VOCATIONAL HIGHER SECONDARY

ECG & AMT

TEACHERSSOURCEBOOK (Class XII)

Government of Kerala Department of Education

2006

State Council of Educational Research & Training (SCERT)

Vidyabhavan, Poojappura, Thriuvananthapuram-12, Kerala

Government of Kerala Prepared by : State Council of Educational Research and Training (SCERT)
Vidyabhavan, Poojappura, Thiruvananthapuram - 12, Kerala

2006

Preface
Dear Teachers, One of the aim of education is to help the learners to internalise to the maximum the immense possibilities of the ever-expanding body of knowledge. The revision of curriculum and transactional strategies is aimed at changing the educational scenario. It is with this view that the ECG & AMT Sourcebook for Standard XII has been prepared. This Sourcebook for teachers includes many new concepts and principles along with suggestions for transactional strategies. The teacher is expected to select and use these strategies judiciously and transact them to learners. If the acquired knowledge is to contribute to the over all development of the learner, it has to be internalised through activities. For the effective transaction of concepts, clarity is as important as involving in meaningful activities. The sourcebook has been prepared as an instrument to equip the teacher with indication to make the activities more purposeful by specifying what help is to be given at which stage and how. It is hoped that the activities suggested in this book are suitable to the existing situation in our schools. It is also expected that the teacher has to seek help from other sources like general reference books available in various libraries, websites, etc. Only then we can attain the objectives of learning science practically and meaningfully. It is report that this Sourcebook will be utilised to its maximum for the effective transaction of the curriculum. With regards,
Thiruvananthapuram Dr E. Valsala Kumar Director SCERT, Kerala

Contents
Approach ............................................................... Subject Approach .................................................. Teaching Learning Strategies ................................... CurriculumObjectives ............................................ Syllabus ................................................................. Planning ................................................................. Evaluation ............................................................... Unit wise analysis
ECG Unit1 ElectroCardiography ......................... Unit2 Other Cardio Vascular Measurements and equipments ................................ Unit3 Cardiopulmonary resuscitation & Medical Ethics ................................. AMT Pure Tone and Speech Audiometry ..... Assessment of Hearing Loss ............... Hearing Aids ................................... Ear moulds ....................................... Rehabilitation Adults and Childrens withHearingImpairments ................... 05

23 25 35 38 42 46

56 72 84

Unit1 Unit2 Unit3 Unit4 Unit5

88 94 106 112 116

References ...............................................................

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GENERAL APPROACH

Significance of vocational education

The ultimate aim of education is human refinement. Education should enable the learner to formulate a positive outlook towards life and to accept a stand which suits the well being of the society and the individual as well. The attitude and potential to work has determined the destiny, progress and cultural development of the human race. As we all are aware, the objective of education is to form a society and individuals having a positive work culture. The educational process expected in and outside our formal schools should concentrate upon inculcating concepts, abilities, attitudes and values in tune with these work culture. Hence vocationalised education cannot be isolated from the main stream of education. In another sense, every educational process should be vocationalised. However due to our inability to utilize the resources wisely, scarcity of job opportunities is a severe issue of the present society. For overcoming this deep crisis, emergent techniques have to be sorted out and appropriate researches have to be seriously carried out. It is in this sense that the content and methodology of Vocational Higher Secondary Education have to be approached. The need for meaningful linkages between the world of work and world of education is well recognized. The essence of the recommendations made by various commissions and committees is that the vocationalisation should be the main feature of the future system of education at the higher secondary stage, it can be extended to school level also. Vocational Education is the system of education which intends to prepare students for identified occupations , opening several areas of activities. The Vocational Higher Secondary course envisaged as a part of the National Policy on Education with the noble idea of securing a job along with education. The relevance of vocational education is very great in this age of unemployment. This education system, which ensures a job along with higher education stands aloof from other systems of education. This education imparts the life skills required by the youth to enter the world of work and assuming the responsibilities of adulthood. As per the expert meeting report (2001) of UNESCO, the life skills are grouped under 4 categories. They are

1. 2. 3. 4.

skills for personal fulfillment skills for living in society skills for dealing with changing economies skills for dealing with changing work patterns.

Vocational Education ensures fulfillment of manpower requirement for national development and for social security for the citizens through self-employment. It also helps to reduce the migration of rural youth to urban areas and thus helps in rural development. The learners of Vocational Education get an opportunity to avail one year apprenticeship training in industries to improve their practical skill. During the course of study, on the Job Training (OJT) for 10 days in a year is arranged to improve the skill and efficiency of the learner. This education system motivates the attitude towards self 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 of vocationalisation of education, considering the following objectives. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. To fulfill national goals of development and the removal of unemployment and poverty. To impart education relevant to increased production and productivity, economic development and individual prosperity. To make available skilled work force at all levels to alleviate the rural unemployment and for the development of nation. To develop environmental awareness to ensure sustainable development. To develop vocational aptitude, work culture, values and attitudes of the learners so as to enrich the productivity of the nation. To develop entrepreneurial competencies and skills of learners for self reliance and to undertake gainful self employment. To facilitate the expansion of higher education and explore future opportunities through innovative guidance and programmes. To develop vocational competencies, creative thinking in the related areas and facilitate training. To create awareness on mental, physical and social health. To acquire awareness about different job areas and to provide background for acquiring higher level training in subjects concerned.

LEARNING
Learning is construction of knowledge through a continuous mental process. It is an advancement through adding and correcting in the light of comparing the new issue with the previously learned concepts. It is an intellectual process rather than the mere memorization of facts. Learning is a conglomeration of a variety of activities like problem solving, finding out co-rrelations, prediction, arriving at conclusions, rational as well as critical thinking, finding applications, grouping for other possibilities and extracting the crux when opportunities are provided for intellectual processes learning will 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. It should be democratic in content and process and should acknowledge the rights of the learner. It should also provide opportunity for better citizenship training. The concept of equality at all areas should get recognition in theory and practice. There should be conscious programme of action to develop nationality, humanness and love against the encroachment of sectarianism of caste and religion. The learner should become cognizant of the implications of privatisation, liberalisation, globalisation etc. 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 well being. 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 influence our educational philosophy. The solution to the present day perplexities of the society which approaches education on the basis of competitions and marketisation is only a comprehensive view of life. It is high time that education was recognized on the basis of the philosophy of human education. The human approach to education has to reflect in its content, learning process and outlook. The perspective of learning to be and learning to live together as expressed by the UNESCO and the concepts of existential, intrapersonal and interpersonal intelligence. The basis of new approaches on curriculum and teaching- learning process are derived from 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 teaching process has to be changed timely. It is the result of the rapid growth and development

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 2 3 4 5 6 7 8 9 10 Great curiosity Good imagination Numerous other qualities and interests Independent individuality Interest in free thinking and working In a fearless atmosphere. Interest in enquiring and questioning. Ability to reach conclusions after logical thinking. Ability for manifest arid establish freely the conclusions arrived at. Interest for recognition in the society. Determination to face the interference of society and make components which is a part of social life.

When we consider the learning system, the domains to be stressed in education according to the modern development becomes relevant. The knowledge domain consists of 1 2 2 3 Facts Ideas Laws The temporary conclusions and principles used presently by scientists.

The learning is a process. The continuous procedures we undergo to reach a particular goal is process. The skills which are parts of the process to analyze the collected ideas and proofs and come to a conclusion is called process skills. Some important process skills are, the skills; 1 2 3 4 5 6 7 To observe To collect data and record To classify To measure and prepare charts To experiment To predict To recognize and control the variables

8 9 10 11 12 13 14 1 2 3 4 5 6

To raise questions To generalize To form a hypothesis and check. To conclude To communicate To predict and infer To use tools. To visualize To connect facts and ideas in new ways. To find out new and uncommon uses of objects To fantasize To dream To develop creative isolated thoughts

In addition to this, consider the skills related to creative domain also, they are skills:

Again, the following factors consisting in the Attitudinal domain are also important as; 1 2 3 4 5 6 1 2 3 4 5 Self confidence Love for scientific knowledge Attitude to know and value history Respect human emotions Decide with reasonable present problems Take logical decisions regarding personal values observe in daily life examples of ideas acquired. take the help of scientific process to solve the problems of daily life. choose a scientific life style connect the ideas acquired with other subjects. integrate the subjects with other subjects.

As regards the application domain the important factors are the ability to:

Some basic stands have to be taken on the new scientific knowledge about intelligence learning and teaching. When such basic concepts are accepted changes are required in the following factors.
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1 2 3 4

The vision, approach, structure and content of the curriculum. The vision, approach, structure and content of the textbooks. Role of the teacher and the learner. Learner atmosphere, learning materials and learning techniques.

Some scientific perspectives accepted by modem world in Educational Psychology are given below.

Constructivism
This approach puts forward the concept that the learner constructs knowledge. New knowledge is constructed when ideas are examined and practiced in new situations relating them with the previously acquired knowledge and experience. That is assimilated into the cognitive structure of ones knowledge. This method which gives priority to critical thinking and problem solving provides opportunity for self motivated learning.

Social Constructivism
Social constructivism is a branch of constructivism. Knowledge is formed, spread and imbibed and it becomes relevant in a social environment. Interactive learning, group learning, co-operative participatory learning, all these are concepts put forward by social constructivism. The main propounders of constructivism are Piaget, Vygotsky and Bruner. Discovery learning and interactive learning have prime importance. Learning takes place as a part of the attempt for problem solving. The activities of a learner who confronts cognitive disequilibrium in a learning situation when he tries to overcome it leads to the renewal of cognitive structure. It is through this process construction of new knowledge, the assimilation of them takes place. Observation and enquiry are unavoidable factors. The learner advances towards new areas of acquisition of knowledge 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 facts cognitive 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 crux and other processes are of critical importance in learning. Constructivism gives greater predominance to co-operative learning. Social and cultural factors influence learning. Sharing of knowledge and experience among learners, collective enquiry, assessment and improvement, group activity and collaborative learning by sharing responsibilities with the objective of public activity, provide opportunity for effective learning.
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In learning internal motivation is more important than external motivation. The learner should have interest and initiative in learning. Learning situation should be capable of forming 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 and wider.

