To get an idea about various ECG recorders through field visit, OJT and assignment.
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UNIT - 2 Other Cardiovascular measurements and Equipments
2.1 To develop an idea about the technique of TMT through illustration, field visit, OJT anddiscussion. Prepare reports
2.2 To familiarize with the use of Holter monitor system through demonstration, discussion,data collection, field visit, expert opinion. Prepare a report
2.3 To develop an idea about cardiac monitors used in the ICU for electrocardiography andpulse frequency measurement through data collection, hospital visit/OJT and discussion.Prepare a report.
2.4 To create an awareness on the need and technique of catheterization through data collection,discussion, observation, field visit and group discussion. Prepare notes.
2.5 To acquire a skill in recording BP measurement by auscultatory method through practicals,observation and discussion. Prepare a report.
2.6 To create an awareness about echocardiography and its techniques through brainstorming,field visit, OJT and group discussion. Prepare a report.
2.7 To understand the working of defibrillator and its application through discussion, field visit/OJT, observation. Prepare a seminar.
2.8 To develop an idea about pace makers, its principles and types through brain storming,discussion, OJT/ field visit. Submit the assignment.
UNIT - 3 Cardiopulmonary Resuscitation and Medical ethics
3.1 To create an awareness about the first aid measures though the discussion, field visit /OJT/animated Cd's, expert opinion, Role play.
3.2 To get a brief idea about the medical ethics though discussion. Prepare notes.
AUDIOMETRY
UNIT - 1 Pure tone and Speech Audiometry
1.1 To understand different parts and working of pure tone audiometer used for audiologicalevaluation though demonstration, discussion and chart preparation. Prepare notes.
1.2 To understand procedure and operation of pure tone audiometry and to plot audiogramthrough, brainstorming, demonstration, discussion, practical, OJT. Prepare an assignment
1.3 To get a brief idea about play audiometer though discussion, field visit, OJT and practical.Prepare notes.
1.4 To understand the procedure of Speech Audiometer though discussion, OJT, datacollection, practicals. Prepare notes.
UNIT - 2 Assessment of Hearing loss
2.1 To get a brief idea about case history evaluation through data collection, discussion andOJT. Prepare notes.
2.2 To understand the screening procedure for evaluating hearing loss through data collection,discussion. Prepare notes.
373737
2.3 To understand the various tuning fork test used for audiological evaluation through discussion,demonstration, practicals. Prepare a seminar.
2.4 To understand different types of audiometers through group discussion, field visit. Preparean assignment.
2.5 To under stand the need and concept of masking through observation, discussion field visit/OJT. Prepare notes and charts.
2.6 To familiarize with various objective measurements for audiological evaluation through datacollection, field visit / OJT. Prepare an assignment.
2.7 To get an awareness about the special audiometric tests used for differentiating sensoryloss from retro cochlear disorders through discussion, practicals and observations. Preparenotes.
UNIT - 3 Hearing Aids
3.1 To understand the need and working of hearing aid through discussion, data collection andchart preparation. Prepare notes.
3.2 To familiarize with the circuit details of hearing aids through demonstration and discussion.Prepare a working model.
3.3 To understand different types of hearing aids through data collection, chart preparation anddiscussion. Prepare notes.
3.4 To get an idea about the assistive devices for hearing impaired, through data collection,group discussion, expert opinion, field visit and OJT. Prepare an assignment.
3.5 To create an awareness about the care and maintenance of hearing aid through groupdiscussion, observation. Prepare an assignment.
3.6 To get an idea about cochlear implants through data collection and discussion. Preparenotes.
UNIT - 4 Ear Moulds
4.1 To get an awareness about ear mould, types, procedure of making ear mould and itsmodification through illustration, discussion, field visit / OJT. Prepare notes.
UNIT - 5 Rehabilitation of Hearing impaireds
5.1 To understand the various rehabilitation methods adopted for deaf adult and children thoughdiscussion, field visit and interview. Prepare reports.
5.2 To understand the various educational options for hearing impaired though discussion,interview and OJT. Prepare an assignment
38
SYLLABUS
ELECTROCARDIOGRAPHY & AUDIOMETRIC TECHNICIAN
SECOND YEAR
Total duration 560 hrs
Theory 140 hrs
Practical 420 hrs
Unit No. Name of the Unit Theory Practical
1 Electro Cardiography 30 Hrs 75 Hrs
2 Other Cardio vascular measurements & Equipments 28 Hrs 50 Hrs
3 Medical ethics & Cardio pulmonary resuscitation 4 Hrs
Total 62 Hrs 125 Hrs
Unit No. Name of the Unit Theory Practical
1 Puretone & Speech Audiometry 10 Hrs 100 Hrs
2 Assessment of hearing loss 20 Hrs 35 Hrs
3 Hearing aids 10 Hrs 10 Hrs
4 Ear moulds 20 Hrs 30 Hrs
5 Rehabilation of children and adults withhearing impairment. 18 Hrs
Total 78 Hrs 175 Hrs
ELECTRO CARDIOGRAPHY
AUDIOMETRY
PRACTICALS
Hospital visit (ECG & AMT) - 120 Hrs
393939
ELECTROCARDIOGRAPHY
1. Electrocardiography [30 Hrs]
1.1 History and introduction
1.2 Basic principles of E.C.G
1.3 Lead system
1.4 Normal E.C.G wave form
1.5 Abnormal patterns-brief description
1.6 E.C.G instrumentation
• Details of E.C.G machine with block diagram
1.7 Procedure for E.C.G recording
1.8 Artifacts in E.C.G recording
1.9 Types of E.C.G recorders
2 Other cardiovascular measurements & Equipments [28 Hrs]
2.1 Tread Mill Test
2.2 Holter monitors
2.3 ICU Monitors ( Monitors for Electrocardiography and pulse frequencymeasurement)
2.4 Cardiac Catheterisation
2.5 Blood pressure measurement
• Auscultatory method in detail
2.6 Echocardiography
2.7 Defibrillators
2.8 Pacemakers
3 Medical Ethics and Cardiopulmonary Resuscitation [4 Hrs]Hospital Visit [60 Hrs]
PRACTICALS [75 Hrs]
1. Electrocardiography
• Leads of E.C.G
• Parts of E.C.G machine
• Standardization
• Damping
• Precautions and patient preparation
• Recognition of minor faults and trouble shooting
• Familiarization of various types of E.C.G recorders
• Recording of 20 normal cases
40
2 Measurement of B.P by auscultatory method [50 Hrs]
• Familiarisation on operation and measurement of various equipments mentioned
in Unit II
3 Hospital visit [60 Hrs]
• One month visit to hospitals.
• Getting familiarized with the use of cardiology equipments
AUDIOLOGY
1. Puretone and speech Audiometry [10 Hrs]
• Audiometer
• Procedure of Puretone Audiometry (Including play Audiometry),Plotting the Audiogram
• Speech Audiometry
2. Assessment of Hearing loss [20 Hrs]
• Case history evaluation
• Screening procedures for hearing evaluation
• Tuning fork test
• Over view of Audiometry
• Orientation to masking - need for masking
• Orientation to free field Audiometry and objective measurement such as tympanometry,
reflexometry, BSERA, OAE
3. Hearing Aids [10 Hrs]
• Types including digital and programmable aids, parts of the aids, group amplficationsystem and other assistive listening devices. Brief account of the main Electro Acousticcharacteristics
• Aided Audiometry
• Ling sound test
• Care and maintanance of hearing aids
• Introduction to cochlear implant
4. Ear moulds [20 Hrs]
Parts and types of Ear mould.
Procedure of making regular ear mould
Brief note on Ear mould modification
5. Rehabiliation of children and adults with hearing impairment [18 Hrs]
Hospital visit [60 Hrs]
414141
PRACTICALS
1. Observation of Puretone Audiometry and play Audiometry (10 cases) [175 Hrs]
Participating in plotting audiograms.
2. Obtaining and plotting the Audiograms of normal subjects (10 Nos)
3. Obtaining and plotting the Audiograms independently (10 adult cases and 10 children)
4. Observation of Speech audiometry (10 cases)
5. Administration of speech audiometry (10 cases)
6. Observation of case history (10 cases)
7. Observation of other objective test used for hearing assessment
8. Observation of regular ear mould making (2 pairs)
9. Making regular ear mould independently (1 pair)
REFERENCE
ELECTROCARDIOGRAPHY
1. Human Anatomy - B.D.Chaurasia - Volume one- Third edition, CBS publishers anddistributors, New Delhi
2. Introduction to Biomedical Equipment Technology - Joseph.J.Carr, John.M.Brown -prentice Hall, Upper saddle river, New jersey, Ohio.
3. ECG Assessment and interpretation - Bradford.C.Lipman - Jaypee Brothers
4. Biomedical Instrumentation - Dr.M.Arumugham
5. Biomedical Instrumentation and measurements - Leslie cromwell, Fred.J.Weibell,Ericha.Pfeiffer - Prentice Hall of India Pvt. Ltd. New Delhi.
6. A textbook of medicine by K.V. Krishna Das - Jaypee brothers.
AUDIOLOGY
1. Martin.F.N (1991) Introduction to audiology. IVEd, NewJersey: Frentice Hall.
2. Newby. H.A (1985) audiology, Newyork: appletion - Century - Crofts
3. Katz.J et al (Ed) 2002, Handbook of Clinical Audiology, Baltmore, Williams & wilkins
4. Bassand Hummes (1990) Audiology - fundamental, Williams & wilkins
5. Human Anatomy - B.D.Chaurasia - Volume three- Third edition, CBS publishers anddistributors, New Delhi
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PLANNING
To learn ECG & AMT the learning process must be activity oriented. We have to Providelearning experiences that would help to develop practical skill and components of multipleintelligence. Whether the activities are conducted in the class or outside, they are to be completedin a time bound manner.
The teacher has to plan the activities necessary to make learning effective, in prescribed time,evaluation method and all other aspects.
Teachers must prepare at least three planning documents
• Year plan
• Unit plan
• Daily plan
Year plan
The year plan include the total number of units to be transacted though the three term, units to becovered during each month and the number of periods allotted for each unit.
Unit Name of Unit Period Activity / Strategy
Theory Practical Month
1 Electrocardiography
2 Other Cardiovascularmeasurements and
equipments
3 Medical ethics &cardiopulmonaryresuscitation
Brain storming, groupdiscussion, practicals,chart preparation,field visit/OJT, datacollection andSeminar
Data collection,discussion, field visit /OJT practicals,Seminar, assignment,Observation
Discussion, Chart,preparation,observation, role play
30 Hours 75 Hours JuneJuly
28 Hours 50 hours JulyAugust
4 hours September
E C G
434343
UNIT PLAN
Teacher may prepare unit Plan before the actual transaction of the unit in the class room. Thisplan mast make clear the curriculum objectives, essential strategies to be used and materialsrequired. How the outcome are to be evaluated may also be spelt out.
Unit Name of Unit Period Activity / Strategy
Theory Practical Month
1 Pure tone and Speechaudiometry
2 Assessment of
Hearing loss
3 Hearing Aids
4 Ear mould
5 Rehabilitation ofchildren and adults withhearing impairment.
6. Hospital Visit
(ECG & AMT combined)
Demonstration,discussion, chartpreparation, brainstorming, datacollection,observation practical,field visit, OJT
Data collection,discussion, OJT/hospital visit, Demo-nstration, practicals,Seminar, assignment,
Discussion, Datacollection, Chart,preparation,Demonstration,Expert opinion, fieldvisit, OJT
Illustration, field visit,OJT
Discussion, FieldVisit, Interview, OJT
One the job training
10 Hours 100 Hours Sept-October
20 Hours 35 hours October
10 hours 10 Hours OctoberNovember
20 Hours 30 Hours November
December
18 Hours January
120 Hours JanuaryFebruary
A M T
44
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454545
Class : Second Year Subject : ECG & AMTUnit : Electro Cardiography Date :Topic : Normal ECG wave Form Time : 1 Hour
Curriculum Objectives : To understand the normal ECG wave form pattern through brainstorming, chart preparation, observation and discussion. Preparecharts and notes.
Concept/Ideas : Normal ECG wave form, Character of a wavePrevious Knowledge : Basic principles of ECG waves and conductive system of heart
Materials Required : ECG machine, ECG paper, animated CD'sReference text - ECG assessment and interpretation-Bradford.C.Lipman, Charts, Animated CD's
Activity /strategies
Activity - I (Brain storming) Ask the learners to recollecttheir previous knowledge about conductive system of heart& basic principles of ECG recording
Activity - II (Chart Preparation) Instruct the learners toprepare a chart of normal ECG wave form using thereference text.
Activity - III (Observation) Ask the learner to observe theanimated CD's showing the development of ECG waveforms in relation to the working of heart. Lead them togroup discussion.
Activities - III (Group Discussion) Discussion Points:• Why the ECG wave shows different deflections?• What does each deflections represents?• Can you differentiate the characteristics of each
waveform?
Presentation: Ask the group leaders to prepare a note
Consolidation: From the above activities the teacher canconsolidate the topic with an idea that P waves - Atrialdepolarization,QRS-Ventricular depolarization,T wave -Repolarization of ventricles, PR interval -Total amount oftime required for the depolarization of atria, QRS interval-Time required for the depolarization of ventricles, QTinterval-Time required for both depolarization andrepolarization of ventricles
Response/ Evaluation
All the learners participated in brainstorming sessions and theyconsolidate the points in diary.
Ashok Prepare the chart very well
Raju and Kavitha identify thedevelopment of ECG wave formswith perfection. Others prartially getan idea about the topic
3 Groups activitively participated indiscussion. 4th group is not active dueto the bad grouping.
Presentation of notes by Sarath wasvery good
Other Activities
Collection of normal ECG waveforms
DAILY PLAN
The daily plan includes curriculum objectives to be transacted in class period, learning activities,learning aid and feed back.
4646
INTRODUCTION
Evaluation is a systematic process of collecting, analysing, synthesising and interpreteringevidences of student’s progress and achievements, both in cognitive and non cognitive areasof learning. Evaluation has to play significant role in making the learning process more effective.It provides diverse experience to the learners, keeping in view the skills to be attainedcontinuously by them.
As the curriculum is based on a particular vocation, the selected stream is the most importantpart and it should be evaluated accordingly. Technical skills, interest and devotion in the field,communication skills, organisational and presentation skills are to be evaluated. Evaluation ofthe personal and social qualities also should be done. So the evaluation should be continuousand comprehensive.
Term End Evaluation (TE)
It is the written form of evaluation aimed at evaluating the facts, concepts and ideas gained bythe learner. The test should not be aimed to evaluate the memory alone. Questions are framedin such a way that the learners are able to apply different mental process while answering. Theterm end evaluation question give more emphasis on application, analysis and synthesis level.
The maximum scores for TE is 80 and the minimum is 24 (30%). The questions and scoreshould be formulated taking into consideration the time required to read, think, understandand write answers. To avoid wild guessing, multiple choice questions of application level maybe used. The total number of questions may vary from time to time. All the questions shouldbe based on the curricular objectives. Open ended questions may also be included. Internalchoice may be given to questions but the choice question also should be based on the samecurricular objectives.
Continuous and Comprehensive Evaluation (CCE)
Our traditional evaluation methods measure only the memory and recollection capacity of thelearner. To eliminate / these limitations the evaluation should be done on multi dimensionalways by measuring multiple intellectual capacities of the learner. So it is better to evaluate thelearner in a continuous and comprehensive manner. CCE helps the learner to understand andevaluate his own progress and to develop adequate strategies for further improvement.
EVALUATION
474747
Meritsl Assess the all round development of the learner on a continuous basis through
variety of activities.l Effective feed back is possible.l Remedial and diagnostic teaching is possible.l Process as well as product are assessed.
A series of learning activities are grouped into five major thrust areas as follows
1. Investigative Activities
Activities which create a spirit of enquiry, investigation and a mind for research in the learnerbelongs to this group.
For example l Study projectl Case studyl Field studyl
l
2. Interactive activities
Activities which improve the communication skill, abilities of sharing ideas, etcFor example l Seminar
l Panel discussionl Debatel Group discussionl
l
3. Assigned Task
Activities assigned to the learner to enrich/strengthen the concepts and ideasFor example l Assignments
l Collectionsl
l
4. Performance Task (Tests)
Activities related to the achievements of the learner.
For example l Class test (Oral/ Written / Performance test)l Quizl Open Book Examinationl Interviewl Group testingl
l
4848
1. Planning l Relevatace of the studyl Identification of problem: Ability to
select appropriate toolsl Ability to select suitable learning
method2. Data Collection l Ability to collect sufficient and
relevant data.l Ability to classify.l Arrange data for analysis.l Reliability and authenticity of the
data collected3. Analysis and Inference l Ability to analyse the data.
l Systematic arrangements. Abilityto draw inferences based onanalysis.
l Ability to give suggestions basedon inference.
4. Report presentation l Ability to present in logical andsequential order.
l Authenticity of report.l Time bound completion
5. Viva - Voice l Knowledge of content andprocess.
l Ability to analyse datal Ability to justify inference.l Ability to explain.l Stratigies and methods adopted
Total
Sl No. Stages Criteria Score TotalScores
4/3/2/1
4/3/2/1
4/3/2/1
4/3/2/1
4/3/2/1
20
5. Practical based activities likeFor example l Preparation of working model
l Albuml improvisationl
l
From the above five group of activities, the teacher has the freedom to choose any three areasfor evaluation purpose.
CE Items
1. Study Project
494949
2. Case study
Sl No. Criteria Score
1. Identify the problem 4/3/2/12. Approach to the problem 4/3/2/13. Time bound Action 4/3/2/14. Analysis of the problem 4/3/2/15. Problem solving / Reporting 4/3/2/1
Total 20
3. Field Study
Sl No. Criteria Score
1. Attitude and readiness towards the task 4/3/2/12. Capacity for observation 4/3/2/13. Data collection 4/3/2/14. Application of ideas 4/3/2/15. Documentation / Recording 4/3/2/1
Total 20
4. Assignment
Sl No. Criteria Score
1. Awarness of the content 4/3/2/12. Comprehensiveness of the content 4/3/2/13. Systematic and sequential arrangement 4/3/2/14. Observation / suggestion/ views / judgements/ evaluation 4/3/2/15. Timely submission 4/3/2/1
Total 20
5. Seminar
Sl No. Criteria Score
1. Planning and Organisation 4/3/2/12. Collection of data / content 4/3/2/13. Observation / appraisal and clarity 4/3/2/14. Content knowledge 4/3/2/15. Presentation 4/3/2/1
Total 20
5050
6. Debate
Sl No. Criteria Score
1. Readiness to participate 4/3/2/12. Depth of subject knowledge 4/3/2/13. Communication skill 4/3/2/14. Ability to justify the stand 4/3/2/15. Presentation 4/3/2/1
Total 20
7. Group Discussion
Sl No. Criteria Score
1. Readiness to participate 4/3/2/12. Depth of subject knowledge 4/3/2/13. Communication skill 4/3/2/14. Ability to justify in a democratic way 4/3/2/15. Leadership quality 4/3/2/1
Total 20
8. InterviewSl No. Criteria Score1. Planning 4/3/2/12. Preparation of Questions 4/3/2/13. Communication skill 4/3/2/14. Participation 4/3/2/15. Report preparation 4/3/2/1
Total 20
Practical Evaluation (PE)
The goal of Vocational Education is to generate skills through continuous practices along with
investigation and inventions. Continuous and comprehensive practice transforms the unskilled
learner to a skilled one. This is the importance and significance of vocational practicals.
PE is done to evaluate the practical skills achieved by the learner in the concerned vocational
subject Total score for PE is 150 and minimum is 60 Score (40%) Practical Examination is
conducted for a batch of 8 learners having 6 hours duration.
515151
Vocational Competency Evaluation (VCE)
Vocational competency evaluation is to evaluate the vocational skills and aptitude developedby the students during the learning process. This is a system to evaluate judiciously the requiredvalue addition and consequent capacity building in the concerned vocational curriculum. Thevocational education is aimed at developing interest, skills and devotion in specific vocationalfields. As other evaluation components like CE, PE and TE cannot assess the vocationalcompetencies and professional skills, acquired by the students an Internship Evaluation (IE)components have been introduced to meet this requirement.
Intership Evaluation should be done based on the follwing components like regularity andpunctuality, value addition and capacity building
1. Regularity and Punctuality
Regularity and punctuality has vital role in vocational education Learning is a continuous process,the regular presence of the learner is a must for attaning maximum efficiency.
2. Value Addition
Value addition is the qualitative measure of the learner’s interest, devotion perseverance andefficiency. Value addition can be evaluated through conducting field visits/ vocational survey.The experiences gained through field visit/ Vocational survey increase the level of intrinsicmotivation and develop positive attitude towards the vocational field and thereby increase hisvalue as a semi-professional.
3. Capacity Building
It gives a quantitative measure of the student’s skill in graded area exposure. Capacity buildingcan be evaluated through conducting the following activities.
1. OJT / Simulated experiment
2. Performance - camp /exhibition / clinic
3. Performance - Production / Service cum Training centre (PTC)
These components help the learner to practise the acquired skills in the real situation andthereby increasing self - comfidence and promoting self reliance.
5252
Vocational Competency Evaluation Indicators
No Items Score
1. Regularity and punctuality 10
2. Field visit / Survey / Vocational project (anyone) 20
3. OJT / simulated experimentPerfomance - camp / exhibition / clinic 20Performance - PTCPractical skills (any one)
Total 50
1. Regularity and Punctulity can be assessed by using attendance of the learner andtime bound completion of tasks. It is evaluated by using 5 point gradingsystem.
Rating Scale
Sl. No. Item 1 2 3 4 5
1 Regularity Never often usually most of Alwaysregular regular regular the time regular
regular
2. Punctuality Never often usually most of Alwayspunctual punctual punctual the time punctual
punctual
VCE Items Evaluation Indicators Scoring Score
Regulatarity 10and punctuality
Value addition Field Visit
1. Attitude and readiness towards the task 4/3/2/1
2. Capacity for observation 4/3/2/1
3. Data collection 4/3/2/1
4. Application of ideas 4/3/2/1
5 Documentation / recording 4/3/2/1
OR 20
535353
Survey
1. Planning 4/3/2/1
2. Data Collection 4/3/2/1
3. Consolidation of data and analysis 4/3/2/1
4. Drawing inference 4/3/2/1
5. Reporting 4/3/2/1
Capacity
Building OJT / Simulated experiment
1. Involvement / participation 4/3/2/1
2. Skills in doing work / communication skills 4/3/2/1
3. Time bound action 4/3/2/1
4. Capacity for observations, analysis and innovation 4/3/2/1
5. Documentation, Recording and display 4/3/2/1
OR 20
Performance in camp / exhibition / clinic
1. Ability for planning and organising 4/3/2/1
2. Mastery of subject 4/3/2/1
3. Ability for communication 4/3/2/1
4. Innovation 4/3/2/1
5. Involvement / Social commitment 4/3/2/1
OR
Performance in Production/ Service
cum training centre (PTC)
1. Mastery of vocational skills 4/3/2/1
2. Managerial capacity 4/3/2/1
3. Promiting self condidence 4/3/2/1
4. Innovative approach 4/3/2/1
5. Promoting self reliance 4/3/2/1
VCE Items Evaluation Indicators Scorin Score
5454
Consolidated Statement of VCECourse : ECG & AMT Year: Class:
Consolidated Grade Record of Vocational Subjects
Course : ECG & AMT Year: Class:
Roll. Name of CE TE Grade PE Grade IE GradeNo Pupil 20 80 150 50
Vocational Theory Vocational Practical VCE
Total 100
Roll No Name of Regularity of Value addition Capacity Total GradePupil Punctuality Building Score
(10) (20) (20) (50)
555555
PRACTICAL EVALUATION
Practical evaluation is the important part of vocational practicals. The practical skills must beevaluated from time to time. A practical examination is conducted for 150 score and shouldcover all required indicators to evaluate the technical skill and practical knowledge of ECG andAMT
Indicators for PE-ECG & AMT
Indicators Score Total
Identification of tools and items 20 20
Procedure-2 experiments 5 x2 10
Technique 20x2 40
Observation, tabulation, inference 20x2 40
Result 5x2 10
Record 1x10 10
Viva voice 20
Total 150
5656
Course : ECG & AMTYear :
Name of Subjects Term Term Mini.Score
Part I1. English
2. GFC
Part II Voc. Theory
Voc. Practical
VCE
Paper IIIPaper I Physics
Paper IIChemistry
Paper IIIBiology
CETETotalGrade
CETETotalGrade
CETETotalGrade
TotalGrade
IEGrade
CETEPETotalGrade
CETEPETotalGrade
CETEPETotalGrade
I II III I II III
Ist Year II Year
MaxScore
LEARNER EVALUATION PROFILE
575757
Con
solid
ated
Sta
tem
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f CE
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:C
lass
:
Sl. N
oN
ame
CE
item
sE
valu
atio
n In
dica
tors
Tot
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otal
(60)
Ave
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CE
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12
34
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56
ELECTRO CARDIOGRAPHY1
575757
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t 1 :
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tory
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CG
1To
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the
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CG
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grou
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otes
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ooks
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ater
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T
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und
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and
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basi
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ples
of
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CG
reco
rdin
g th
roug
h br
ain
stor
min
g pr
acti
cals
,ob
serv
atio
n &
dis
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ion
prep
are
note
s
Bas
ic p
rinci
ples
of
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rain
sto
rmin
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actic
alob
serv
atio
n,gr
oup
disc
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Ref
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mac
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CG
Not
esC
T
3To
und
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and
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lead
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sed
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CG
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ared
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Mac
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rded
EC
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rtTE PE
4To
ide
ntify
the
par
ts o
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CG
mac
hine
and
its
wor
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thr
ough
Bra
inst
orm
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Cha
rt p
repa
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on a
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rain
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n
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ooks
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58
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ateria
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ts/Ev
aluati
on
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ssio
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und
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and
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ew
atch
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ut th
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ver
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595959
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ooks
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ata
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inar
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ield
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ar
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rts, A
ni-
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obse
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and
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IntroductionElectrocardiography is one of the most widelyused non invasive technique for the diagnosisof heart disease. The Electrocardiograph isthe first electrical device to find widespread usein medical diagnosis and it still holds itsimportance as a diagnostic tool of cardiacdisorders.