NEW CONCEPTS OF LEARNING

1. Discovery Learning The teacher has to create a motivating atmosphere for the learner to discover concepts and facts, instead of listening always. Creating occasion to progress towards discovery is 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 Burners theory. Here discussion is not opposing each other. It is a sharing on the plane of ideas. New ideas are arrived at by seeking explanations, 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 the responsibility of learning it. It is an inborn tendency to act to solve a problem that causes cognitive disequilibrium in a particular area. It is also needed to have confidence that one is capable of doing it. The problems are to be presented in consideration of the ability and level of attainment of the learner. 4. Collaborative learning This is the learning in which the responsibilities are distributed among the members of the group keeping common learning objectives. The common responsibility of the group will be successful only if each member discharges his duties. All the members will reach a stage of sharing the result of learning, equally through the activity with mutual understanding. The teachers who arrange collaborative learning will have to make clear the responsibilities to be discharged. This is possible through the discussion with the learners. Collaborative learning will help to avoid the situations of one person working for the whole group. 5. Co-operative learning This is the learning in which the learners help one another. Those who have more knowledge, experience and competency, will help others. By this exchange of resources the learners develop a plane of social system in learning also. As there are no high ups and 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 not to lead this seeking of help to mechanical copying. It should be on the basis of actual needs. So even while encouraging this exchange of ideas, among the members of the group cautious acceptance is to be observed as a convention. There should be an understanding that satisfactory responses should come from each member and that the achievement of the group will be assessed on the basis of the achievement of all the members 6. Zone of Proximal Development Vygotsky observes that there is a stage of achievement where a learner can reach by himself 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 by themselves there is the possibility of a higher excellence. If appropriate help is provided every learner can better himself. 7. Scaffolding It is natural that the learner may not be able to complete his work if he does not get support at the proper time. The learner may require the help of the teacher in several learning activities. Here helping means to make the learner complete the activity taking responsibility by himself. The teacher has to keep in mind the objective of enabling the 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 to facilitate the creation of learning opportunities. Learning can be made effective by providing learning experiences involving mental processes like 1 2 3 4 5 6 7 8 9 Retrieves/recollects/retells information Readily makes connections to new information based on past experiences and formulates initial ideas /concepts. Detects similarities and differences Classifies/categories/organizes information approximately. Translates/transfer knowledge or understanding and applies them in a new situation. Establishes cause-effect relationships Makes connections/relates prior knowledge to new information/applies reasoning and draw inferences Communicates knowledge/understanding through different media. Imagines/fantasies/designs/predicts based on received information

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10

Judges /appraises/evaluates the merits or demerits of an idea/develops own solutions to a problem.

9. Intrinsic Motivation Intrinsic motivation is given more importance than extrinsic motivation. The teacher has to arouse the internal motivation of the learner. A person internally motivated alone can immerse in learning and own its responsibility. 10. Multiple intelligence The Theory of Multiple Intelligence put forward by Howard Gardener has created a turning point in the field of education. The National curriculum documents has recommended that the curriculum is to be designed taking into consideration of this theory.

MAIN FACTORS OF THE INTELLECT

1. Verbal/linguistic Intelligence Ability to read and write, making linguistic creations, ability to lecture competence to effective communication, all these come under this. This can be developed by engaging in language games and by teaching others. 2. Logical/mathematical Intelligence Thinking rationally with causes and effect relation and finding out patterns and relations come under this area. Finding out relations, explaining things, sequential and arithmetical 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 into visual form and in philosophers, designers and sculptors this area of intelligence is developed. 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 more developed in dancers and actors who are able to express ideas through body movements 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 to recognize the different elements of music in musicians and in those who can here and enjoy songs. Playing musical instruments, imitating the songs of musicians, listening silently to the rhythms and activities like this are capable of developing this area of intelligence.
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6. Interpersonal Intelligence Those in whom this area of intelligence is developed show qualities of leadership and behave with others in a noble manner. They are capable of understanding the thought of others and carrying on activities like discussion successfully. 7. Intrapersonal Intelligence This is the ability to understand oneself. These people can recognize their own abilities and disabilities. Writing diaries truthfully and in an analyzing way and assessing the ideas 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 interest in 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 to distinguish the meaning and meaninglessness of life, the ability to realize the ultimate nature of mental and physical existences, all these are the peculiarities of this faculty of intelligence.

EMOTIONAL QUOTIENT
The concept of emotional intelligence put forward by Daniel Golman is used in framing the new curriculum. The fact that ones Emotional Quotient (E.Q) is the greatest factor affecting success in life is now widely accepted. The teacher who aims to focus on improving 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, the students may be allowed to take part in the decision making process. Taking decisions through open discussion in the class, inviting students suggestions on common problems etc. are habits to be cultivated. ii) Ability to reach consensus When different opinions, ideas and positions arise, the students may be given the responsibility to reach a consensus. Imagining what would be the course of action in some situtations, allowing to intervene in a healthy way in problems between individuals. Developing the idea that there is reason and solution to any problem. Training in finding reasons for problems.

iii) Problem solving

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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 influence classroom learning and for which the learner can actively contribute solution needs to be posed 1 2 3 Self criticism, evaluation Ability to face problem-situation in life Thinking what one would do if placed in the situation of others, how one would respond to certain experiences of others - All these foster the growth of emotional intelligence.

iv) Life skills Life skills need to be given a prominent place in education. W.H.O. has listed : skills required for-success in life. 1 2 3 4 5 6 7 8 9 10 Self awareness Empathy Inter personal relations Communication Critical thinking Creative thinking Decision making Problem solving Coping with emotion Coping with stress

THE NEW CURRICULUM ADDRESSES THESE AREAS.

Knowing the characteristics of the learner, role of the teacher and how to use the teachers 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 for teaching. But in the new method of education the student centered approach is given more importance than the teacher centered approach. Under this changed scenario the teacher has to perform the following roles in the classroom.

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The teacher should be 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

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A facilitator of learning A guide to the overall development of the student A good observer and motivator Able to consider the activities, needs, special features and age group of students at higher secondary level. Able to understand the limitations of learner and their learning problems. An instructional material developer A good communicator An innovator Able to raise leadership qualities and self confidence of the learner An authoritarian in the concerned subject Able to arrest and sustain the attention of the learner Able to bring out and encourage the inborn talents. A resource manger to ensure the optimum utilization of resources. A systematic record keeper A controller to issue guidance to the students A person with high level of practical competency Able to correlate area of study with familiar environmental situations A self evaluator and good listener Able to create awareness in social problems A person with democratic and humanitarian approach A professionalist as well as philosopher A good evaluator A good organizer and a friend. A co-learner as well as co-researcher Able to give assistance and advice in placement needs and self employment by giving moral and technical support Able to keep moral values A person equipped with skill for using new techniques of learning Optimistic and impartial

Child friendly Class Room Atmosphere

Learning can be effective and enjoyable only when the class atmosphere is according to the new conception of learning and the characteristics of vocational higher secondary teacher. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Class and seating are arranged in an attractive way Democratic nature is upheld Always active Students interact with teachers without fear Opportunity for a variety of activities Students allowed to involve interesting group activities Learning speed, learning style and different levels of attitudes are considered. Help is extended whenever needed. Sufficient instructional materials are available There is freedom of expression, students share their ideas and experiences Students are given acceptance and encouragement Healthy atmosphere Needs of each student is given consideration. Happy and energetic atmosphere Teachers work considering the rights of students Prtoblems handled in a patient way 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 psychological problems and varying socio-cultural background. The learning experiences provided must help to bring the low activities to an expected level and extended the breadth and depth of the skills of the high activities. By repeating experiences, introducing variations in a learning experience to suit different levels and if needed, formulating additional experiences the problem of varying ability levels can be tackled.

Role of Learner
The learner in second year VHSE has undergone a learner centered and process oriented learning experience up to first year. The learner at this age is in awakening stage and he is 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 to select vocational subjects according to his aptitude and interact and to acquire higher education and profession as he wishes. The aspirations about future life is framed in this particular age for seeing national and international job opportunities. Some of the peculiarities of learner at this stage are 1 2 3 4 5 6 7 8 1 2 3 4 Physical, intellectual and emotional plans have intensive changes during the age and their reflections can be observed Ability to enquire discover and establish cause effect relationship between phenomena Readiness to undertake challenges Capacity to shoulder leadership roles Attempt to interpret oneself Susceptibility to different pressures Doubts, anxieties and eagerness about sex Imaging for social recognition To make acquaintance with a job or self employment through vocational education To acquire more knowledge in the concerned area through higher education To recognize and encourage the peculiar personality of the later adolescent period To enable him to defend against the unfavorable circumstances without any help Active participant in the learning process Act as a researcher Sharer of information Sharer of responsibilities Collect information Takes leadership Involves in group work Act as a co-participant

Needs of Learner

Role of learner 1 2 3 4 5 6 7 8
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9 10 11 12

Observes his environment Experiments and realises Make interpretations and draw inferences 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 evaluation should be made. Evaluation must be a systematic and continuous process. As the curriculum is based on vocational stream, capacity building is a most important part and it should be evaluated accordingly. The technical skills, interest in the particular field, communication skill, analysis organizing and presentation skills etc have to be evaluated. 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 organized and a proper learning atmosphere is to be provided. Many organizations can support the learning activity. They are:1. School Resource Group (SRG) Comprising all teachers (vocational and non vocational) instructors, and lab assistants with academic head as the group leader. 2. School Support Group (SSG) Comprising PTA president, members of local bodies, members of social clubs, subject experts etc who can contribute guidance /technology /infrastructure /financial assistance 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 infrastructure ie, class rooms, laboratory, library, seminar hall, audiovisual equipments etc. 5. Subject club All vocational teachers handling same vocational subjects should form a subject club at regional level or district level. This will helps to share the knowledge and practical facilities, 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 provide facilities 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 helps for OJT , PTC and field visit.

Monitoring system
Education is a sort of journey from darkness to light satisfying the needs and the wants of the individual and the society. The modernization of education through activity oriented system enhances free thinking and working in a fearless atmosphere. It is a qualitative process not a quantitative one. This necessitates a proper monitoring system. The system of monitoring should have the following features. 1) 2) 3) 4) 5) It must be transparent. It must enrich the ideas of the facilitator through innovative process. It must be time bound and rational. It must motive the facilitator to adopt new strategies. It must be recordable and ensure effective feedback for the effective monitoring of the system, three levels of the mechanism should be setup. 1. 2. 3. School level monitoring group. Regional level monitoring group. State level monitoring group

Moreover a social auditing system is advisable to achieve the objective effectively.

FEATURES OF LEARNING PROCESS IN THE NEW SYSTEM OF 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 2 3
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A continuous mental process Simple learner must feel that he is able to undertake the task Enable the learner to attain the curriculum objective

4 5 6 7 8 9 10 11 12 13

Interesting Suitable to the age and attitude of the learner Future possibilities Enable group activity Challenging Time bound Constructive and curiosity developing Possibilities for evaluation Capacity to generate independent thinking Ability to enquire discover and establish cause effect relationship between phenomena.