When the heart contract electric current isproduced and propagated through out the bodyto the skin. By using electrodes and agalvanometer this current can be recorded.This is called electrocardiogram. Theproduction and propagation of bioelectricpotential across the cardiac cells are alreadydiscussed in the first year. This unit includesthe history of ECG, basic principle, working,parts of ECG machine, method of recordingECG and common artifacts occurring whilerecording ECG.
This unit enables the student to acquire skill inrecording ECG, its applications, identifying theparts of ECG machine and various types ofrecorders.
Curriculum Objectives1.1 To understand the history of ECG
through brain storming, group discussion.Prepare notes.
1.2 To understand the basic principles ofECG recording through brainstorming,practicals, observation, group discussionand prepare notes.
1.3 To understand the various lead systemuses for ECG recording through chartpreparation, discussion and practicals.
1.4 To identify the parts of ECG machine andits working through brainstorming,discussion, chart preparation anddemonstration of dismantled specimensand operation manuals. Prepare notesand draw diagrams in chart.
1.5 To develop an idea about standardizationof ECG machine through brainstorming,discussion, demonstration and practicalexperiments. Prepare notes.
1.6 To develop an idea about the need ofcritically damped and the concepts ofover damping and under dampingthrough observation, discussion andpracticals. Prepare a chart demonstratingthe damped condition.
1.7 To understand the precautions and patientpreparation before recording ECGthrough discussion, demonstration andpractical. Prepare an assignment.
ELECTRO CARDIOGRAPHY1
62
1.8 To acquire practical skill in recordingECG through group discussion,observation, practicals, field visit andOJT. Prepare a report.
1.9 To understand the normal ECGwaveform pattern through brainstorming,chart preparation, observation and groupdiscussion. Prepare charts and notes
1.10 To understand the ECG measurementparameters through discussion, datacollection and observation. Prepare anote
1.11 To get an idea about abnormal ECGwaveforms associated with certaindiseases through interview, seminar,reference materials, IT support and agroup discussion. Present the seminarreport.
1.12 To understand the common artifactsoccurring in ECG recording and able tominimize the artifacts throughobservation, discussion and assignment.
1.13 To get an idea about various ECGrecorders through field visit OJT andassignment.
Syllabus1.1 History and introduction
1.2 Basic principles of E.C.G
1.3 Lead system
1.4 Normal E.C.G wave form
1.5 Abnormal patterns-brief description
1.6 E.C.G instrumentation
• Details of E.C.G machine with blockdiagram
1.7 Procedure for E.C.G recording
1.8 Artifacts in E.C.G recording
1.9 Types of E.C.G recorders
Practicals
• Leads of E.C.G
• Parts of E.C.G machine
• Standardization
• Damping
• Precautions and patient preparation
• Recognition of minor faults and troubleshooting
• Familiarization of various types of E.C.Grecorders
• Recording of 20 normal cases
1.1 History of ECGLearning activity
- brainstorming and group discussion.
Learning materials
- Print outs taken from the Internet.
Reference Text- Biomedical instrumentation and
measurements By Cromwell- ECG Assessment &Interpretation
By Brad Ford C. Lipman
ProcessThe teacher initiate a brainstorming session torecollect their previous knowledge by askingquestions.
a) What is biopotential?
b) How it is propagated?
c) ....................................
d) ....................................
Collect responses from the students
l Production and propagation of actionpotentials
l
l
Then the teacher divides the students into 5
636363
groups and asked to discuss the followingpoints using reference material and printoutstaken from Internet.
Ask them to discuss the following points.
Discussion Points
l Invention of biopotential
l Need of measurement
l Introduction of capillary electrometer
l Contribution of William Einthovan
l String Galvanometer
l Modification of writing system
l
The teacher must facilitate during discussion
Reporting
- Presentation by group leadersAsk the learners to prepare a note based onthe discussion.
Consolidation
- Invention of biopotential by LuigiGalvani
- Waller – Capillary Electrometer- Demerits of Capillary Electrometer- William Einthovan, 1903-
Outcome
The learner understand the historicalbackground of ECG.
Evaluation TE
Link coloumn A with the appropriate item fromB & C
A B CLuigi String 1786
Galvani Galvanometer
William Capillary 1887Einthovan Electrometer
Waller Animal Electricity 1903
1.2 Basic Principles of ECGLearning activity
- brainstorming, practical,observation, discussion.
Learning materials :-
Reference Text:- A text book of medical
instruments:By S Ananthi- ECG assessment and interpretation:
By Brad Ford C. Lipman- Electrocardiography: Aspi F.
Golwalla- ECG Machine
Process
l Recollection of previous knowledgeabout biopotential through brainstormingsession
l The teacher divides the student into 5groups. The ECG of one student fromeach group is recorded [Lead 1 or 2]
Let them observe the recorded tracings. Askthem to redraw the tracings in their notebook.Direct them to a group discussion usingreference materials.
Points
1) Where does the waves come from?
2) What are the features of the tracings?
3) .....................................................
4) .....................................................
Consolidation
l Bioelectric potentials
l ECG – Definition
l Electrocardiograph
l Electrocardiography
l Nomenclature of ECG waves
l
Prepare a note based on discussion
64
Other activities
- Collections of recorded tracings ofEEG and EMG. Ask them tocompare with ECG tracings
Outcome
The student get an idea about the basicprinciples of ECG
Evaluation CT
ECG signal differ from other bioelectricpotentials in their characteristics.Analyze this statement.
1.3. Lead systemLearning activity
- Chart preparation, discussion,practicals
Learning materials
- Prepared charts, ECG machine,Recorded ECG
Website- http://nobel prize.org/medicine/
education/ecg/index.html
Text Book:- Biomedical instrumentation and
measurement By Cromwell- Electrocardiography Aspi F.
Golwalla
Process
Step 1
Teacher divide the students into groups. Givethem the task of preparing chart showing12leads ECG using references. Charts aredisplayed in the classroom. Let the students tocompare the 12 charts and note the differences.Teacher asks them to group the chart basedon similarity. 3 groups are obtained. Thestudents can do the title for each group byreferring text materials.
Step 2
The teacher suggests an example of takingphotograph of a person from different angles.The photograph gives different details of thesame person. Similarly recording ECG fromdifferent points of the body gives more details.By this example teacher can conclude the needof multiple leads in ECG.
l Ask the students to prepare notes
Consolidation:
1) Electrodes2) Leads3) Comparison and classification of
leads4) importance of multiple leads than a
single lead5)6)
l Practicals: - Students can practice theplacement of leads in laboratory.
Outcome
The learner understands the different leadsystem and acquire skill in the placementof leads
Evaluation: TE
656565
Observe the above two figures Identifyand compare these two leads
PE
Identification of wrong lead connectionand their correction.
1.4 Part of ECG machine and itsworking
Suggested activity: illustration, group discussion,Demonstration using dismantled specimen,chart preparation..
Learning materials:
- Reference Text: A text book ofmedical instrumentsBy S.Ananthi
- ECG Machine ,- Prepared charts- Dismantled ECG machine
operation manuals
Process
With the help of prepared charts the teachercan demonstrate the parts of ECG machineusing reference materials. Ask the learner todiscuss the following points.
Discussion points
l Lead selector
l Preamplifier
l Pen motor
l
Ask the learners to relate the different parts ofmachine in a proper way.
The learner can prepare a block diagramshowing the parts of ECG machine usingreferences
l The teacher must facilitate the studentsto discuss the function of each block withthe help of dismantled machine. Thelearner can prepare notes and the groupleaders can present the topic inclassroom.
Other activities.
- Prepare a chart showing the partsof ECG machine.
Consolidation
- Lead selector - select the lead signal- pre amplifier- power amplifier-
Evaluation
• Complete the given block diagram ofECG machine
PE
Identify the controls in the front panel ofECG machine
1.5 Standardization of ECG machine
Learning activity
- Brainstorming, discussion,demonstration and practical.
Learning materials:
- ECG machine, ECG paper,prepared charts, Reference text:ECG assessment & interpretationBy Bradford C. Lipman
Process
Teacher can initiate a brainstorming session onthe need of calibration by measuring a physicalquantity.
Eg: A meter scale is used in textile shop tomeasure fabrics. A wooden stick of length in 1m and marked accordingly can be used for thispurpose i.e. the length of the wooden stick iscompared with the length of the meter scale.
Discussion
The teacher can divide the students into 5
Lead selectorBridgeO/P
circuit
66
groups (Grouping strategy: - Ask them to name5 physical quantities) e.g. voltage, current,length, time, weight
Points to be discussed
How can we calibrate an ECG machine?
l Need of standardization in ECG machine.
l
Let the students to observe the standardizationprocedure conducted by teacher.
Ask them to compare ECG tracings withproper calibration and without calibration
Let them note the differences
Practicals
Practice the standardization in ECGmachine by each learner
The group leaders of each group can do apresentation on this topic with the help ofcharts and submit the report in the form of anote.
Consolidation
- Standardization- 1 mv = 10 mm- Under standardization- Over standardization-
Outcome
The students get the concept of standardizationby practicals and preparing a chart showingnormal, over and under standardization
Evaluation:TE
Compare the given standardization signal.
1.6 DampingLearning activities
- Observation, discussion and Chartpreparation
Learning materials
- Reference text
An introduction to Electro-cardiography by Leoschamroth
- ECG machine
Process
Students observe the standardization marksobtained in different damping condition anddiscuss the following points
Points
- Damping
- Under damping
- Over damping
Note the points in a diary
In practical session teacher demonstrate thedamping
Consolidation points
- Rounding of signals- Overshoot-
Other Activities
- Prepare a chart demonstrates thedamped condition.
Outcome
- The students get an idea aboutdamping
Evaluation
Commend on these signals
676767
1.7 Precautions and preparationstaken before ECG
Learning strategy
- Group discussion, demonstration,practical.
Learning materials:
Reference text
- BPL, Operation Manual- A text book of Medical Instruments
By S Ananthi
Group discussion
- Divide the students into 5 groups.The teacher can supply the printouts of this topic. Lead them adiscussion.
Discussion points
l Need for taking precautions
l What kind of precaution can be taken?
l Need for applying electrode paste
l Proper electrode placement
l Lead placement
Let the students to observe the practicalexperiment conducted by the teacher
l Ask them to prepare a note and the groupleaders of each group can present thetopic in the form of assignment
Consolidation
l Supine position
l Removal of metal objects
l Application of electro depaste
l
Other activities- Prepare an assignment pointing out
the precautions and patientpreparation
- Exhibit a chart showing the majorpoints regarding the precautions tobe taken before taking ECG
Practicals
The learner can practice the placementleads, patient preparation and placementof leads
Outcome
The students get an idea about theprecautions to be taken before recordingECG and skill for patient preparation.
Evaluation
CT
PE
l Patient preparation
l Standardization
l
1.8 Procedure for ECG recordingLearning activity
- Group discussion, observation,practical, field visit/OJT
Learning materials
- Operating manuals, ECG machine, ECGpaper, Electrode paste
Reference text
- A text book of Medical InstrumentsBy S Ananthi
Process
Divide the students into groups and ask torecollect their previous knowledge on thefollowing points
l Precautions to be taken before ECGrecording
l Patient preparation
l Electrode placement
l Lead placement
l
Consolidate the discussion points
The students can observe the procedure forECG recording by following ways
68
l Demonstration by teacher in school labs
OR
l Observation during field visit
OR
l The learner itself can visit and observethe procedure in a nearest lab
Ask them to prepare note on the recording ofECG using operation manuals.
Practicals
The learner can practice the recording ofECG from school laboratories and duringOJT.
Consolidation
l Precaution
l Patient preparation
l Electrode paste
l Standardization
l Recording
l
Outcome
The learner acquires a skill in ECGrecording through OJT
Evaluation
OT, PE
Evaluating the practical skill in
l Precautions
l Patient preparation
l Electrode placement
l Standardization
l Recording
l
1.9 Normal ECG wave formLearning activity
- Brainstorming, chart preparation,observation, Group discussion
Learning materials
- Reference books, charts, animatedCDs
Reference text:
- ECG assessment & interpretationBy Bradford C. Lipman
- Biomedical instrumentation andmeasurement By Cromwell
Website- http://www.rneens.com
Process
Step 1
Recollection of previous knowledge about thebasic principle of ECG and conductive systemof heart through a brainstorming session. Askto note the points in a diary
Step 2
Let the students prepare chart of normal ECGwaveform using reference materials.
l With the help of animated CDs studentscan observe ECG waveforms in relationto the working of heart
l Lead them to a group discussion basedon the above activities (5 groups) andusing reference materials.
Points
l Why the ECG shows differentdeflections?
l What does each deflection represent?
l Can you differentiate the characteristicsof each deflection?
l
Group leaders can present the topic in the formof notes
Consolidation- P wave: atrial activity- QRS complex:
696969
- ST segment- T wave- U wave--
Other activities
Collection of recorded ECGs
Outcome
Learner understand normal ECGwaveform and identify the electricalevents responsible for their formation.
Evaluation
TE
l P wave represent atrial activity. Justifythis statement.
1.10 ECG MeasurementsLearning activity
- Discussion, Data collection andObservation
Learning materials
- Reference text: ECG assessment &interpretation By Bradford C.Lipman,
- ECG paper, recorded-ECG
Process
Teacher supplies reference materials along withan ECG paper to discuss the points.
l ECG paper
l Paper speed
l Normal calibration
l Horizontal axis- duration
l Vertical axis – amplitude
l
Parameters
l P-wave amplitude, P-wave duration
l QRS amplitude, QRS duration
l P-R interval, QRS width, QT internal
l
Consolidate the discussion points with the helpof teacher
l Types of ECG paper
l 25/50 mm/sec
l Horizontal axis represents duration
l Normal values of P wave, QRS interval,PR interval, QT interval
l
l
prepare notes
Other activities
- Collection of ECG tracings and findout the values of above parameters.
Activity 2
- The learner can collect the print outof the topic (calculation of heart ratefrom ECG) from the teacher anddiscuss the matter in groups(Teacher act as facilitator)
Points to be discussed:
l 1500 method for calculating heart rate
l 6 sec method for calculating heart rate
l
Note the points in a diary
Consolidation
- Heart rate = 1500/No of smallsquares
-
Other activities
Let the students to collect the recorded ECGtracing and ask to calculate the heart rate by1500 and 6 second methods
Outcome
The learner understand the different typesof ECG papers, parameters of ECG andcalculation of heart rate from ECG.
70
Evaluation TE Outcome
The students get an awareness oncommon abnormalities in ECG.
Evaluation
Calculate the heart rate from ECG by 300methods if the R-R interval is 25 small squares
1.11 Abnormal ECG waveform (Briefdescriptions only)
Learning activity:
- Interview, OJT/ Field visit andseminar
Learning materials
- Animated CDs, Reference books
Reference text
- ECG made easy- John R. HamptonWebsites
- http://www.skill stat.com/ECG_Sim_demo.html
Process
The teacher can give the topic to the studentsand ask to collect information during OJT/ Fieldvisit.
Students make interaction with a Cardiologistand collect information about abnormal ECGwaveform.
Present the collected information in the formof a seminar.
Consolidation
- Hypertrophy- IHD- MI- Common Arrythmias--
l Observe the above two ECG signals andcommend on it.
1.12 ECG ArtifactsLearning activity
- Discussion, Observation
Learning materials
- Reference books, Expert opinion
Reference text
- Biomedical instrumentation -Arumukham
Process
The teacher can initiate a discussion on artifactsby giving ECG tracings which contain someartifacts.
e.g. wandering of baseline
Ask them to find out the reason for that artifactwith the help of reference material. List out theother artifacts and let them to find out the reasonand their remedial measures using referencetexts
Present the report in the form of an assignment.
Consolidation
- Artifacts - Definition- Wandering of baseline
717171
- AC noise--
Outcome
The students are capable of identifyingthe commonly occurring artifacts andtheir remedial measures.
Evaluation
TE
Observe the above signal and commendon it
How these kind of signals can be avoidedduring recording
PE
Identification and elimination of artifactsduring ECG recording
1.13 Various types of ECG recordersLearning activity
- Field Visit/OJT
Learning materials- Operation manuals of various ECG
recorders, charts and diagrams
Reference text
- Biomedical instrumentation -Cromwell
Process
The students can collect the various informationregarding various types of ECG recorders,advantages and disadvantages during OJT/Field visit/Exhibition. The learner can interactwith Biomedical Engineers and collect theoperation manuals.
Let them present the report in the form of anassignment.
Consolidation
- Portable single channel ECGmachine.
- Multichannel recorders- ECG for computer processing--
Outcome
The students can get an awareness regardingthe various types of ECG recorders with theiradvantages and disadvantages.
Evaluation
CT
Enumerate the different types of ECGrecorders with their advantages anddisadvantages
72
2OTHER CARDIO VASCULAR
MEASUREMENTS AND EQUIPMENTS
737373
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scus
sion
, fie
ld v
isit,
OJT
. Pre
pare
not
es
Bra
inst
orm
ing,
disc
ussi
on, O
JT,
Fiel
d vi
sit
Not
eTE
Ref
eren
cete
xt:-
BM
I by
Cro
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ell
•Pa
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aker
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76
IntroductionThe heart attack in its various forms is the causeof many deaths in the world today. The use ofengineering methods and the development ofinstrumentation have contributed substantiallyin progress made in recent years in reducingdeath from heart disease. Blood pressure,flow, and volume are measured by usingengineering techniques. The electro cardiogramand echo cardiogram are measured andrecorded with electronic instruments. Intensivecoronary care units now illustrated in manyhospitals relay on bio-instrumentation for theirfunction. There are also cardiac pacemakersystem, defibrillators, which although notmeasuring instruments, they are electronicdevices often used in conjunction with cardiacmeasurements.
In this unit cardiac measurement systems otherthan ECG are discussed. A well knowledge inthis unit can only be attained through hospitalvisit and OJT only.
Curriculum Objectives2.1 To develop an idea about the technique
of TMT through illustration, field visit,OJT and discussion. Prepare reports
2.2 To familiarize with the use of Holtermonitor system through demonstration,
discussion data, collection field visit.Prepare a report
2.3 To develop an idea about cardiacmonitors used in the ICU forelectrocardiography and pulse frequencymeasurement through data collection,hospital visit/OJT and discussion. Preparea report.
2.4 To create an awareness on the need andtechnique of catheterization through datacollection, discussion, observation, fieldvisit and group discussion. Prepare notes.
2.5 To acquire a skill in recording BPmeasurement by auscultatory methodthrough practicals, observation anddiscussion. Prepare a report.
2.6 To create an awareness aboutechocardiography and its techniquesthrough brainstorming, field visit, OJT andgroup discussion. Prepare a report.
2.7 To understand the working of defibrillatorand its application through a discussion,field visit/OJT, observation. Prepare aassignment.
2.8 To develop an idea about pace maker,its principles and types through brainstorming, discussion, OJT/field visit.Prepare a note.
OTHER CARDIO VASCULARMEASUREMENTS & EQUIPMENTS2
777777
Syllabus2.1 Treadmill test
2.2 Holter monitors
2.3 ICU monitors( for electro cardiographyand pulse frequency measurement)
2.4 Cardiac catheterization
2.5 B.P measurement (Ascultatory method indetail)
2.6 Echo cardiography
2.7 Defibrillators
2.8 Pacemaker systems
Treadmill Test
Introduction
Patient with coronary artery blockages mayhave minimal symptoms and an unremarkableor unchanged ECG while at rest. However,symptoms and signs of heart disease maybecome unmarked by exposing the heart to thestress of exercise. During exercise, healthycoronary arteries dilated than an artery whichhas blockage. This unequal dilation causesmore blood to be delivered to heart musclesupplied by the normal artery. In contrast,narrowed arteries end up supplying reducedflow to its area of distribution. This reducedflow causes the induced muscle to starve duringexercise. The starvation may producesymptoms like chest discomfort orinappropriate shortness of breath, and the ECGmay produce characteristic abnormalities.Most commonly a motorized treadmill is usedfor exercise while a stationary bicycle is usedin some exercise Lab.
Learning activity
- Illustration, Field Visit/ OJT anddiscussion
Learning materials- Reference books, Collected data
Reference text- ECG assessment and interpretation
by Bradford C. LipmanWebsite- h t t p : / / w w w . n l m . n i h . g o v /
medl ineplus /ency/ar t ic le /003878.htm/article/003869.htm
Process:l Teacher gives an introductory idea about
TMT in the class room through illustration
l The learner observes the procedure andtechniques of Tread mill test during OJTor Field visit in a hospital. Prepare areport
l Teacher divide the students in 5 groups.Based on the prepared report adiscussion is conducted
The discussion points are –
l The need of performing TMT
l The precautions to be taken beforeperforming TMT
l The procedure of Test
l The accessories and instruments used forTMT
l The significant changes in ECG- As the group leaders to present the
discussion points- The Notes are prepared based on
this presentation
78
ProcessTeacher introduce the instrument in the classroom with the help of CD’s and Photographsand discuss the following points
l The difference between routine ECGrecording and Ambulatory moniotoring
l Special leads and electrode position
l Need of Ambulatory monitoring
l Instruments and accessories used
l Lead and electrode placement
l Advantages adn disadvantages
The learner can strengthen his conceptwith the help of experts during field visit
Consolidation
Outcome
Students understand the need andtechnique of ambulatory monitoring
Evaluation:
OT
ICU Monitors for ECG recording andPulse frequency measurement
Introduction
In patient monitors electronic equipmentprovides continuous watch over the vitalcharacteristics and parameters of the criticallyill. Patients are monitored because they havean unbalance in their body system. This canbe caused by heart attack or stroke. Bycontinuous monitoring, the patient problem canbe detected as they occur and remedies takenbefore these problems get out of hand.
Learning activity:
- Data collection, OJT/ Field visit/Discussion
Learning Materials
- Reference text: Principle ofbiomedical engineering for nursing
Consolidation
- Treadmill - parts- procedure- ST segment change-
Outcome:
The learner understand the technique ofTMT
Evaluation
TE
Exercise ECG is more useful that routineECG recording. Justify
Holter Monitor
Introduction
Holter monitoring is a method of recordingcontinuously the cardiac rhythms over aspecific period of time. The test can beconducted on an out patient basis and is usedto detect arrythmias or coronary artery disease.