Learning Aids
To make the teaching and learning process simple and effective , certain learning aids and necessary use of such aids for transacting a complex idea make the class room live and students get more and more involved. The advances in science and technology may be effectively utilized for this purpose. Some of the learning aids listed below. 1 2 3 4 5 6 7 8 9 10 11 12 13 Multimedia Over Head Projector Computer Internet Liquid Crystal display Projector TV, VCD, DVD and tape recorders Working models Charts Slides Video Conferencing facility Library Text book Source book

Society
The new educational policy uplifts the social commitment of the learner. Therefore the 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 the betterment of society. The social obligations can be illustrated as follows. 1 2 3 4 5 6 To enrich social values, aptitude and ability in learner To develop entrepreneurial aptitude and ability which helps social welfare and self employment New system of education adopts OJT, PTC etc or part of vocational curriculum which helps to make close contact with the society. The resources available from our society can be positively utilized to convene seminars, interview etc. Social organizations can help learners to make their education socially committed. The social clubs like NSS, Tourism Club, CDO Club, Energy Club etc functioning in 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 science group 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 set up. In these circumstancesECG & Other Cardiovascular measurement techniques included in the curriculum are essential for proper diagnosis. The purpose of this course is to create skilled technicians to meet the heath needs of society. Despite the appearence over the last decades of the large number of novel instrumental techniques for the diagnosis of cardiovascular diseases, electrocardiography remains the most important and commonly used single diagnostic procedure, in this field. Millions of ECGs are recorded annually and then often help the physicians to make the correct diagnosis, evaluate myocardial functions and monitor the efficiency of treatment. It has been demonstrated by many authorities that the adequate clinical diagnosis is now a days virtually impossible without ECG. As a result electrocardiography found wide spread application not only in cardiology but 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 knowledge of audiology is essential for all those working in audiology laboratories and with hearing impaired pupils. The aim of the course curriculum is to create an awareness about clinical audiological procedures 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 about the subject. To develop skills in various learning activities in a co-operative, collective and creative way. To develop an idea about the opperation of advanced cardiovascular measurement techniques 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 the students to enhance their opportunity in higher studies. The learning of ECG should also be through activities. The content based approach should be replaced by the process approach which gives adequate emphasis to develop their vocational skill. Learning of ECG needs to be Activity oriented Process oriented Learner centered Environmental based

Life oriented The new approach gives emphasis to Multiple intelligence Co-operative learning Constructivism

Emotional quotient Content The course content in second year ECG includes ECG, other cardiovascular measurements and equipments, cardio pulmonary resuscitation and medical ethics. The course content in second year AMT includes pure tone and speech audiometry, assessment of hearing loss, hearing aids, ear moulds and rehabilitation of children and adults with hearing impairment.

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LEARNING STRATEGIES

n the modern era of globalization the introduction of new technologies ensure only the survival of the fittest. So it becomes a necessity to equip the learners to face the growing challenges in the competitive world. Hence the traditional approach to learning is no more relevant in the present context. The teacher should use instructional techniques that motivate the students to construct his own knowledge. Now the learners are not passive listeners, but they are the active participants in the construction of knowledge. Here the teacher student interaction should be given much importance. In the new instructional strategy while selecting the methods of teaching, the social 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 according to the discretion of the teacher. To obtain the objectives, the new system of education is introduced in the Vocational Higher Secondary Education for attaining the objectives of the courses in this system, we can adopt the following strategies.

I. Assignment
Assignment is some specific work assigned to the students as a part of their academic enrichment. There are learning activities undertaken as a continuation of class room activities to realize the curriculum objectives to a broader extent . They should be completed in time bound 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 achieve fruitful results. The teachers may at as a guide. Assignment may be given on individuals or group basis. Assignment includes preparation of notes, preparation of charts, models, collection of materials from institutions etc. Assignments develop skills of reference, observation, enquire reporting etc. It ensures the effective utilization of leisure time of the students.

II. Seminar
Seminar is a learning strategy involving an in-depth analysis of specific topic, preparation of a paper 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 can participate. The students get an opportunity to clear their doubts and make clarification. Seminar helps to develop communication skill and overcome stage fright.

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Stages 1.
2. 3. Selection of Topic: The topic of seminar should be relevant to the subject of study Assignment of topic to individuals students or team: The topic may be assigned to one student or to a group of students. Collection of relevant information: Information required for seminar can be collected from various sources namely books, magazines, internet, institutions, place and persons. Preparation of draft paper: Based on the information collected the student may prepare a draft paper and submit it to the teachers for comments. Revise the draft paper based on the comments of the teachers. The refined draft is submitted for approval. Program scheduling: The date, time and venue of the seminar is fixed. A seminar leader may be selected from the students Seminar paper presentation: The student/ students shall present the paper in the seminar. The teacher may function as the moderator during the initial stages. Discussion / Interaction: A number of respondents from the students make comments on the topic. This will be followed by a general discussion. All the group members should actively participate in discussion. Summing up deliberation: The moderator sums up the deliberation Evaluation / Feed back: Both teachers and students evaluate the programme. Preparation of final report: A final seminar report is prepared covering all the additional points discussed and consolidated.

4.

5. 6. 7.

8. 9. 10.

III. Panel Discussion

It is a learning strategy in which a panel of experts are allowed to discuss a specific subject under the control and direction of a moderator. Subjects can be divided according to the number of panel members. Number of panel members are fixed according to subdivision of points 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 to start the discussion. Each panel member is invited for discussion afterwards. After briefing by the panel members the questions are raised from the audience and the panel members give suitable answer to them. A report should be submitted by each learner to the moderator.

26

IV. Project
Project is a self-learning strategy which can exert great influence on the overall development of the learner. Project as learning strategy is to be selected where a problem arises in any part of the curriculum. The students may be divided into groups and assigned different aspects of the problem. Each group works independently .Specific aspects of the problem such as data collection, classification, analysis, report preparation and presentation is to be undertaken by each of the members. Even though the work is divided among the members, it must be ensured that the execution of each and every activity is done with the active participation of all. After analyzing data collected from different sources, the learner arrives at a conclusion that can help to solve the problem. Thereby learner learns the topic though his own activity. The other advantage of this learning activities is that it helps the learner to scientifically handle any problematic situation. It helps in the development of scientific thinking and thereby builds up the 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 for projects sake. The topic or problem should arise from the curriculum. 2. Planning of the Project (a) (b) Hypothesizing: Hypothesizing means making assumptions based on the available primary information. Methods and Technique : The methods and Technique should be based on the aim and Hypothesizing of the Project. The nature of the project, suitability of the tools, 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 be used based on the objective of the project. Suitable questionnaires are to be prepared for the 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 graphs and diagrams and maps will positively help the analysis. The similarities, relations and differences gathered from the analyzed information would tell whether the hypothesis should be accepted or rejected.

27

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. 2. 3. 4. 5. 6. 7. 8. 9. Title Preface Hypothesis and aim Methodology Sources of data Analysis and conclusion Suggestions (if any) References 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 this presentation that ideas are shared with others in the class and society. The project methods promotes scientific self learning and makes him capable of solving the problem arising in real life situations.

V. Debate
Debate is a hot and interesting learning activities. A debate can be organized only on a topic on 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 to society. Students with different opinions have to be identified for discussion. Those who have similar opinion should join together to form a side . Those who hold the opposite view with form the other side. It would be ideal to write down the topic of the debate and displayed in advance. 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 other means

Stage of Debate 1.
2. 3.
28

Topic Selection Selection of panels keeping in balance with intelligence, gender etc. Selection of moderator

4. 5. 6.

Collection of information guided by the teacher Conducting the debate under the control of moderator by avoiding any sort of personal conflicts 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 an actual event or situation. It presents real pictures of situation with facts, objective information or 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 and theory 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 of specific on the job problem and also acquire knowledge of the latest concepts and principles 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. 2. 3. 4. 5. Collection of data Conversion of data into information Analysis of the case in groups Presentation of the finding by each group leader. Evaluation

In addition to the above mentioned learning strategy there are many other learning strategies which 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. 2. 3. 4. No response is wrong. So welcome every response. Welcome as many responses as possible No criticism is allowed Allow to work on others idea

Steps in Brain storming 1.

Presentation of the problem

29

2. 3. 4. 5. 6.

Provide relevant information Record the ideas put forth by the participants Combine similar ideas

Evaluate each idea and solution 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 stage of learning with fellow students and teachers. In general discussion the teachers should guide the discussion through questioning and summarizing. The major steps involved are 1. 2. 3. 4. Introduction initiated by the teacher Development of discussion by giving lead points and follow up interactions Transaction stage in which the key points are reviewed by the teacher and Summarizing stage in which teacher provides additional support materials to ensure the achievement of the objectives

IX. Group Discussion

Group discussion is an ideal method to develop cooperation, democratic attitude, friendliness and compromising attitude which are the ultimate aims of education. During group discussion the teacher may observe each group and it needed help them to channel the discussion towards the common objectives. All students may be given opportunity to take part and express their ideas within a time limit. The conclusion reached may be entered by each student. A group representative must present this during consolidation in which the teacher may correct or add informations 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 provides direct experience to learn. An exhibition of collected materials will help to strengthen the concept.

XI. Practical works

Experimentation contains the process skill in an integrated way. In the new approach of curriculum 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 doing an experiment is to explore new ideas through investigation only. Its main purpose is to verify

30

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 practice along with investigation and invention. Continuous practice transforms the unskilled to the skilled. This is the significance and importance of practical in the Vocational stream. Hence it is very crucial that Vocational teachers as well as instructor should understand the importance of vocational practical and act accordingly.

XII. Quiz
Quiz programmes can be used as an interesting class room tool for transaction of curriculum objectives 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 a particular team and the other teams to answer them if they can answer the question they get points 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 equal number of chances to ask the question . Time limit is also prescribed for the conduction of the programme. The team who scores maximum points wins All the participants can make notes on the questions asked, answers and their explanations which 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 models and working models help the students to understand the structure, working principles, actual operation etc. Several steps are involved 1. 2. 3. 4. Locating the problem The teacher should plan the type of model according to COs Grouping the students Briefing the tasks
l l l l

Aim Need Material required Source & Materials

31

l l l l

Cost of materials Division of Labour Guidance Fixing of a time limit

5.

Presentation by each group about

l

How the models were prepared Details of - Expenses

Working and principles Finally documentation of the process

6.

Evaluation
l

By the other groups Later a consolidation by teachers are to be done.

XIV. Games
Class rooms can be made attractive by introducing different types of games. Games should be interesting as well as informative. Some of suitable games are 1. 2. 3. 4. 5. Odd man out Cross word puzzles Match the following Aswamedham Link game Answer using clues.

XV. Survey
This strategy involves collection of data from the group under study (book, person, materials etc.) It develops the social interaction and communication ability of the learner. It also provides a scope for discovery learning.