Learning activity
- Demonstration, Discussion, FieldVisit & expert opinion
Learning materials
- Reference books, Expert opinion,chart etc., Photograph and CDs
Website- h t t p : / / w w w . n l m . n i h . g o v /
medlineplus/ency/imagepages/8810.htm
797979
staff – Hans.A.Von Des Model,Black well publications
Processl Teacher can give the print outs of this
topic
l Ask to collect more informations aboutthis topic during field visit/OJT
l Group discussion (5 group)
Points to be discussed
l Use of Monitors
l Instrument set up
l Special lead used
l Electrodes used
l Measuring parameters
One student from each group can present thistopic. After presentation a question session isconducted. Other group members giveanswers for questions.
l Prepare a report on this topic
Consolidation
- Silver- Silver cholride electrodes- Principles of ECG monitors--
Other activities- Prepare an assignment on central
monitors
Outcome
The learner gets an idea about cardiacmonitors
Evaluation
CE
OT
Participation of learner in groupdiscussion and answering to questions
Cardiac Catheterisation
Introduction
Catheterization was first developed in the late1940’s and has become a major diagnostictechnique for analyzing the heart and othercomponents of cardiovascular system. Apartfrom obtaining blood pressure in the heartchambers and great vessel, this technique is alsoused to obtain blood samples from the heartfor oxygen content analysis, and to detect thelocation of abnormal blood, flow path ways.Catheter is also used investigations withinjection of radio opaque dyes for x-ray studies.Coloured dyes for indicator dilution studies andof vasoactive drugs directly into the heart andcertain vessels
Learning activity
- Data collection, discussion,observation, field visit/OJT
Learning Materials
- Reference text- Animated CDs- Expert opinion
Website- h t t p : / / w w w . n l m . n i h . g o v /
medl ineplus /ency/ar t ic le /003419.htm
Process – Group Discussion – 5 groups
The learner can collect the data relating thistopic from library and discuss the followingpoints with the help of teachers
Discussion points
l What is catheter?
l What is the need of catheterisation?
l Technique of catheterization
l Applications
l
80
Consolidate the discussed points and note themin a diary
l Using animated CDs or websites thelearner can observe the technique ofcatheterization
l During field visit/OJT learner can furtherimprove his idea about catheterizationwith the help of cardiologist
Make a report on this topic based on the aboveactivities and present it in the form of Seminar
Consolidation
l Catheter – Definitionl Angiograml Applicationsl Procedure - Precatheterization
- Catheterisation- Post catheterization
Outcome
The learner gets a brief idea about thecatheterization
Evaluation
Clinical applications of catheterization
Blood Pressure Measurement( Auscultatory method)
Introduction
As one of the physiological variable that canbe quite readily measured, BP is consideredas a good indicator of the status of cardiovascular system. BP measurement has savedmany persons from untimely death by providingwarnings of dangerously high BP in time toprovide treatment.
Learning activity
- Observation, Practical andDiscussion
Learning materials
- Sphygmomanometer, Stethoscope
Reference Books- A text book of biomedical
instrumentation by S.Ananthi
Website- h t t p : / / w w w . n l m . n i h . g o v /
medl ineplus /ency/ar t ic le /003398.htm
ProcessThe students can observe the procedure of BPmeasurement by following ways
l By visiting a nearest lab/hospital
or
l Demonstration in school using BPapparatus by teacher
or
l Observation during field visit
Using prints out or reference materials thelearner can prepare the note and discuss thematter in groups. The group leaders presentthe topic in class and make a final report withthe help of teacher.
Practicals
The learner practises the BP measurementduring OJT/Schools labs
Consolidation
- Blood pressure – definition- Systolic & Diastolic- BP apparatus- Normal values- Interpretation
Other activities
- Assignment- Prepare anassignment on BP measurementother than auscultatory method.
Outcome
The learner acquire the skill in measuringBP by Auscultatory method
818181
Evaluation
CT
The doctor send a patient to you sufferingfrom heart disease and asked to checkthe BP of the patient. On examinationshows the BP of 180/90mm of Hg
Name the instrument used for the purpose
How will you perform this test
Mention the normal systolic and diastolicvalues?
PE
Evaluating the practical skill in recordingBP
- Handling of apparatus
- Technique
EchocardiographyEcho Cardiography is widely used andvaluable instrument for cardiac examination andassessment of many congenital and acquiredcardiac disease. Using this instrument it ispossible to see intracardiac structures, detectblood flow velocity, valve stenosis etc
Learning Activity:
- Brains storming, illustratation Fieldvisit/ OJT, Discussions
Learning Materials:
- Animated CD, Reference books,expert opinion
Reference books
- Echo made easy By Athul Luthra
Website- h t t p : / / w w w . n l m . n i h . g o v /
medl ineplus /ency/ar t ic le /003869.htm
ProcessThe teacher can initiate a brain storming sessionon ultra sound and its basic principles. Using
an animated CD and reference text teacher canillustrate the technique and working of Echocardiography
Points
l Definition of Ultra sound
l Basic Principles
l Technique
l
Consolidation
- Echocardiography - definition- Principles of Doppler- Conventional Echo- Clinical applications-
During Field visit and OJT the student canstrengthen their concept with the help of experts.Make a report on echo cardiology based onthe above activity.
Other activities
- Seminar- Application of Ultra soundin Medical field.
Evaluation
OT
Outcome
The students understand the basic principle andtechnique of Echocardiography
Evaluation – CT
Defibrillators
Introduction
Defibrillator is a device used for correcting thefibrillation of cardiac muscles. Duringfibrillation, the normal rhythmic contraction ofeither atria or ventricle are replaced by rapidirregular twitching of muscular wall. In orderto correct this fibrillation an electric shock isapplied to the chest wall.
82
Learning activity
- Discussion, Field visit/OJT,Observation, Assignment
Learning materials
- Operation manuals, expert opinion(BME) (Cardiologist) Referencetext: BMI by Cromwell)
ProcessWith the help of teacher, the students candiscuss about the following points
l Fibrillation (artial & ventricular)
l Instrument used for correcting fibrillation
l Types of defibrillators
l Working of DC defibrillators
l Electrodes used for defibrillators
l
The students can prepare a note based on theabove discussion. The knowledge about thetopic can further strengthen during the filed visitand OJT.
Prepare an assignment after the field visit
Consolidation
- Defibrillator (Definition)- Internal and External Defibrillators- Application of paddle electrodes- Working of defibrillators-
Outcome
- The learner gets a brief knowledgeabout the defibrillators
Evaluation: CT
Pacemakers
Introduction
The rhythmic beating of heart is due to originand spread of impulses from the S.A nodewhich is the natural pacemaker of heart. If SA
node fails to function, the normal synchronismof heart action get disturbed. By providingexternal electric impulse stimulation to thecardiac muscles, it is possible to regulate therhythm of Heart. These impulses are given byan electronic instrument called pace maker.
Learning activity
- Brain storming, discussion, OJT/Field visit
Learning materials
- Reference text : Biomedicalinstrumentation - Cromwel
Website- h t t p : / / w w w . n l m . n i h . g o v /
medl ineplus /ency/ar t ic le /007070.htm#visualContent
ProcessThe teacher can initiate a brain storming sessionon conducting system of the heart
l Natural pacemaker
l What happens if natural pacemaker notfunctioning properly
l Need for artificial pacing
l
Using reference text and photographs andnecessary guidance from the teacher the learnercan further discuss the following points.
l What is a pacemaker?
l Different types of pacemakers
l Power supply
l
During the hospital visit the students canobserve the different types of pacemakers andfurther improve their knowledge about thepacemaker with the help of cardiologist.
Prepare a note on pacemakers.
838383
Consolidation
- Pacemaker – definition- External pacemakers- Internal pacemakers-
Evaluation
TE
A patient admitted to the hospital due to heartdisease. On clinical evaluation cardiologist
found that SA-Node is not functioning properlyand sujjest for artifical pacing
• Name the device used for artificial pacing
• What is the principle of this device?
• Mention its different types
The learner gets a basic awareness aboutpacemakers and their functions.
84
3CARDIO PULMONARY
RESUSCITATION & MEDICAL ETHICS
858585
Cur
ricul
umC
onte
nt/a
rea
Act
iviti
es/le
arni
ngM
ater
ials
Prod
ucts
/Ev
alua
tion
obje
ctiv
esst
rate
gies
Out
com
e
UN
IT A
T A
GL
AN
CE
Uni
t 3 :
CPR
and
Med
ical
Eth
ics
1To
und
ersta
nd th
e fir
st ai
dm
easu
res
in t
he c
ase
ofca
rdia
c ar
rest
, th
roug
hdi
scus
sion
, ch
art
prep
arat
ion,
obs
erva
tion
and
role
pla
y
•C
PR•
CPR
in a
dults
Dis
cuss
ion,
cha
rtpr
epar
atio
n,ob
serv
atio
n, R
ole
play
Ref
eren
ce b
ooks
,A
nim
ated
CD
,Pr
epar
ed c
hart
Cha
rtPE
2To
get
a b
rief
idea
abo
utm
edic
al e
thic
s, t
hrou
ghdi
scus
sion
•M
edic
al E
thic
sD
iscu
ssio
nR
efer
ence
book
s,Ex
pert
opin
ion
Rep
ort
CT
86
IntroductionCPR is an emergency first aid measure donewhen there is massive cardiac arrest. Manycardiac arrest are purely managed becauseof the disorganization of the cardiac arrestteam and a lack of knowledge about therecommended procedures by its members.The main objective of this unit is to create anawareness in students about the first aidmeasure to be done in cardiac arrest.
Curriculum Objectives3.1 To get an idea about the first aid
measures though the discussion, fieldvisit /OJT/animated Cd’s, expertopinion ,Role play
SyllabusLearning activities
- Discussion and using animatedcd’s, charts preparationobservation and role play.
Learning Materials
- Reference text, animated Cd’s,prepared charts.
Website- h t t p : / / w w w . n l m . n i h . g o v /
medl ineplus /ency/ar t ic le /000010.htm
ProcessThe teacher can initiate a discussion by usingreferences test and divide the students into fourgroups.
Discussion points;
l What is cardiac arrest?
l What should you do the patientcollapses
l How do I perform basic life support(BLS)
l
By using an animated CD’s and prepared chartsthe students can observe the various first aidprocedures. Note the points in a diary.
Other Activities
- Role Play
- Ask 2 or 3 students to perform arole play in cardiopulmonaryresuscitation
Consolidation
- CPR – definition- First aid measures in adult---
CARDIO PULMONARYRESUSCITATION & MEDICAL ETHICS3
878787
Out come:
The students get an awareness about theCPR procedure
Evaluation:
A healthy normal person suddenlyunconscious before you.
What first aid measures will you givebefore transporting him to ICU?
Medical Ethics
Introduction
Medical professions governed by a cord ofethics
Medical ethics deals with the moral Principleswhich should guide the member of medicalprofession in their dealings with each other, theirpatients and the state.
In this unit the learner should gets an idea aboutthe rules and regulations to be followed by atechnician in paramedical field.
Curriculum objectives3.2 To get a brief idea about the medical
ethics though discussion.
Syllabus- Medical ethics
Learning Strategy- Discussion
Learning material
- Medical laboratory Technology -CMC Vellore
Discussion
Points:
l Dedicated to the service of humanity
l All reports on patients as confidentialinformation to be communicated onlyto the physicians
l
l
Consolidate the topic with the help of a Teacher.