Step involved in survey 1

2 3 Objective of survey Selection of area for survey/sampling frame Selection of survey method

32

Direct method With help of questionnaire/schedule 1 2 Tabulation and analysis Consolidation and Presentation

XVI. Exhibition
It is a learning strategy by which the learner can get a chance to show the skill developed. It provides the intrinsic motivation and exposure. Exhibition item can be conducted either individually or as a group task. It can be conducted at school / Regional/State/National level. Necessary publicity and other arrangements can be provided. Presentation, documentation, participation and innovative skills of the learner can be 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. 2. 3. 4. 5. 6. 7. 8. How to introduce a problem? Invite a resource person Decide the questions by learners Decide the time, place etc. How to discuss? How many students to participate? Implementation of the interview Conclusion (Facilitator)

Items required
1 2 Interview Schedule List of questions prepared by learners Selection of students, selected names sequence of question

XVIII. Field Visit

Field visit is an inevitable vocational tool to be implemented in Vocational Higher Secondary Education. This helps the students to familarise with the modern technologies and new situation in a different atmosphere. It provides learning though viewing. It is based on the principle that seeing is better than having. It enables the learning to retain the learned information longer and
33

to make the subject more interesting. It motivates and give more confidence in his/her particular vocation. The facilitator should identify suitable center/ institution/site. Get prior permission from the authorities before conducting the field visit. Give instructions to the learners for collection data/information/materials/specimens. Teacher may assign different duties to learners by working them different groups. Each learner should take utmost care and interest during the visit. He/She should observe and interact 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 future carrier. 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. 2. 3. 4. 1. 2. 3. 4. 5. Material/Item/Process Demonstration Venue Additional requirements depending upon the nature of the item Introduction about the item/Material Principles Working Operation Components Merits of the item

Demonstration Process

XX. Chart display

It is also one of the important teaching aids. It can be used in every activities of a learning process. Chart display is a written or pictorial representation of idea or concept. It is abbreviate, brief and clear. It is prepared by study

Benefits
1. 2. 3. A learner gets clear idea about the concept The leaner can retain the ideas in his mind for longer periods A complicated idea can be simplified though a chart

Cheap method of teaching aid.

34

CURRICULUM OBJECTIVES
UNIT 1 Electrocardiography

1.1 To understand the history of ECG through brain storming and group discussion. Prepare notes. 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. Prepare notes 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 and under damping through observation, discussion and practicals. Prepare a chart demonstrating the damped condition. 1.7 To understand the precautions and patient preparation before recording ECG through discussion, 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 and observation. Prepare a note 1.11 To get an idea about abnormal ECG waveforms associated with certain diseases through interview, seminar, reference materials, IT support and group discussion. Present the seminar report. 1.12 To understand the common artifacts occurring in ECG recording and able to minimize those artifacts through observation, discussion. Prepare an assignment. 1.13 To get an idea about various ECG recorders through field visit, OJT and assignment.

35

UNIT - 2 Other Cardiovascular measurements and Equipments 2.1 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 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 and pulse 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 audiological evaluation though demonstration, discussion and chart preparation. Prepare notes. 1.2 To understand procedure and operation of pure tone audiometry and to plot audiogram through, 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, data collection, practicals. Prepare notes. UNIT - 2 Assessment of Hearing loss 2.1 To get a brief idea about case history evaluation through data collection, discussion and OJT. Prepare notes. 2.2 To understand the screening procedure for evaluating hearing loss through data collection, discussion. Prepare notes.
36

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. Prepare an 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 data collection, field visit / OJT. Prepare an assignment. 2.7 To get an awareness about the special audiometric tests used for differentiating sensory loss from retro cochlear disorders through discussion, practicals and observations. Prepare notes. UNIT - 3 Hearing Aids 3.1 To understand the need and working of hearing aid through discussion, data collection and chart 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 and discussion. 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 group discussion, observation. Prepare an assignment. 3.6 To get an idea about cochlear implants through data collection and discussion. Prepare notes. UNIT - 4 Ear Moulds 4.1 To get an awareness about ear mould, types, procedure of making ear mould and its modification 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 though discussion, 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

37

SYLLABUS
ELECTROCARDIOGRAPHY & AUDIOMETRIC TECHNICIAN SECOND YEAR
Total duration Theory Practical 560 hrs 140 hrs 420 hrs

ELECTRO CARDIOGRAPHY
Unit No. Name of the Unit Theory Practical

1 2 3

Electro Cardiography Other Cardio vascular measurements & Equipments Medical ethics & Cardio pulmonary resuscitation
Total

30 Hrs 28 Hrs 4 Hrs

62 Hrs

75 Hrs 50 Hrs

125 Hrs

AUDIOMETRY
Unit No. Name of the Unit Theory Practical

1 2 3 4 5

Puretone & Speech Audiometry Assessment of hearing loss Hearing aids Ear moulds Rehabilation of children and adults with hearing impairment.
Total

10 Hrs 20 Hrs 10 Hrs 20 Hrs 18 Hrs

78 Hrs

100 Hrs 35 Hrs 10 Hrs 30 Hrs

175 Hrs

PRACTICALS
Hospital visit (ECG & AMT) 120 Hrs

38

ELECTROCARDIOGRAPHY 1. Electrocardiography 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 3 History and introduction Basic principles of E.C.G Lead system Normal E.C.G wave form Abnormal patterns-brief description E.C.G instrumentation Details of E.C.G machine with block diagram Procedure for E.C.G recording Artifacts in E.C.G recording Types of E.C.G recorders [28 Hrs] Tread Mill Test Holter monitors ICU Monitors ( Monitors for Electrocardiography and pulse frequency measurement) Cardiac Catheterisation Blood pressure measurement Auscultatory method in detail Echocardiography Defibrillators Pacemakers [4 Hrs] [60 Hrs] [75 Hrs] [30 Hrs]

Other cardiovascular measurements & Equipments

Medical Ethics and Cardiopulmonary Resuscitation Hospital Visit PRACTICALS

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
39

Measurement of B.P by auscultatory method in Unit II

[50 Hrs]

Familiarisation on operation and measurement of various equipments mentioned [60 Hrs]

Hospital visit One month visit to hospitals. Getting familiarized with the use of cardiology equipments AUDIOLOGY

1.

Puretone and speech Audiometry Audiometer Procedure of Puretone Audiometry (Including play Audiometry), Plotting the Audiogram Speech Audiometry

[10 Hrs]

2.

Assessment of Hearing loss Case history evaluation Screening procedures for hearing evaluation Tuning fork test Over view of Audiometry Orientation to masking - need for masking

[20 Hrs]

Orientation to free field Audiometry and objective measurement such as tympanometry, reflexometry, BSERA, OAE [10 Hrs]

3.

Hearing Aids

Types including digital and programmable aids, parts of the aids, group amplfication system and other assistive listening devices. Brief account of the main Electro Acoustic characteristics Aided Audiometry Ling sound test Care and maintanance of hearing aids Introduction to cochlear implant [20 Hrs]

4.

Ear moulds 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 Hospital visit

[18 Hrs] [60 Hrs]

40

PRACTICALS 1. 2. 3. 4. 5. 6. 7. 8. 9. Observation of Puretone Audiometry and play Audiometry (10 cases) Participating in plotting audiograms. Obtaining and plotting the Audiograms of normal subjects (10 Nos) Obtaining and plotting the Audiograms independently (10 adult cases and 10 children) Observation of Speech audiometry (10 cases) Administration of speech audiometry (10 cases) Observation of case history (10 cases) Observation of other objective test used for hearing assessment Observation of regular ear mould making (2 pairs) Making regular ear mould independently (1 pair) REFERENCE
ELECTROCARDIOGRAPHY

[175 Hrs]

1. 2. 3. 4. 5. 6. 1. 2. 3. 4. 5.

Human Anatomy - B.D.Chaurasia - Volume one- Third edition, CBS publishers and distributors, New Delhi Introduction to Biomedical Equipment Technology - Joseph.J.Carr, John.M.Brown prentice Hall, Upper saddle river, New jersey, Ohio. ECG Assessment and interpretation - Bradford.C.Lipman - Jaypee Brothers Biomedical Instrumentation - Dr.M.Arumugham Biomedical Instrumentation and measurements - Leslie cromwell, Fred.J.Weibell, Ericha.Pfeiffer - Prentice Hall of India Pvt. Ltd. New Delhi. A textbook of medicine by K.V. Krishna Das - Jaypee brothers. Martin.F.N (1991) Introduction to audiology. IVEd, NewJersey: Frentice Hall. Newby. H.A (1985) audiology, Newyork: appletion - Century - Crofts Katz.J et al (Ed) 2002, Handbook of Clinical Audiology, Baltmore, Williams & wilkins Bassand Hummes (1990) Audiology - fundamental, Williams & wilkins Human Anatomy - B.D.Chaurasia - Volume three- Third edition, CBS publishers and distributors, New Delhi

AUDIOLOGY

41

PLANNING
To learn ECG & AMT the learning process must be activity oriented. We have to Provide learning experiences that would help to develop practical skill and components of multiple intelligence. Whether the activities are conducted in the class or outside, they are to be completed in 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

Y plan ear The year plan include the total number of units to be transacted though the three term, units to be covered during each month and the number of periods allotted for each unit. ECG
Unit Name of Unit Theory Period Practical Month Activity / Strategy

Electrocardiography

30 Hours

75 Hours

June July

Brain storming, group discussion, practicals, chart preparation, field visit/OJT, data collection and Seminar Data collection, discussion, field visit / OJT practicals, Seminar, assignment, Observation

Other Cardiovascular 28 Hours measurements and equipments

50 hours

July August

Medical ethics & 4 hours cardiopulmonary resuscitation

September Discussion, Chart, preparation, observation, role play

42

AMT
Unit Name of Unit Theory Period Practical Month Activity / Strategy

Pure tone and Speech 10 Hours audiometry

100 Hours

SeptOctober

Demonstration, discussion, chart preparation, brain storming, data collection, observation practical, field visit, OJT Data collection, discussion, OJT/ hospital visit, Demonstration, practicals, Seminar, assignment,

Assessment of Hearing loss

20 Hours

35 hours

October

Hearing Aids

10 hours

10 Hours

October Discussion, Data November collection, Chart, preparation, Demonstration, Expert opinion, field visit, OJT

4 5

Ear mould

20 Hours

30 Hours November Illustration, field visit, December OJT January Discussion, Field Visit, Interview, OJT

18 Hours Rehabilitation of children and adults with hearing impairment. Hospital Visit
(ECG & AMT combined)

6.

120 Hours

January One the job training February

UNIT PLAN Teacher may prepare unit Plan before the actual transaction of the unit in the class room. This plan mast make clear the curriculum objectives, essential strategies to be used and materials required. How the outcome are to be evaluated may also be spelt out.

43

44
UNIT PLAN

Unit 2 : Other Cardio Vascular Measurements and equipments

Concept/ Idea Observation, comparison Illustration, Field Reference Books CT visits, OJT, discussion communication Observation, comparison Discussion/Field visit/ Reference Text communication OJT observation, makes connection Data collection Discussion/ Field visit/OJT Reference Text Reports Notes Process / Skill Activity Materials Evaluation Period 4 Hours

Objectives

To develop an idea about the Tread mill test

procedure and technique of TMT Holter Monitor

To familiarize with the use of

Holter monitor system

3 Hours 3 Hours

To develop an idea about ICU monitor and Comparison,

cardiac monitors used in the monitoring leads ICU for electrocardiography and pulse frequency measurement through data collection, hospital visit/OJT and discussion Observation, communication, identification Data collections Discussion/Field visit/OJT

To create an awareness on Cardiac

need and technique of catheterization catheterization Applications.