88
PURE TONE ANDSPEECH AUDIOMETRY
1
AMT
898989
Cur
ricul
umC
onte
nt/a
rea
Act
iviti
es/le
arni
ngM
ater
ials
Prod
ucts
/Ev
alua
tion
obje
ctiv
esst
rate
gies
Out
com
e
UN
IT A
T A
GL
AN
CE
Uni
t 1 :
Pure
Ton
e an
d Sp
eech
Aud
iom
etry
1To
und
erst
and
diff
eren
tpa
rts a
nd w
orki
ng o
f pur
eto
ne a
udio
met
ers
usin
gfo
r aud
iolo
gica
l eva
lua-
tion
thro
ugh
dem
onst
ra-
tion,
dis
cuss
ion
and
char
tpr
epar
atio
n
Aud
iom
eter
sPa
rts
Dem
onst
ratio
n,D
iscu
ssio
n, c
hart
prep
arat
ion
Aud
iom
eter
,R
efer
ence
boo
ks,
Blo
ck d
iagr
am,
Cha
rt, in
stru
ctio
nm
anua
ls
Not
esPE C
T
2To
und
erst
and
oper
atio
nof
pur
e to
ne a
udio
met
eran
d pr
oced
ure
of p
lotin
gau
diog
ram
thro
ugh
brai
nst
orm
ing
data
col
lect
ion,
obse
rvat
ion,
dis
cuss
ion
and
prac
tical
/OJT
Pure
tone
audi
omet
ryPr
inci
ple
Proc
edur
eA
udio
gram
Ref
eren
ce T
ext;
Ope
ratio
nm
anua
ls,
Aud
iom
eter
,A
udio
gram
Bra
in s
torm
ing,
data
col
lect
ion,
obse
rvat
ion,
disc
ussi
on a
ndpr
actic
al/O
JT
Rep
ort
PE TE
3To
get
an
idea
abo
ut th
epl
ay a
udio
met
ry th
roug
hdi
scus
sion
, file
d vi
sit/O
JTPr
epar
e no
tes
Disc
ussio
n, fi
eld
visi
t/ O
JT
Ref
eren
cebo
oks;
Exp
ert
opin
ion
Not
eO
T
4To
und
erst
and
the
proc
edur
e of
spe
ech
audi
omet
ry th
roug
hdi
scus
sion
, OJT
/ Fie
ldvi
sit a
nd p
ract
ical
s
Spee
ch a
udio
met
rySR
TSD
S
Disc
ussio
n, F
ield
Vis
it/ O
JTR
efer
ence
book
s; S
peec
hau
diom
eter
Rep
ort
PE OT
Play
aud
iom
etry
90
IntroductionAudiometry is an important investigation forauditory dysfunction. It not only gives an ideaabout the hearing handicap and the degree ofdeafness, but it is also a valuable method fordiagnosing ear disease.
Pure tone Audiometry is an instrument ofcomparison which indicates the differencebetween the sound pressure level required toproduce hearing in the individual under testand that required to produce hearing in anaverage normal young person.
Speech audiometry is aimed at evaluating thelistener’s response to speech. It is helpful inevaluating the functional state of auditorysystem, to predict the outcome of otologicsurgery and to assess the value of therapeuticmeasures, such as auditory training or selectionof hearing aid.
In this unit working and operation of pure toneand speech audiometers are discussed
This unit enables the students to identify theparts of audiometers and to understand theprocedure of audiometric test.
l To understand different parts and workingof pure tone Audiometer used foraudiological evaluation throughdemonstration, discussion and chartpreparation. Prepare note.
l To understand operation and procedureof pure tone audiometry and to plotaudiogram though brain storming,demonstration, discussion, practical,OJT. Prepare an assignment
l To get a brief idea about play audiometrythrough discussion, field visit, OJT andpracticals. Prepare note
l To understand the procedure of Speechaudiometry though discussion, OJT, datacollection, Practicals. Prepare notes.
Syllabusl Audiometer
l Procedure of pure tone audiometry(Including play audiometry), Plotting theaudiogram. Speech audiometry
Parts of audiometer
Learning activity
- Demonstration, discussion, chartpreparation
Learning materials
- Audiometer, prepared charts,instruction manuals
Reference text
- Martin F.N.- Introduction toaudiology.
PURE TONE ANDSPEECH AUDIOMETRY1
919191
Process:
Activity -1
Teacher demonstrates the parts of the puretone audiometer in the lab using a preparedchart and the learner can discuss the followingpoints using operation manuals
Points:
Function switch – mode switch – frequencydial – Intensity dial – Masking dial – patient –signal switch – head phones – bone conductionvibrator
Activity -2
Teacher displays the block diagram ofaudiometer in the class. Divide the students into groups of five. Let them discuss thefunctions of each block using reference books
Prepare a note based on the above activities
Other activities
- Prepare a chart that showing theparts of the audiometer
Consolidation
- Oscillator- Amplifier- Microphones- Earphone- Bone conduction vibrator--
Outcome
Students identify the parts of theaudiometer
EvaluationC.T
Prepare a block diagram showing theparts of audiometer.
P.E
Identifying the parts of Audiometer
1.2 Pure tone Audiometry (Operationand procedure) Learning activity
- Brain storming, Data collection,observation, discussion, practical,OJT
Learning Materials
- Operation Manual, Audiometer,Audiogram
Reference text
- Katz J. etal Handbook of clinicalaudiology.
ProcessRecollection of previous knowledge though abrain storming session.
Points
1. Pure tone
2. Audiometers
3. Parts and working of PTA
4.
Ask the learner to collect the print outs relatingto the procedure of pure tone audiometry fromlibrary.
Observe the procedure of P.T.A with the helpof teacher
Teacher divide the students into groups of 5and discuss the following points
Points
l Need of P.T.Audiometry
l Principles
l Test frequency
l Procedure of Threshold determination
l Symbols, Plotting Audiogram
l Interpretations
Ask the group leaders to prepare a report andpresent them in the class room.
92
Ask the leaners to submit an assignment basedon the above activities
Practicals: Students independently perform theP.TA Test in the lab
Consolidation
- Degree of hearing loss and type- Principles- Procedure- Interpretation of audiogram--
The learner practise procedure of P.T.A thoughOJT
Out come
The students acquire the skill inperforming pure tone audiometry andploting audiogram.
Evaluation
CT
A person comes to you withdeafness.After preliminary investigationsthe doctor asked for pure toneaudiometry. How will you perform thistest?
PE
Evaluating the practical skill in
l Operating an audiometer
l Head phone placement
l Procedure
l Threshold determination
l
Play audiometryLearning Strategy:
- Discussion, field visit, OJT
Learning Materials :
- Reference Text, expert opinion
Reference
- Maryanne Tate malt by andPameela Knight.
ProcessThe learner can collect the print outs relatingthis topic from library. Discuss the followingpoints in groups
Discussion points
l Need of play audiometry
l Selection of age
l Procedure of play audiometry
l
l
Note the points in a diary. During field visit orOJT the learner can collect more informationwith the help of experts
Consolidation
- 6-9 years of age- To bring out the concentration of
Childs-
Evaluation
- OT
Speech AudiometryLearning activity
- Discussion, OJT and practicals
Leaning Materials
- Reference texts, audiometerReference text:- Handbook of clinical audiology -
Katz
ProcessThe teacher divide the students into group. Thelearner collect print outs of this topic from thelibrary and discuss the following points.
939393
l Need for performing speech audiometry
l Principle of speech audiometry
l Procedure
l Interpretation
l
Consolidate the discussion points with help ofteacher
Consolidation
- Ability to understand speechprinciple
- Spondee words, phoneticallybalance words
- SRT- SDS--
During field visit and OJT the students improvetheir knowledge with the help of an audiologist
Prepare notes
Practicals
- The learner can independentlyperform speech audiometric test inthe laboratory.
Out Come
The students acquire skill in performingspeech audiometry
Evaluation
PE
Evaluating the Practical skill in performingspeech audiometry.
94
ASSESSMENT OFHEARING LOSS
2
959595
Cur
ricul
umC
onte
nt/a
rea
Act
iviti
es/le
arni
ngM
ater
ials
Prod
ucts
/Ev
alua
tion
obje
ctiv
esst
rate
gies
Out
com
e
UN
IT A
T A
GL
AN
CE
Uni
t 2 :
Ass
essm
ent o
f Hea
ring
loss
1To
get
a b
rief i
dea
abou
tca
se h
isto
ry e
valu
atio
nth
roug
h da
ta c
olle
ctio
n,di
scus
sion
and
OJT
.Pr
epar
e no
tes
Cas
e hi
stor
yev
alua
tion,
Form
at
Dat
a co
llect
ion,
disc
ussi
on, O
JTR
efer
ence
book
s; C
ol-
lect
ed d
ata
Cas
e hi
stor
ies
prep
ared
by
stud
ents
PE OT
2To
und
erst
and
the
scre
enin
g pr
oced
ure
for e
valu
atin
g he
arin
glo
ss th
roug
h, d
ata
colle
ctio
n, d
iscu
ssio
n.Pr
epar
e ch
arts
Scre
enin
g of
adu
ltsD
iscu
ssio
n,D
ata
colle
ctio
n
Ref
eren
cebo
oks;
Cha
rt,tu
ning
fork
Cha
rtO
T
4To
und
erst
and
diff
eren
t typ
es o
fau
diom
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and
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and
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need
and
conc
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f mas
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thro
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ield
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atz
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TE
7To
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awar
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out t
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eren
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ract
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.N
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T
979797
IntroductionSound is one of the most important factors inour environment. In the form of speech, it isthe most convenient form of communication.It is often a source of pleasure, as when welisten to music. When sound becomesexcessive, distracting or even Painful, such asthe din of machinery in a factory, the blax of anunwanted radio or the scream of a jet enginewe have the Problem of noise. Without sound,our world seems empty and dead.
If we know something of the nature of soundand its relationship to hearing, we canunderstand how our hearing may be measuredand how such measurements can be used byan otologist to determine the nature of hisPatients loss and then what assistance can beprovided.
Curriculum Objectives2.1 To get a brief idea about case history
evaluation through data collection,discussion and OJT. Prepare notes.
2.2 To understand the screening procedurefor evaluating hearing loss through datacollection, discussion.
2.3 To understand the various tuning fork testused for audiological evaluation throughdiscussion, demonstration, practicals.Prepare seminar.
2.4 To understand different types ofaudiometers through group discussion,field visit and assignment
2.5 To understand the need and concept ofmasking through observation, discussionfield visit/OJT.
2.6 To familiarize with various objectivemeasurement for audiological evaluationthrough data collection, field visit / OJT.Prepare an assignment.
2.7 To get an awareness about the specialaudiometric tests used for differentiatingsensory loss from retro cochleardisorders through discussion, Practicalsand observations. Prepare notes.
SyllabusAssessment of hearing loss.
l Case history evaluation.
l Screening procedure for hearing evaluation
l Tuning fork test
l Overview of audiometry
l Orientation to masking
l Need for masking
Orientation to free field audiometry andobjective measurements such as tympanometryReflexometry. BSERA, OAE
2.1Case History EvaluationLearning activity:
- Data collection, discussion and OJTLearning materials:
- Reference book: Principle of Hearingaid Audiology By Maryantate,
- Collected data.
ASSESSMENT OFHEARING LOSS2
98
Process:The students collect the general format of casehistory from nearest audiology lab.
Divide the students in to groups. Let themdiscussing it the following points.
Discussion points
• The duration of hearing loss• The rate of deterioration/ any fluctuation
in hearing level.• The cause of loss if known• Any family history• Previous or current audiological
assessment/ treatment• Any condition necesitating medical referal• Experience with hearing aid.
During field visit or OJT, the students canobserve the preparation of case histories.
Prepare a note on the general format of casehistory.
Consolidation
Out Come
Learner gets an idea about case history.
Evaluation:OT
2.2 Screening procedure for hearingevaluation
Learning activity
- Data collection
- Discussion
Learning materials
- Reference text - Martin F.N. -Introduction to audiology.
Process
The learner can collect the general formatrelated to this topic from library or an audiologylab.
Discuss the matter in groups with the help ofteacher
999999
During hospital visit the learner can observethe various case histories with the permissionof an audiologist.
Consolidation
100
Other activities
Prepare a chart showing the general format ofthis topic.
Out come
The learner get a brief idea about the screeningprocedure
Evaluation
OT
2.3 Tuning Fork testLearning activity
- Discussion, Demonstration,practicals
Learning materials
- Charts, Tuning fork (512Hz)
Reference text- Martin F.N Introduction to
audiology.