Reference Text, animated cd's, expert opinion

Report CT,PE

4 hours

To acquire a skill in recording BP,

4 Hours

BP measurement auscultatory method

CT

3 Hours

CT CT

3 Hours 4 Hours

systolic B.P, Recollects, comparison, by diastolic B.P, Normal Judges value, interpretation To get an awareness about Echocardiography, Observation echocardiography and its ultrasound, different communication, comparison techniques types Observation To understand defibrillators Defibrillators and its application though discussion To develop an idea about Pacemaker, Different Recollects, Pacemakers, its working and types of Pacemakers, Classifies its types power supply

Observation Reference books, Practical, discussion BP apparatus, stethoscope Discussion, Field visit, Reference books, OJT, Observation, animated CDs, Assignment expert opinion Discussion, Field Reference books, visit, OJT, Seminar, operation manuals, assignment expert Opinion Brain storming, Reference books, discussion, OJT, field Photographs visit

DAILYPLAN The daily plan includes curriculum objectives to be transacted in class period, learning activities, learning aid and feed back. Class Unit Topic : Second Year : Electro Cardiography : Normal ECG wave Form Subject Date Time : ECG & AMT : : 1 Hour

Curriculum Objectives : To understand the normal ECG wave form pattern through brain storming, chart preparation, observation and discussion. Prepare charts and notes. Concept/Ideas : Normal ECG wave form, Character of a wave Previous Knowledge : Basic principles of ECG waves and conductive system of heart Materials Required : ECG machine, ECG paper, animated CD's Reference text - ECG assessment and interpretation-Brad ford.C.Lipman, Charts, Animated CD's Response/ Evaluation

Activity /strategies

Activity - I (Brain storming) Ask the learners to recollect All the learners participated in brain their previous knowledge about conductive system of heart storming sessions and they & basic principles of ECG recording consolidate the points in diary. Activity - II (Chart Preparation) Instruct the learners to Ashok Prepare the chart very well prepare a chart of normal ECG wave form using the reference text. Activity - III (Observation) Ask the learner to observe the animated CD's showing the development of ECG wave forms in relation to the working of heart. Lead them to group discussion. Raju and Kavitha identify the development of ECG wave forms with perfection. Others prartially get an idea about the topic

Activities - III (Group Discussion) Discussion Points: 3 Groups activitively participated in Why the ECG wave shows different deflections? discussion. 4th group is not active due What does each deflections represents? to the bad grouping. Can you differentiate the characteristics of each waveform? Presentation: Ask the group leaders to prepare a note Presentation of notes by Sarath was Consolidation: From the above activities the teacher can very good consolidate the topic with an idea that P waves - Atrial depolarization,QRS-Ventricular depolarization,T wave Repolarization of ventricles, PR interval -Total amount of time required for the depolarization of atria, QRS intervalTime required for the depolarization of ventricles, QT interval-Time required for both depolarization and repolarization of ventricles

Other Activities Collection of normal ECG waveforms

45

EVALUATION

INTRODUCTION
Evaluation is a systematic process of collecting, analysing, synthesising and interpretering evidences of students progress and achievements, both in cognitive and non cognitive areas of 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 attained continuously by them. As the curriculum is based on a particular vocation, the selected stream is the most important part 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 of the personal and social qualities also should be done. So the evaluation should be continuous and comprehensive.

Term End Evaluation (TE)

It is the written form of evaluation aimed at evaluating the facts, concepts and ideas gained by the learner. The test should not be aimed to evaluate the memory alone. Questions are framed in such a way that the learners are able to apply different mental process while answering. The term 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 score should be formulated taking into consideration the time required to read, think, understand and write answers. To avoid wild guessing, multiple choice questions of application level may be used. The total number of questions may vary from time to time. All the questions should be based on the curricular objectives. Open ended questions may also be included. Internal choice may be given to questions but the choice question also should be based on the same curricular objectives.

Continuous and Comprehensive Evaluation (CCE)

Our traditional evaluation methods measure only the memory and recollection capacity of the learner. To eliminate / these limitations the evaluation should be done on multi dimensional ways by measuring multiple intellectual capacities of the learner. So it is better to evaluate the learner in a continuous and comprehensive manner. CCE helps the learner to understand and evaluate his own progress and to develop adequate strategies for further improvement.

46

Merits
l l l l

Assess the all round development of the learner on a continuous basis through variety of activities. Effective feed back is possible. Remedial and diagnostic teaching is possible. 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 learner belongs to this group. For example
l l l l l

Study project Case study Field study

2. Interactive activities
Activities which improve the communication skill, abilities of sharing ideas, etc For example l Seminar l Panel discussion l Debate l Group discussion
l l

3. Assigned Task
Activities assigned to the learner to enrich/strengthen the concepts and ideas For example l Assignments l Collections
l l

4.

Performance Task (Tests)

Class test (Oral/ Written / Performance test) Quiz Open Book Examination Interview Group testing

Activities related to the achievements of the learner. For example

l l l l l l l

47

5. Practical based activities like

For example
l l l l l

Preparation of working model Album improvisation

From the above five group of activities, the teacher has the freedom to choose any three areas for evaluation purpose.

CE Items 1. Study Project

Sl No. 1. Stages Planning
l l

Criteria

Score

Total Scores

2.

Data Collection

l l l

3.

Analysis and Inference

l l

Relevatace of the study 4/3/2/1 Identification of problem: Ability to select appropriate tools Ability to select suitable learning method Ability to collect sufficient and 4/3/2/1 relevant data. Ability to classify. Arrange data for analysis. Reliability and authenticity of the data collected Ability to analyse the data. Systematic arrangements. Ability 4/3/2/1 to draw inferences based on analysis. Ability to give suggestions based on inference. Ability to present in logical and 4/3/2/1 sequential order. Authenticity of report. Time bound completion Knowledge of content and 4/3/2/1 process. Ability to analyse data Ability to justify inference. Ability to explain. Stratigies and methods adopted Total 20

4.

Report presentation

l l

5.

Viva - Voice

l l l l

48

2. Case study
Sl No. 1. 2. 3. 4. 5. Identify the problem Approach to the problem Time bound Action Analysis of the problem Problem solving / Reporting Total Criteria Score 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

3. Field Study
Sl No. 1. 2. 3. 4. 5. Criteria Attitude and readiness towards the task Capacity for observation Data collection Application of ideas Documentation / Recording Total Score 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

4. Assignment
Sl No. 1. 2. 3. 4. 5. Criteria Awarness of the content Comprehensiveness of the content Systematic and sequential arrangement Observation / suggestion/ views / judgements/ evaluation Timely submission Total Score 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

5. Seminar
Sl No. 1. 2. 3. 4. 5. Criteria Planning and Organisation Collection of data / content Observation / appraisal and clarity Content knowledge Presentation Total Score 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

49

6. Debate
Sl No. 1. 2. 3. 4. 5. Readiness to participate Depth of subject knowledge Communication skill Ability to justify the stand Presentation Total Criteria Score 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

7. Group Discussion
Sl No. 1. 2. 3. 4. 5. Criteria Readiness to participate Depth of subject knowledge Communication skill Ability to justify in a democratic way Leadership quality Total Score 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

8. Interview
Sl No. Criteria 1. Planning 2. Preparation of Questions 3. Communication skill 4. Participation 5. Report preparation Total Score 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 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.

50

Vocational Competency Evaluation (VCE)

Vocational competency evaluation is to evaluate the vocational skills and aptitude developed by the students during the learning process. This is a system to evaluate judiciously the required value addition and consequent capacity building in the concerned vocational curriculum. The vocational education is aimed at developing interest, skills and devotion in specific vocational fields. As other evaluation components like CE, PE and TE cannot assess the vocational competencies 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 and punctuality, 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 learners interest, devotion perseverance and efficiency. Value addition can be evaluated through conducting field visits/ vocational survey. The experiences gained through field visit/ Vocational survey increase the level of intrinsic motivation and develop positive attitude towards the vocational field and thereby increase his value as a semi-professional.

3. Capacity Building
It gives a quantitative measure of the students skill in graded area exposure. Capacity building can be evaluated through conducting the following activities. 1. 2. 3. OJT / Simulated experiment Performance - camp /exhibition / clinic Performance - Production / Service cum Training centre (PTC)

These components help the learner to practise the acquired skills in the real situation and thereby increasing self - comfidence and promoting self reliance.

51

Vocational Competency Evaluation Indicators

No 1. 2. 3. Items Regularity and punctuality Field visit / Survey / Vocational project (anyone) OJT / simulated experiment Perfomance - camp / exhibition / clinic Performance - PTC Practical skills (any one) Total Score 10 20

20

50

1.

Regularity and Punctulity can be assessed by using attendance of the learner and time bound completion of tasks. It is evaluated by using 5 point grading system.

Rating Scale
Sl. No. 1 Item Regularity 1 Never regular Never punctual 2 often regular often punctual 3 usually regular usually punctual 4 most of the time regular 5 Always regular

2.

Punctuality

most of Always the time punctual punctual Scoring Score 10

VCE Items Regulatarity and punctuality Value addition Field Visit

Evaluation Indicators

1. Attitude and readiness towards the task 2. Capacity for observation 3. Data collection 4. Application of ideas 5 Documentation / recording OR

4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

52

VCE Items Survey 1. Planning

Evaluation Indicators

Scorin Score

4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1

2. Data Collection 3. Consolidation of data and analysis 4. Drawing inference 5. Reporting Capacity Building OJT / Simulated experiment 1. Involvement / participation 2. Skills in doing work / communication skills 3. Time bound action 4. Capacity for observations, analysis and innovation 5. Documentation, Recording and display OR Performance in camp / exhibition / clinic 1. Ability for planning and organising 2. Mastery of subject 3. Ability for communication 4. Innovation 5. Involvement / Social commitment OR Performance in Production/ Service cum training centre (PTC) 1. Mastery of vocational skills 2. Managerial capacity 3. Promiting self condidence 4. Innovative approach 5. Promoting self reliance

4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 20

4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1

4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1 4/3/2/1

53

Consolidated Statement of VCE

Course : ECG & AMT
Roll No Name of Pupil Regularity of Value addition Punctuality (10) (20)

Y ear:
Capacity Building (20)

Class:
Total Score (50) Grade

Consolidated Grade Record of Vocational Subjects

Course : ECG & AMT Vocational Theory Roll. Name of No Pupil CE 20 TE Total Grade 80 100 Y ear: Vocational Practical PE 150 Grade VCE IE 50 Grade Class:

54

PRACTICAL EVALUATION Practical evaluation is the important part of vocational practicals. The practical skills must be evaluated from time to time. A practical examination is conducted for 150 score and should cover all required indicators to evaluate the technical skill and practical knowledge of ECG and AMT Indicators for PE-ECG & AMT Indicators Identification of tools and items Procedure-2 experiments Technique Observation, tabulation, inference Result Record Viva voice Total Score 20 5 x2 20x2 20x2 5x2 1x10 Total 20 10 40 40 10 10 20 150