Process:Demonstration: - Demonstration of tuning forktests by the teacher
Teacher divides the students in to groups (4)Using reference materials groups can discussthe following points.
l Rinne’s test - Group I
l Weber test - Group II
l ABC test - Group III
l Schwaback test - Group IV
Consolidate the discussion points with the helpteacher. Ask them to present the report (oneamong each group)
Consolidation
- Tuning fork test - Rinne’s, Webertest, ABC, Schwabach(Principle, procedure,interpretation)
- The learner can strengthen theknowledge about this topic duringfield visit with the help of a doctor.
Practicals:
- Students are instructed to performthe above tests till they get sufficientpractice
- Ask the group leaders to conducta seminar on this topic.
Out come
The learner acquire a skill in performingscreening tests.
Evaluation
PE
Evaluating the practical skill in performingtuning fork test
2.4 Overview of Audiometry.Learning activity
- Group discussion, field visit
Learning materials
- Reference text -Martin.F.NIntroduction to audiology,Audiometers.
ProcessDivide the students into 5 groups. Ask them tocollect the reference materials from the libraryand discuss the following points.
l Pure tone audiometryl Speech audiometryl Impedance audiometryl Evoked Response Audiometryl Free field audiometryl
During field visit/OJT the learner can improvehis knowledge with the help of expertsconsolidate the discussion with the help of theteacher prepare an assignment
101101101
Consolidation:
- Free field -open or an area withboundaries that are negligible for thetest.
- Impedene audiometryThe instrument used to assess themiddle ear status
- Procedures
Out come
The students get a brief idea about thedifferent audiometers.
Evaluation:O.T
2.5 Orientation to masking-need formaskingLearning activities
- Observation, Group discussion,field visit/OJT
Learning materials
- Audiograms
Reference text- Hand book of clinical audiology by
Katz
Process:Let the students to observe an audiogram withmasking and without masking. Ask them tocompare the thresholds obtained for each time.Teacher divide the students in to 5 groupssupply reference materials and discuss thefollowing Points
l What is maskingl Need of maskingl Methods of maskingl Rules for maskingl
Note the points in a diary
Field visit /OJT helps the learner to strength
the concept by going through clinical tests
Prepare notes
Consolidation
- Masking-Definition- Cross over effect- Masking for AC and BC
Prepare a note based on the aboveactivities
Other activities:
Prepare a chart showing the rules of maskingnand display in laboratory.
Out come
The students get an idea about themasking and need for masking
Evaluation
TE
Masking is essential for bone conduction testcommend on this statement
2.6 Objective Audiometric TestLearning activities
- Data collection, group discussionField visit/OJT.
Learning materials
- Reference text- Hand book ofclinical audiology by Katz
ProcessAsk the learner to collect data from libraryregarding this topic. Arrange a groupdiscussion.
Points
Objective measurements such as
l Tympanometry
l Reflexometry
l Evoked response audiometry
l OAE
l
102
During field visit / OJT the students can collectmore information about the objective tests. Askthe students to present the report in the formof an assignment.
Consolidation:-
- Principle of objective test- Applications-
Out come:
The learner gets an idea about the aboveobjective test
Tests.
Evaluation
TE
Learning materials
- Reference books Introduction toaudiology By Martin.F.N
Process:Teacher distributes the print out materials ofthis topic to the groups.
Points
l Purpose of special audiometric tests.
l Retro cochlear &cochlear deafness.
l Recruitment
l ABLB test
l SISI test
l
The learner can note the points with theguidance of teacher
Students strengthen their idea by conductingpracticals in lab with help of teacher andobserving the clinical test during OJT.
Ask the students to prepare a note based onthe above activities
Consolidation :
Recruitment - DefinitionABLB - to detect recruitment in
unilateral deafnessSISI - to differentiate cochlear
from retrocochlear Lesions.- Procedure
Out come
Students understand the specialaudiological tests and their applications
Evaluation
OT
Mr. Jamal suffering from hearing loss consultedan ENT specialist. Doctor advisedtympanometry. Tympanogram obtained is givenabove.
(a) Comment on the tympanogram
(b) What is the principle of this test
(c) Clinical applications of tympanometry.
2.7 Special Audiometric tests(ABLB, SISI)
Learning activity
- Discussion, practical, observation
103103103
HEARING AIDS
3
104
Cur
ricul
umC
onte
nt/a
rea
Act
iviti
es/le
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ngM
ater
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ucts
/Ev
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Out
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e
UN
IT A
T A
GL
AN
CE
Uni
t 3 :
Hea
ring
Aid
s
1To
und
ersta
nd th
e ne
edan
d w
orki
ng o
f hea
ring
aid
thro
ugh
disc
ussi
on,
data
col
lect
ion
and
char
tpr
epar
atio
n. P
repa
reno
tes
Hea
ring
aids
,Pr
inci
ple,
App
lica-
tion
Dis
cuss
ion,
dat
aco
llect
ion,
cha
rtpr
epar
atio
n
Mod
els,
inst
ruc-
tion
man
ual,
phot
ogra
phs,
prep
ared
cha
rts
Ref
eren
ce te
xt;
Mar
yann
e ta
te
Cha
rtN
otes
TE
2To
fam
iliar
ize
with
the
circ
uit d
etai
ls o
f hea
ring
aids
thro
ugh
dem
onst
ratio
n an
ddi
scus
sion
. Pre
pare
mod
els
Hea
ring
aid,
Circ
uit
deta
ilsD
emon
stra
tion,
Dis
cuss
ion
Circ
uit d
iagr
am,
wor
king
mod
el,
bloc
k di
agra
m
Rep
ort
PE
3To
und
erst
and
diff
eren
tty
pes
of h
earin
g ai
dth
roug
h da
ta c
olle
ctio
n,ch
art p
repa
ratio
n an
ddi
scus
sion
Type
of h
earin
g ai
dA
C ty
pes
Dig
ital a
ndpr
ogra
mm
able
hear
ing
aids
Dat
a co
llect
ion,
char
t pre
para
tion
and
disc
ussi
on
Inst
ruct
ion
man
uals
Rep
ort
OT
4To
get
an
idea
abo
ut th
eas
sist
ive
devi
ces
for
hear
ing
impa
ired,
thro
ugh
data
col
lect
ion,
grou
p di
scus
sion
, exp
ert
opin
ion,
fiel
d vi
sits
&O
JT. P
repa
re n
otes
•A
ssis
tive
devi
ces
for h
earin
gim
paire
d• •
Dat
a co
llect
ion,
grou
p di
scus
sion
,ex
pert
opin
ion,
field
vis
it &
OJT
Ref
eren
ce T
ext
Ass
ignm
ent
CT
105105105
Cur
ricul
umC
onte
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arni
ngM
ater
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Prod
ucts
/Ev
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tion
obje
ctiv
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rate
gies
Out
com
e
5To
get
an
awar
enes
sab
out t
he c
are
and
mai
nten
ance
of h
earin
gai
d th
roug
h gr
oup
disc
ussi
on, o
bser
vatio
ndu
ring
field
visi
t/ O
JT.
Prep
are
an a
ssig
nmen
t
Car
e an
d m
aint
e-na
nce
of h
earin
gai
ds
Gro
up d
iscu
ssio
n,ob
serv
atio
n, fi
eld
visit
/ OJT
,A
ssig
nmen
t
Ref
eren
ce T
ext
hear
ing
aids
–In
stru
ctio
nm
anua
l
Ass
ignm
ent
CT
6To
get
an
idea
abo
utco
chle
ar im
plan
tsth
roug
h da
ta c
olle
ctio
nan
d di
scus
sion
Coc
hlea
r im
plan
tsD
ata
colle
ctio
n,di
scus
sion
Jour
nals
, ref
er-
ence
text
,A
nim
ated
CD
s
Rep
ort
CT
106
IntroductionHearing aid is a device that brings sound to theear more effectively. It is a miniature audioamplifier specially designed for improvinghuman communication. Any individual who hasa hearing problem that cannot be helped bymedical or surgical means is a candidate forhearing aid. There are very few deaf peoplewho have no hearing whatsoever; It is muchmore usual to have some residual hearing. Ahearing aid system enable a hearing impairedperson to make maximum use of this residualhearing area, and provide maximum speechclarity and useful information fromenvironmental sound.
In this unit the working of hearing aid, its parts,components and types of hearing aids arediscussed.
By going through this unit the learner get anawareness about hearing aid system and itsapplications.
Curriculum Objectives3.1 To understand the need and working of
hearing aid through discussion, datacollection and chart preparation. Preparenotes
3.2 To familiarize with the circuit details ofhearing aids through demonstration anddiscussion. Prepare notes.
3.3 To understand different types of hearingaids through data collection, chartpreparation and discussion.
3.4 To get an idea about the assistive devicesfor hearing impaireds, through datacollection, group discussion, expertopinion, field visit and OJT
3.5 To create an awareness about the careand maintenance of hearing aid throughgroup discussion and observation.
3.6 To get an idea about cochlear implantsthrough data collection and discussion.
Syllabusl Hearing aids-Types including digital and
programmable aids-Parts of hearing aid-Group amplification system and otherassistive listening devices-Brief accountof main electro acoustic characteristics-Aided audiometry- Ling sound test- Careand maintenance of hearing aids-Introduction to cochlear implants.
Hearing AidLearning activity
- Discussion, Data collection, Chartpreparation.
Learning materials
- Models, Product Manual,Photographs, Prepared Chart
HEARING AIDS3
107107107
Reference text- Principles of hearing aid audiology
by Maryanne Tate Maltby
ProcessTeacher initiate a discussion on hearing aid byasking questions.
l What can be done if a person is havinghearing impairment.
l Do you see any person wearing hearingaid.
l
Teacher exhibits the prepared chart showingblock diagram of a hearing aid.
Divide the students into 4 groups, supplyreference materials. Let them identify thefunction of each block and present in the class.
Discussion points: -
l Microphone
l Amplifier
l Receiver
l Battery
Prepare notes based in this discussion
Other activities
- Ask the students to prepare a chartshowing the block diagram ofHearing aid.
Consolidation:- Microphone: Picks up the sound
signals and converted in to electricsignals
--
Out Come
The learner gets an awareness about theneed and working of hearing aid.
Evaluation TE
Complete the block diagram and explain.
3.2 Hearing Aid Circuit DetailsLearning Activity
- Demonstration and Discussion.
Learning Materials
- Circuit Diagram, Working inModel, Block Diagram.
ProcessTeacher demonstrates the working of a hearingaid in laboratory with the help of a workingmodel. The block diagram charts and circuitdiagram are displayed.
Students identify the parts according to blockdiagram.
Points:
1. Microphone
2. Amplifier
3. Controls
4. Battery (Power supply)
5. Receiver (Ear piece)
Let the students to draw the circuit diagramand block diagram in their notebook andprepare notes.
Other Activities
- Prepare a working model of lowcost hearing aid in laboratory.
Out Come
Students identify the circuit componentsof hearing aid
Microphone Receiver
108
EvaluationPE
3.3 Various Types of Hearing AidLearning Activity
- Data Collections, Chartpreparation, Discussion.
Learning Materials
- Photographs from reference books,Product Manuals,Charts referencebooks.
ProcessStudents collect the details of different varietiesof hearing aid. Teacher lead them into a discussionon the merits and demerits of each model, onthe basis of comfort, cost, effectiveness, problemin using, size. Divide the students into groups of5. Let each group prepare charts showing onemodel, its merits and demerits, applications andexhibit it in the laboratory.
Points:
Types of
l AC Hearing Aid
l B.C Hearing Aid
Basic varieties in A.C Hearing Aid
l Digital and programmable hearing aid
l Advantages and disadvantages of eachmodel
Note the points in a diary. Prepare notes basedon the above activities
Consolidation:
- Body Worn & AC type - Definition- BTE
- ICT
-
Other activities
- Prepare chart showing Hearing aidsand their features.
Out Come
Students understand the working ofHearing aid and its use.
Evaluation:O.T
3.4 Assistive DevicesLearning Activity
- Group discussion, Expert Opinion,Field visit/OJT
Learning Material
- Principles of hearing and audiologyby Maryanne tate
ProcessThe learner collects the reference materials tocreate an awareness about this topic. Duringfiled visit/ OJT the learner then collect moreinformation about assistive devices with thehelp of experts
Group Discussion
Divide the students into 5 groups and ask todiscuss the following points.