55

LEARNER EVALUATION PROFILE Course : ECG & AMT Y ear : Ist Year Name of Subjects I Part I 1. English CE TE Total Grade CE TE Total Grade CE TE Total Grade Total Grade IE Grade CE TE PE Total Grade CE TE PE Total Grade CE TE PE Total Grade Term II III I II Year Term II III Mini. Max Score Score

2. GFC

Part II Voc. Theory

Voc. Practical VCE

Paper III Paper I Physics

Paper II Chemistry

Paper III Biology

56

Consolidated Statement of CE

Course Class
CE items 1 1............................. 2............................. 3............................. 1............................. 2............................. 3............................. 1............................. 2............................. 3............................. 1............................. 2............................. 3............................. 1............................. 2............................. 3............................. Evaluation Indicators 2 3 4 5

:
Total (20) Total (60) Average CE (20)

Sl. No

Name

57

1
ELECTRO CARDIOGRAPHY

56

UNIT AT A GLANCE

Unit 1 : Electro Cardiography

Content/area Activities/learning strategies Materials Products/ Outcome Evaluation

Curriculum objectives

To understand the history History of ECG of ECG through Brain storming and group discussion Brain storming Practical observation, group discussion Reference Text, ECG machine, recorded ECG Note s CT

Brain Storming, Reference books, Group discussion Materials from internet

Notes

TE, OT

2 To understand the basic Basic principles of principles of ECG ECG recording through brain storming practicals, observation & discussion prepare notes

3 To understand the lead system used for ECG recording through prepared charts, discussion and practicals Lead system Chart preparation, Discussion practicals Parts of ECG machine Brain storming Discussion Chart preparation Demonstration

Prepared chart, ECG Machine recorded ECG

Chart

TE PE

4 To identify the parts of ECG machine and its working through Brain storming, Discussion, Chart preparation and demonstration

Reference Books: Medical Instrumentation by S.Ananthi prepared chart Dismantled ECG machine

Chart

CT PE

57

58 Content/area Standardisation of ECG, Need of standardisation Normal Calibration Brain Storming, Discussion, demonstration, Practicals ECG machine, ECG- paper, prepared chart References Note TE Activities/learning Materials Products/ Evaluation Damping Under damping over damping Observation Discussion Practicals ECG machine Reference text Notes OT Supine position Remove watch, bankles Discussion, demonstration, Practicals BPL operation manual, Text book: A text book of Medical Instruments by S.Ananthi Assignment P.E CT procedure of ECG recording G.D, Observation, Practical, Field visit/OJT Operation manuals, ECG machine, paper, ECG gell Notes OT PE

Curriculum

5 To develop an idea about standardization of ECG machine through brain storming, discussion, Observation and Practicals

6 To get an idea about the need of crtically damped concepts of over damping and through observation discussion and practicals

7 To understand the precautions and patient preparation before recording ECG through discussion, demonstration and practicals

8 To acquire practial skill in recording ECG through G.D, observation, practical filed visit/OJT

Curriculum objectives Brain storming Chart preparation observation Group Discussion Reference Books: Notes ECG Assessment and interpretation by Bradford.C.Lipman, Biomedical Instrumentation by Cromewell, Animated CDs TE Collected data CT

Content/area

Activities/learning strategies

Materials

Products/ Outcome

Evaluation

9 To understand the Normal wave normal ECG wave form form through brain sotrming, Pwave form chart preparation, QRS complex observation and group discussion.

Measurement
Parameters, Heart rate calculation

Discussion, data collection, observation

10 To understand the measurement of ECG through discussion, data collection and observation

TE Seminar report

11 To familiarize with abnormal ECG wave forms through interview, OJT/Field visit and seminar

Abnormal ECG MI Common Arrhythmias Hypertrophy Septal defect

Interview, OJT/ Field visit Seminar

Reference books: ECG assessment and interpretation by Bradford C. Lipman, ECG paper, collected ECG Tracings. Experts, Animated CDs Reference Book: (ECG made easy by John.R Hampton)

Wandering of
backine

12 To identify common artifacts occurring while recording ECG and the methods of minimising it through observation, discussion

Ac interference

Observation, discussion, Assignment

Refernce Book: Medical Instrumentation by Arumukham, Expert opinion

Assignment

TE PE

59

60 Content/area Activities/learning Field visit/ OJT, Assignment Seminar report Assignment CE Operating manuals of various types of ECG recorders, Charts and diagrams Materials Products/ Evaluation

Curriculum

Protable single
channel recorders

13 To familiarize with various ECG recorders through field visit/OJT Assignment

ELECTRO CARDIOGRAPHY

Introduction
Electrocardiography is one of the most widely used non invasive technique for the diagnosis of heart disease. The Electrocardiograph is the first electrical device to find widespread use in medical diagnosis and it still holds its importance as a diagnostic tool of cardiac disorders. When the heart contract electric current is produced and propagated through out the body to the skin. By using electrodes and a galvanometer this current can be recorded. This is called electrocardiogram. The production and propagation of bioelectric potential across the cardiac cells are already discussed in the first year. This unit includes the history of ECG, basic principle, working, parts of ECG machine, method of recording ECG and common artifacts occurring while recording ECG. This unit enables the student to acquire skill in recording ECG, its applications, identifying the parts of ECG machine and various types of recorders.

1.2 To understand the basic principles of ECG recording through brainstorming, practicals, observation, group discussion and prepare notes. 1.3 To understand the various lead system uses 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 and demonstration of dismantled specimens and operation manuals. Prepare notes 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 develop an idea about the need of critically damped and the concepts of over damping and under damping through observation, discussion and practicals. Prepare a chart demonstrating the damped condition. 1.7 To understand the precautions and patient preparation before recording ECG through discussion, demonstration and practical. Prepare an assignment.

Curriculum Objectives
1.1 To understand the history of ECG through brain storming, group discussion. Prepare notes.

61

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 and observation. Prepare a note 1.11 To get an idea about abnormal ECG waveforms associated with certain diseases through interview, seminar, reference materials, IT support and a group discussion. Present the seminar report. 1.12 To understand the common artifacts occurring in ECG recording and able to minimize the artifacts through observation, discussion and assignment. 1.13 To get an idea about various ECG recorders through field visit OJT and assignment.

Practicals

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

1.1 History of ECG

Learning activity brainstorming and group discussion. Print outs taken from the Internet. Learning materials Reference Text Biomedical instrumentation and measurements By Cromwell ECG Assessment &Interpretation By Brad Ford C. Lipman

Process
The teacher initiate a brainstorming session to recollect their previous knowledge by asking questions. a) b) c) d) What is biopotential? How it is propagated? .................................... .................................... Production and propagation of action potentials

Syllabus
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

Collect responses from the students

l

1.7 Procedure for E.C.G recording 1.8 Artifacts in E.C.G recording 1.9 Types of E.C.G recorders

l l

Then the teacher divides the students into 5

62

groups and asked to discuss the following points using reference material and printouts taken from Internet. Ask them to discuss the following points.
Discussion Points
l l l l l l l

1.2 Basic Principles of ECG

Learning 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

Invention of biopotential Need of measurement Introduction of capillary electrometer Contribution of William Einthovan String Galvanometer Modification of writing system

The teacher must facilitate during discussion

Reporting

Presentation by group leaders Ask the learners to prepare a note based on the discussion.
Consolidation

Recollection of previous knowledge about biopotential through brainstorming session The teacher divides the student into 5 groups. The ECG of one student from each group is recorded [Lead 1 or 2]

Outcome

Invention of biopotential by Luigi Galvani Waller Capillary Electrometer Demerits of Capillary Electrometer William Einthovan, 1903

Let them observe the recorded tracings. Ask them to redraw the tracings in their notebook. Direct them to a group discussion using reference materials.
Points

1) 2) 3) 4)
l l l l

Where does the waves come from? What are the features of the tracings? ..................................................... ..................................................... Bioelectric potentials ECG Definition Electrocardiograph Electrocardiography Nomenclature of ECG waves

The learner understand the historical background of ECG.

Evaluation TE

Link coloumn A with the appropriate item from B&C

A Luigi Galvani William Einthovan Waller B String Galvanometer Capillary Electrometer Animal Electricity C 1786 1887 1903

Consolidation

l l

Prepare a note based on discussion

63

Other activities

Step 2

Collections of recorded tracings of EEG and EMG. Ask them to compare with ECG tracings

Outcome

The student get an idea about the basic principles of ECG

Evaluation CT

The teacher suggests an example of taking photograph of a person from different angles. The photograph gives different details of the same person. Similarly recording ECG from different points of the body gives more details. By this example teacher can conclude the need of multiple leads in ECG.
l

ECG signal differ from other bioelectric potentials in their characteristics. Analyze this statement.

Ask the students to prepare notes 1) 2) 3) 4) Electrodes Leads Comparison and classification of leads importance of multiple leads than a single lead

Consolidation:

1.3. Lead system

Learning activity Chart preparation, discussion, practicals Learning materials Website Prepared charts, ECG machine, Recorded ECG http://nobel prize.org/medicine/ education/ecg/index.html
l

5) 6) Practicals: - Students can practice the placement of leads in laboratory. The learner understands the different lead system and acquire skill in the placement of leads

Outcome

Text Book: Biomedical instrumentation and measurement By Cromwell Electrocardiography Aspi F. Golwalla
Process
Step 1

Evaluation: TE

Teacher divide the students into groups. Give them the task of preparing chart showing12 leads ECG using references. Charts are displayed in the classroom. Let the students to compare the 12 charts and note the differences. Teacher asks them to group the chart based on similarity. 3 groups are obtained. The students can do the title for each group by referring text materials.

64

Observe the above two figures Identify and compare these two leads
PE

Other activities.

Prepare a chart showing the parts of ECG machine. Lead selector - select the lead signal pre amplifier power amplifier

Identification of wrong lead connection and their correction.

Consolidation

1.4

Part of ECG machine and its working

Suggested activity: illustration, group discussion, Demonstration using dismantled specimen, chart preparation.. Learning materials: Process

Evaluation
Lead selector

Bridge O/P circuit

Reference Text: A text book of medical instrumentsBy S.Ananthi ECG Machine , Prepared charts Dismantled ECG machine operation manuals

PE

Complete the given block diagram of ECG machine Identify the controls in the front panel of ECG machine

With the help of prepared charts the teacher can demonstrate the parts of ECG machine using reference materials. Ask the learner to discuss the following points.
Discussion points
l l l l

1.5

Standardization of ECG machine

Learning activity Brainstorming, discussion, demonstration and practical. ECG machine, ECG paper, prepared charts, Reference text: ECG assessment & interpretation By Bradford C. Lipman

Lead selector Preamplifier Pen motor

Learning materials: -

Ask the learners to relate the different parts of machine in a proper way. The learner can prepare a block diagram showing the parts of ECG machine using references
l

Process

Teacher can initiate a brainstorming session on the need of calibration by measuring a physical quantity. Eg: A meter scale is used in textile shop to measure fabrics. A wooden stick of length in 1 m and marked accordingly can be used for this purpose i.e. the length of the wooden stick is compared with the length of the meter scale.
Discussion

The teacher must facilitate the students to discuss the function of each block with the help of dismantled machine. The learner can prepare notes and the group leaders can present the topic in classroom.

The teacher can divide the students into 5

65

groups (Grouping strategy: - Ask them to name 5 physical quantities) e.g. voltage, current, length, time, weight
Points to be discussed

Compare the given standardization signal.

1.6 Damping
Learning activities Observation, discussion and Chart preparation Reference text An introduction to Electrocardiography by Leoschamroth Process

How can we calibrate an ECG machine?

l l

Need of standardization in ECG machine.

Learning materials -

Let the students to observe the standardization procedure conducted by teacher. Ask them to compare ECG tracings with proper calibration and without calibration Let them note the differences
Practicals

ECG machine

Practice the standardization in ECG machine by each learner The group leaders of each group can do a presentation on this topic with the help of charts and submit the report in the form of a note.
Consolidation

Students observe the standardization marks obtained in different damping condition and discuss the following points
Points

Damping Under damping Over damping

Note the points in a diary In practical session teacher demonstrate the damping
Consolidation points

Outcome

Standardization 1 mv = 10 mm Under standardization Over standardization

Outcome

Rounding of signals Overshoot

The students get the concept of standardization by practicals and preparing a chart showing normal, over and under standardization
Evaluation:TE

Other Activities Prepare a chart demonstrates the damped condition. The students get an idea about damping

Evaluation

Commend on these signals

66

1.7

Precautions and preparations taken before ECG

Group discussion, demonstration, practical.

Practicals The learner can practice the placement leads, patient preparation and placement of leads
Outcome

Learning strategy

Learning materials: Reference text BPL, Operation Manual A text book of Medical Instruments By S Ananthi Divide the students into 5 groups. The teacher can supply the print outs of this topic. Lead them a discussion.

The students get an idea about the precautions to be taken before recording ECG and skill for patient preparation.
Evaluation CT PE
l l l

Group discussion -

Patient preparation Standardization

Discussion points
l l l l l

1.8 Procedure for ECG recording

Learning activity Group discussion, observation, practical, field visit/OJT Learning materials Operating manuals, ECG machine, ECG paper, Electrode paste Process Divide the students into groups and ask to recollect their previous knowledge on the following points
l

Need for taking precautions What kind of precaution can be taken? Need for applying electrode paste Proper electrode placement Lead placement

Let the students to observe the practical experiment conducted by the teacher
l

Reference text A text book of Medical Instruments By S Ananthi

Ask them to prepare a note and the group leaders of each group can present the topic in the form of assignment Supine position Removal of metal objects Application of electro depaste

Consolidation
l l l l

Precautions to be taken before ECG recording Patient preparation Electrode placement Lead placement

l l l l

Other activities Prepare an assignment pointing out the precautions and patient preparation Exhibit a chart showing the major points regarding the precautions to be taken before taking ECG

Consolidate the discussion points The students can observe the procedure for ECG recording by following ways

67

Demonstration by teacher in school labs OR Observation during field visit OR The learner itself can visit and observe the procedure in a nearest lab

Learning materials Reference books, charts, animated CDs ECG assessment & interpretation By Bradford C. Lipman Biomedical instrumentation and measurement By Cromwell http://www.rneens.com

Reference text: Website Process

Step 1

Ask them to prepare note on the recording of ECG using operation manuals. Practicals The learner can practice the recording of ECG from school laboratories and during OJT.
Consolidation
l l l l l l

Precaution Patient preparation Electrode paste Standardization Recording

Recollection of previous knowledge about the basic principle of ECG and conductive system of heart through a brainstorming session. Ask to note the points in a diary
Step 2

Let the students prepare chart of normal ECG waveform using reference materials.
l

Outcome

The learner acquires a skill in ECG recording through OJT

Evaluation OT, PE
l

With the help of animated CDs students can observe ECG waveforms in relation to the working of heart Lead them to a group discussion based on the above activities (5 groups) and using reference materials. Why the ECG shows different deflections? What does each deflection represent? Can you differentiate the characteristics of each deflection?

Evaluating the practical skill in

l l l l l l

Precautions Patient preparation Electrode placement Standardization Recording

Points
l

l l

1.9 Normal ECG wave form

Learning activity Brainstorming, chart preparation, observation, Group discussion

Group leaders can present the topic in the form of notes

Consolidation

P wave: atrial activity QRS complex:

68

ST segment T wave U wave

Consolidate the discussion points with the help of teacher

l l l l

Types of ECG paper 25/50 mm/sec Horizontal axis represents duration Normal values of P wave, QRS interval, PR interval, QT interval

Other activities

Collection of recorded ECGs

Outcome
l l

Learner understand normal ECG waveform and identify the electrical events responsible for their formation.
Evaluation TE
l

prepare notes Other activities Collection of ECG tracings and find out the values of above parameters. The learner can collect the print out of the topic (calculation of heart rate from ECG) from the teacher and discuss the matter in groups (Teacher act as facilitator)

P wave represent atrial activity. Justify this statement.

Activity 2 -

1.10 ECG Measurements

Learning activity Discussion, Data collection and Observation Learning materials Reference text: ECG assessment & interpretation By Bradford C. Lipman, ECG paper, recorded-ECG -

Points to be discussed:
l l l

1500 method for calculating heart rate 6 sec method for calculating heart rate

Process

Note the points in a diary

Consolidation

Teacher supplies reference materials along with an ECG paper to discuss the points.
l l l l l l

Heart rate = 1500/No of small squares

ECG paper Paper speed Normal calibration Horizontal axis- duration Vertical axis amplitude

Other activities

Let the students to collect the recorded ECG tracing and ask to calculate the heart rate by 1500 and 6 second methods
Outcome

Parameters
l l l l

P-wave amplitude, P-wave duration QRS amplitude, QRS duration P-R interval, QRS width, QT internal

The learner understand the different types of ECG papers, parameters of ECG and calculation of heart rate from ECG.

69

Evaluation TE

Outcome

The students get an awareness on common abnormalities in ECG.

Evaluation

Calculate the heart rate from ECG by 300 methods if the R-R interval is 25 small squares

1.11

Abnormal ECG waveform (Brief descriptions only)

Interview, OJT/ Field visit and seminar Animated CDs, Reference books

Learning activity:
l

Observe the above two ECG signals and commend on it.

Learning materials Reference text ECG made easy- John R. Hampton Websites Process

1.12 ECG Artifacts

Learning activity Process The teacher can initiate a discussion on artifacts by giving ECG tracings which contain some artifacts. e.g. wandering of baseline Ask them to find out the reason for that artifact with the help of reference material. List out the other artifacts and let them to find out the reason and their remedial measures using reference texts Present the report in the form of an assignment.
Consolidation

Discussion, Observation Reference books, Expert opinion Biomedical instrumentation Arumukham

Learning materials Reference text

http://www.skill stat.com/ ECG_Sim_demo.html

The teacher can give the topic to the students and ask to collect information during OJT/ Field visit. Students make interaction with a Cardiologist and collect information about abnormal ECG waveform. Present the collected information in the form of a seminar.
Consolidation

Hypertrophy IHD MI Common Arrythmias

Artifacts - Definition Wandering of baseline

70

Outcome

AC noise

Reference text Process The students can collect the various information regarding various types of ECG recorders, advantages and disadvantages during OJT/ Field visit/Exhibition. The learner can interact with Biomedical Engineers and collect the operation manuals. Let them present the report in the form of an assignment.
Consolidation

Biomedical instrumentation Cromwell

The students are capable of identifying the commonly occurring artifacts and their remedial measures.
Evaluation
TE

Outcome

Observe the above signal and commend on it How these kind of signals can be avoided during recording
PE

Portable single channel ECG machine. Multichannel recorders ECG for computer processing

Identification and elimination of artifacts during ECG recording

The students can get an awareness regarding the various types of ECG recorders with their advantages and disadvantages.
Evaluation

1.13 Various types of ECG recorders

Learning activity Field Visit/OJT Learning materials Operation manuals of various ECG recorders, charts and diagrams

CT Enumerate the different types of ECG recorders with their advantages and disadvantages

71

2
OTHER CARDIO VASCULAR MEASUREMENTS AND EQUIPMENTS

72

UNIT AT A GLANCE

Unit 2 : Other Cardio Vascular Measurements and Equipments

Content/area Report Collected dataIllustration, Field Reference text: Visit, OJT, DiscusECG assessment sion and interpretation by bradford Chipman TE Activities/learning strategies Materials Products/ Outcome Evaluation

Curriculum objectives

1 To develop an idea Treadmill unit about the procedure Procedure and technique of TMT Significance through illustration, field visit/OJT and discussion. Prepare a report Discussion, Field visit/ OJT Reference text: Report ECG assessment and interpretation by Bradford.C Lipman, Operating manuals, Expert opinion chart, Photograph Reference: Principles of Bio medical engineering for nursing staff by Hans.A. van Des Model Data collection, Field visit/OJT discussion Notes OT

2 To familiarise with the Holter Monitors use of Holter Monitor Leads system through Recording demonstration, discussion, data Collection, field visit and discussion. Prepare a report

3 To develop an idea ICU monitors about cardiac monitors Monitoring leads used in ICU for electro cardiography and pulse frequency measurement through data collection, Filed visit/ OJT and discussion Prepare notes

OT

73

74 Content/area Data collection, discussion, observation field visit/OJT Animated CDs, Report Expert opinion Reference book : A textbook of medicine K.V Krishna Das CT B.P Apparatus Stethoscope Reference Joseph J. Carr Report PE/ OT Activities/learning strategies Materials Products/ Outcome Evaluation

Curriculum objectives

4 To create awareness on Catheter the need and technique Catheterisation Technique of catheterisation through data collection, discussion, observation, field visit/OJT

5 To understand method of B.P measurement through observation, Practicals and discussion Discussion, Field Animated CDs, Notes visit, OJT, Seminar Expert opinion Seminar Reference booksAthu Lithra

Blood presssure Technique Interpretation

Observation, Practical, Discussion

Echo 6 To create awareness cardiography about echocardiography Principle and its techniques types through discussion, field visit/ OJT and seminar Defibrillators Types Working of DC
defibrillators Discussion, Field Visit/ OJT observation

CE

7 To understand defibrillators and its application through discussion, field visit/ OJT, Observation . Prepare an assignment

Operating manuals, expert opinion Reference text - Biomedical instrumentation - by cromwell

Assignment

CE OT

Curriculum objectives

Content/area TE

Activities/learning strategies Brainstorming, discussion, OJT, Field visit Note Reference text:- BMI by Cromwell

Materials

Products/ Outcome

Evaluation

Pacemakers definition Types of

pacemakers Powersupply

8 To develop an idea about pacemakers, its working, its types through brain storming, discussion, field visit, OJT. Prepare notes

75

OTHER CARDIO VASCULAR MEASUREMENTS & EQUIPMENTS

Introduction
The heart attack in its various forms is the cause of many deaths in the world today. The use of engineering methods and the development of instrumentation have contributed substantially in progress made in recent years in reducing death from heart disease. Blood pressure, flow, and volume are measured by using engineering techniques. The electro cardiogram and echo cardiogram are measured and recorded with electronic instruments. Intensive coronary care units now illustrated in many hospitals relay on bio-instrumentation for their function. There are also cardiac pacemaker system, defibrillators, which although not measuring instruments, they are electronic devices often used in conjunction with cardiac measurements. In this unit cardiac measurement systems other than ECG are discussed. A well knowledge in this unit can only be attained through hospital visit and OJT only. discussion data, collection field visit. Prepare a report 2.3 To develop an idea about cardiac monitors used in the ICU for electrocardiography and pulse 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 a discussion, field visit/OJT, observation. Prepare a assignment. 2.8 To develop an idea about pace maker, its principles and types through brain storming, discussion, OJT/field visit. Prepare a note.