1. Assistive listening devices and systems
2. Alerting devices
3. Tele communication devices.
4.
Ask to prepare a note relating this topic.
Consolidation:
- Induction loops- Amplitude modulation- Frequency modulation- Alarm clock with flashing lights- TDDS
Out Come
The learner gets an idea about theassistive devices
EvaluationOT
109109109
3.5 Care and Maintenance of HearingAids
Learning Activities
- Group discussion, Observation,Field visit/OJT
Learning Materials
- Hearing aids, Instruction manuals
Reference text- Introduction to audiology for
teachers and professionals byMaryanne tate
ProcessThe learner can read out the print out relatingto the topic and discuss the following points ingroups.
Dicussion Points
l Visual check
l Listening check
l
The learner can observe the procedures duringfield visit
Ask the learners to prepare an assignment onthis topic.
Consolidation:
l Visual check
- Cracks in casing, tone hook- Wax in the microphone inlet-
Listening Check- The battery-- Listening through a stethoclip
Out Come
The learner gets an idea about the careand maintenance of hearing aids.
Evaluation
OT
3.6 Introduction to Cochlear ImplantsLearning Activity
- Data collection and discussionLearning Material
- Journals, Reference Text,Animated CD’S
ProcessThe learner collects the informations relatingto the topic from Journals and reference text.Divide the students into groups and discuss thefollowing points: -
1. Principles of cochlear implants
2. Components of cochlear implants
3. Advantages
4.
Note the points in a diary with the guidance ofteacher
During field visit or OJT the learner can collectmore informations with the help of an expertand using animated websites. Group leaderscan present the topic in class.
Prepare notes based on the above activities.
Consolidation
- Devices which converts soundsignals into electrical impulse whichdirectly stimulates the cochlea
Parts
1. Microphone
2. Speech processor
3. Electrodes
Out Come
The learner gets an idea about thecochlear Implants and its uses.
Evaluation:
OT
110
EAR MOULDS
4
111111111
UN
IT A
T A
GL
AN
CE
Uni
t 4 :
Ear
Mou
lds
Cur
ricul
umC
onte
nt/a
rea
Act
iviti
es/le
arni
ngM
ater
ials
Prod
ucts
/Ev
alua
tion
obje
ctiv
esst
rate
gies
Out
com
e
1To
cre
ate
an a
war
enes
sab
out e
ar m
ould
, typ
esof
ear
mou
ld, p
roce
dure
of m
akin
g ea
r mou
lds
and
its m
odifi
catio
nsth
roug
h ill
ustra
tion,
disc
ussio
n, fi
eld
visit
/O
JT. P
repa
re n
otes
Ear m
ould
s, Ty
pes,
Prep
arat
ion,
Mod
ifi-
catio
n
Illus
tratio
n, D
iscu
s-sio
n, F
ield
visi
t/ O
JTPr
epar
ed c
hart
s,Ph
otog
raph
s,re
fere
nce
text
-A
udio
logy
-M
arry
anne
Tat
e
Not
eO
T
112
IntroductionThe purpose of an ear mould is to secure theaid to the ear and convey sound in to the earcanal. The mould may also have significanteffect on the frequency response of the aid.By completing this unit the learner understandsthe various steps involved in ear mould makingand modification.
Curriculum objectives4.1 To create an awareness about ear mould,
types, Procedure of making ear mouldand its modification through illustration,discussion, field visit / OJT
Syllabusl Parts and types of ear moulds
l Procedure of making regular ear moulds
l Brief note on ear mould modification
4.1 Ear mouldLearning activity
- illustration, discussion, field visit /OJT
Learning materials
- Prepared charts photographs,Reference Texts: Principle ofHearing aid audiology byMaryanne tate.
ProcessTeacher exhibit a chart showing the features ofan ear moulds in relation to the pinna andillustrate
Points
l Purpose of ear mould
l Concept
l Features
l
Students redraw the diagram and prepare notes
Activity- Divide the students in to 5 groups
and supply reference materials tothem (5 different portions to eachgroup). Let them discuss thecontent and List out the points
Discussion points
l Impression materials-group1
l Ear impression equipment-group1
l Ear Examination-group2
l Ear impression technique-group3
l Ear mould materials-group4
l Ear mould types-group5 (also preparecharts showing different types)
l
EAR MOULDS4
113113113
Leaders of each group present the points inthe above given order. Teacher may add theleft out points. Note the points in a diary.During OJT / Field visit the learner strengthenthe concept by collecting datas. The learnercan observe the ear mould preparation duringthis period. Prepare a final report based onthe above activities.
Practicals
Ear mould preparation.
Out come
The learner understand the Earmould, itsuse, procedure of making ear mould andits types
EvaluationOT
114
5REHABILITATION OF CHILDRENS ANDADULTS WITH HEARING IMPAIRMENT
115115115
Cur
ricul
umC
onte
nt/a
rea
Act
iviti
es/le
arni
ngM
ater
ials
Prod
ucts
/Ev
alua
tion
obje
ctiv
esst
rate
gies
Out
com
e
UN
IT A
T A
GL
AN
CE
Uni
t 5: R
ehab
ilita
tion
of A
dults
and
Chi
ldre
ns w
ith h
eari
ng im
pair
men
t
1To
und
erst
and
the
vario
usre
habi
litat
ion
met
hods
adop
ted
for d
eaf a
dult
and
child
ren
thro
ugh
disc
us-
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116
IntroductionHearing loss is an under estimated impairmentthat may need to many secondary problems inaddition to primary communication difficulties.Suitable rehabilitation must be provided to deafadult. Specialist teachers of the deaf undertakethe rehabilitation of deaf children. The hearingaid audiologist can make a significantcontribution to the hearing impireds client’squality of life. The rehabilitation process maybe handled entirely by the audiologist.
In this unit various rehabilitation process ofdeaf adult and habilitation of children arediscussed. By going though this unit the learnerget a idea about the rehabilitation process –hearing aid fitting – auditory training – speechtherapy.
Curriculum Objectives5.1 To understand the various rehabilitation
methods adopted for deaf adult andchildren though discussion field visit andinterview.
5.2 To understand the various educationaloptions for hearing impared throughdiscussion, interview and OJT
Rehabilitation of Hearing impaired
Learning activities
- Discussion, Field visit, interview
Learning Material
- Reference text :- Principles ofhearing aid audiology (MaryanneTate), Expert opinion, (audiologist)
ProcessTeacher initiate the discussion on rehabilitationof deaf adult and children through a generaldiscussion.
Points:
l Handicapped persons in society
l What we can do for them?
l Role of Government, Society
l Deaf adult and children. What can bedone for them?
l .
l
After the discussion, teacher divide the studentsin to5 groups. Let the groups to visit the nearby deaf school to collect information byobservation and interview
Teachers give direction on important points tobe noted.
Points;-
l Hearing aid and aural rehabilitation
l Attitude of hearing impaired
REHABILITATION OF CHILDRENS &ADULTS WITH HEARING IMPAIRMENT5
117117117
l Practical aspects- Instruction- Insertion and removal of aid- Operating the hearing Aid and care
training
l Assistive devices
l Improving communications- Speech reading- Lip reading- Auditory training- Speech therapy
l Rehabilitation of deaf children- Rehabilitation process- Fitting of H.A to children- Cochlear implant- Educational provision
Divide the portion among the groups. Conducta discussion and group leaders present thereport
Teacher consolidate by adding additionalpoints
Ask the students to prepare notes based onthe above activities
Students prepare notes
Outcome:
Students get an idea about therehabilitation of deaf adult and children
Evaluation
OT
Educational options for hearingimpairedsCurriculum objectives
To understand the various educationaloptions for hearing impaired through
discussion, reference materials expertopinion, OJT , field visit
Learning materials
- Reference text, discussion
ProcessThe teacher can give the print outs to create anawareness of this topic
Points
l Need of educating the hearing impaireds
l The different methods of educationaloptions.
l
Notes the points in a diary. During the field visit/OJT the learner can strengthen his knowledgeby arranging an interview with the experts.
Consolidate the points of this topic after agroup discussion in the classroom. The groupleaders can present the report in the form of aseminar.
Consolidation
- Aural method- Signed method- Cued method--
Outcome
The learner gets an idea about the variouseducational method
EvaluationOT
118
REFERENCES
ECG
1 An introduction to electrocardiographyColin Schamroth7th editionBlack well science
2 Medical Instrumentation John G. Webster3rd editionJohn Wely & Sons INCNew York
3 Handbook of biomedical instrumentationR.S KandpurTata MC Graw Hell Publishing Company limited
4 ECG made easy John R Hampton
5 Principles of biomedical/ engineering for nursing staffHans A Von Des MoselBlack well Scientifc Publications
6. Introduction to biomedical equipment technology4th editionJoseph J CarsJohn M Brown
7 Biomedical instrumentationDr. M ArumughamAnuradha Agencies publishersVidhyal KaruppurKumbakonam RMS
8 Biomedical instrumentation & PublicationsLeslie CromwellFred J WeibellErich A PfeifferPrentice Hall of India Private Ltd.New Delhi 110001
119119119
9 Foundations of Anatomy & PhysiologyRoas & Wilson
10 Making sense of the ECG Andrew R. Houzhton & David Gray
11 A text book of Medical Instruments S. Ananthi
AMT
1 Martin F.N (1991) Introduction to audiology. IVED. New Jersey Frentice Hall
2 Newby H.A (1985) Audiology, Newyork, Appletion - Century Crofts
3 Katz J etal (Ed) 2002, Handbook of Audiology, Baltmore, Williams of wilkins.
4 Bassand Hummes (1990) Audiology - fundamental - Willams & Wilkins.
5 Human Anatomy - BD Chaurasia - volume three - Third edition, CBS, Publishers anddistributors, New Delhi.
WEBSITE
ECG• http://science.nhmccd.edu/biol/ap2int.htm• http://users.pandora.be/educypedia/education/electrocardiagram.htm• http://nobelprize.org/medicine/educational/ecg/index.html• http://www.rnceus.com/course_frame.asp?exam_id=16&directory=ekg• http://www.skillstat.com/ECG_Sim_demo.html• http://www.skillstat.com/CardiacDictionary_demo.swf• http://medmovie.com/mmdatabase/flash/0038a.swf• http://education.med.nyu.edu/courses/physiology/courseware/ekg_pt1/ekgmenu.html• http://www.ecglibrary.com/• http://highered.mcgraw-hill.com/sites/0072351136/student_view0/
laboratory_exercises.html• http://www.mamc.amedd.army.mil/medlib/ml_cmetut.asp• http://www.khake.com/page67.html• http://medweb.usc.edu/biomedinfo/index.html• http://www.pediheart.org/parents/tests/exercise.htm• http://www.wisegeek.com/what-is-a-treadmill.htm• http://www.pediheart.org/parents/tests/exercise.htm• http://www.nlm.nih.gov/medlineplus/ency/article/003878.htm• http://web.info.com/infocom.us2/search/web exercise%20treadmill? CMP=2553&itkw=
exercise%20treadmill• http://www.nlm.nih.gov/medlineplus/ency/article/003878.htm/article/003869.htm
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• http://www.nlm.nih.gov/medlineplus/ency/imagepages/8810.htm• http://www.nlm.nih.gov/medlineplus/ency/article/003419.htm• http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm• http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm• http://www.nlm.nih.gov/medlineplus/ency/article/007070.htm#visualContent• http://www.nlm.nih.gov/medlineplus/ency/article/000010.htm• http://depts.washington.edu/learncpr/index.html
AMT• http://www.audiologyawareness.com/• http://www.asha.org/about/membership-certification/certification/aud_standards_new.htm• http://www.aud.org.uk/contents/audiology.htm• http://www.thebsa.org.uk/websites.htm• http://www.vestibular.org/• http://www.audiology.org/• http://www.stronghealth.com/services/Audiology/earhealth/hearingtests.cfm• http://www.audiologynet.com/hearing-aids.html• http://ctl.augie.edu/perry/ar/ar.htm• http://www.phys.unsw.edu.au/~jw/dB.html#definition• http://linkage.rockefeller.edu/nshl/hls.html• http://www.oregonspeechandhearing.org/Professional/AudiologyWeb/default.asp
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