Curriculum Objectives
2.1 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 Holter monitor system through demonstration,

76

Syllabus
2.1 Treadmill test 2.2 Holter monitors 2.3 ICU monitors( for electro cardiography and pulse frequency measurement) 2.4 Cardiac catheterization 2.5 B.P measurement (Ascultatory method in detail) 2.6 Echo cardiography 2.7 Defibrillators 2.8 Pacemaker systems

Reference text ECG assessment and interpretation by Bradford C. Lipman Website http://www.nlm.nih.gov/ medlineplus/ency/article/ 003878.htm/article/003869.htm

Process:
l

Teacher gives an introductory idea about TMT in the class room through illustration

Treadmill Test
Introduction

Patient with coronary artery blockages may have minimal symptoms and an unremarkable or unchanged ECG while at rest. However, symptoms and signs of heart disease may become unmarked by exposing the heart to the stress of exercise. During exercise, healthy coronary arteries dilated than an artery which has blockage. This unequal dilation causes more blood to be delivered to heart muscle supplied by the normal artery. In contrast, narrowed arteries end up supplying reduced flow to its area of distribution. This reduced flow causes the induced muscle to starve during exercise. The starvation may produce symptoms like chest discomfort or inappropriate shortness of breath, and the ECG may produce characteristic abnormalities. Most commonly a motorized treadmill is used for exercise while a stationary bicycle is used in some exercise Lab. Learning activity Illustration, Field Visit/ OJT and discussion

The learner observes the procedure and techniques of Tread mill test during OJT or Field visit in a hospital. Prepare a report Teacher divide the students in 5 groups. Based on the prepared report a discussion is conducted The need of performing TMT The precautions to be taken before performing TMT The procedure of Test The accessories and instruments used for TMT The significant changes in ECG As the group leaders to present the discussion points The Notes are prepared based on this presentation

The discussion points are

l l

l l

Learning materials Reference books, Collected data

77

Consolidation

Process
Teacher introduce the instrument in the class room with the help of CDs and Photographs and discuss the following points
l

Outcome:

Treadmill - parts procedure ST segment change

The difference between routine ECG recording and Ambulatory moniotoring Special leads and electrode position Need of Ambulatory monitoring Instruments and accessories used Lead and electrode placement Advantages adn disadvantages The learner can strengthen his concept with the help of experts during field visit

The learner understand the technique of TMT

Evaluation
TE

l l l l

Exercise ECG is more useful that routine ECG recording. Justify

Holter Monitor
Introduction

Consolidation
Outcome

Holter monitoring is a method of recording continuously the cardiac rhythms over a specific period of time. The test can be conducted on an out patient basis and is used to detect arrythmias or coronary artery disease. Learning activity Demonstration, Discussion, Field Visit & expert opinion Reference books, Expert opinion, chart etc., Photograph and CDs http://www.nlm.nih.gov/ medlineplus/ency/imagepages/ 8810.htm

Students understand the need and technique of ambulatory monitoring

Evaluation:
OT

ICU Monitors for ECG recording and Pulse frequency measurement

Introduction

Learning materials Website -

In patient monitors electronic equipment provides continuous watch over the vital characteristics and parameters of the critically ill. Patients are monitored because they have an unbalance in their body system. This can be caused by heart attack or stroke. By continuous monitoring, the patient problem can be detected as they occur and remedies taken before these problems get out of hand. Learning activity: Data collection, OJT/ Field visit/ Discussion Reference text: Principle of biomedical engineering for nursing

Learning Materials -

78

staff Hans.A.Von Des Model, Black well publications

Cardiac Catheterisation
Introduction

Process
l

Teacher can give the print outs of this topic Ask to collect more informations about this topic during field visit/OJT Group discussion (5 group) Use of Monitors Instrument set up Special lead used Electrodes used Measuring parameters

Points to be discussed
l l l l l

Catheterization was first developed in the late 1940s and has become a major diagnostic technique for analyzing the heart and other components of cardiovascular system. Apart from obtaining blood pressure in the heart chambers and great vessel, this technique is also used to obtain blood samples from the heart for oxygen content analysis, and to detect the location of abnormal blood, flow path ways. Catheter is also used investigations with injection of radio opaque dyes for x-ray studies. Coloured dyes for indicator dilution studies and of vasoactive drugs directly into the heart and certain vessels Learning activity Data collection, discussion, observation, field visit/OJT Reference text Animated CDs Expert opinion http://www.nlm.nih.gov/ medlineplus/ency/article/ 003419.htm

One student from each group can present this topic. After presentation a question session is conducted. Other group members give answers for questions.
l

Prepare a report on this topic Silver- Silver cholride electrodes Principles of ECG monitors

Learning Materials Website -

Consolidation

Other activities Prepare an assignment on central monitors

Outcome

Process Group Discussion 5 groups

The learner gets an idea about cardiac monitors

Evaluation

The learner can collect the data relating this topic from library and discuss the following points with the help of teachers
Discussion points
l l l l l

CE OT Participation of learner in group discussion and answering to questions

What is catheter? What is the need of catheterisation? Technique of catheterization Applications

79

Consolidate the discussed points and note them in a diary

l

Using animated CDs or websites the learner can observe the technique of catheterization During field visit/OJT learner can further improve his idea about catheterization with the help of cardiologist

Reference Books A text book of biomedical instrumentation by S.Ananthi Website http://www.nlm.nih.gov/ medlineplus/ency/article/ 003398.htm

Process
The students can observe the procedure of BP measurement by following ways
l

Make a report on this topic based on the above activities and present it in the form of Seminar
Consolidation
l l l l

By visiting a nearest lab/hospital or Demonstration in school using BP apparatus by teacher or Observation during field visit

Catheter Angiogram Applications Procedure

Definition
l

- Precatheterization - Catheterisation - Post catheterization

Outcome

The learner gets a brief idea about the catheterization

Evaluation

Using prints out or reference materials the learner can prepare the note and discuss the matter in groups. The group leaders present the topic in class and make a final report with the help of teacher. Practicals The learner practises the BP measurement during OJT/Schools labs
Consolidation

Clinical applications of catheterization

Blood Pressure Measurement ( Auscultatory method)

Introduction

As one of the physiological variable that can be quite readily measured, BP is considered as a good indicator of the status of cardio vascular system. BP measurement has saved many persons from untimely death by providing warnings of dangerously high BP in time to provide treatment. Learning activity Observation, Practical and Discussion Sphygmomanometer, Stethoscope

Blood pressure definition Systolic & Diastolic BP apparatus Normal values Interpretation Other activities AssignmentPrepare an assignment on BP measurement other than auscultatory method.

Outcome

Learning materials -

The learner acquire the skill in measuring BP by Auscultatory method

80

Evaluation
CT

The doctor send a patient to you suffering from heart disease and asked to check the BP of the patient. On examination shows 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 diastolic values?
PE

an animated CD and reference text teacher can illustrate the technique and working of Echo cardiography
Points
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Definition of Ultra sound Basic Principles Technique

Consolidation

Evaluating the practical skill in recording BP Handling of apparatus Technique

Echocardiography
Echo Cardiography is widely used and valuable instrument for cardiac examination and assessment of many congenital and acquired cardiac disease. Using this instrument it is possible to see intracardiac structures, detect blood flow velocity, valve stenosis etc Learning Activity: Brains storming, illustratation Field visit/ OJT, Discussions

Echocardiography - definition Principles of Doppler Conventional Echo Clinical applications During Field visit and OJT the student can strengthen their concept with the help of experts. Make a report on echo cardiology based on the above activity. Other activities Evaluation OT Outcome

Seminar- Application of Ultra sound in Medical field.

Learning Materials: Animated CD, Reference books, expert opinion Reference books Website Echo made easy By Athul Luthra http://www.nlm.nih.gov/ medlineplus/ency/article/ 003869.htm -

The students understand the basic principle and technique of Echocardiography

Evaluation CT

Defibrillators
Introduction

Process
The teacher can initiate a brain storming session on ultra sound and its basic principles. Using

Defibrillator is a device used for correcting the fibrillation of cardiac muscles. During fibrillation, the normal rhythmic contraction of either atria or ventricle are replaced by rapid irregular twitching of muscular wall. In order to correct this fibrillation an electric shock is applied to the chest wall.

81

Learning activity Discussion, Field visit/OJT, Observation, Assignment Operation manuals, expert opinion (BME) (Cardiologist) Reference text: BMI by Cromwell)

Learning materials -

node fails to function, the normal synchronism of heart action get disturbed. By providing external electric impulse stimulation to the cardiac muscles, it is possible to regulate the rhythm of Heart. These impulses are given by an electronic instrument called pace maker. Learning activity Brain storming, discussion, OJT/ Field visit Learning materials Website Reference text : Biomedical instrumentation - Cromwel http://www.nlm.nih.gov/ medlineplus/ency/article/ 007070.htm#visualContent -

Process
With the help of teacher, the students can discuss about the following points
l l l l l l

Fibrillation (artial & ventricular) Instrument used for correcting fibrillation Types of defibrillators Working of DC defibrillators Electrodes used for defibrillators

Process
The teacher can initiate a brain storming session on conducting system of the heart
l l

The students can prepare a note based on the above discussion. The knowledge about the topic can further strengthen during the filed visit and OJT. Prepare an assignment after the field visit
Consolidation

Natural pacemaker What happens if natural pacemaker not functioning properly Need for artificial pacing

l l

Outcome -

Defibrillator (Definition) Internal and External Defibrillators Application of paddle electrodes Working of defibrillators

Using reference text and photographs and necessary guidance from the teacher the learner can further discuss the following points.
l l

What is a pacemaker? Different types of pacemakers Power supply

The learner gets a brief knowledge about the defibrillators

l l

Evaluation: CT

Pacemakers
Introduction

The rhythmic beating of heart is due to origin and spread of impulses from the S.A node which is the natural pacemaker of heart. If SA

During the hospital visit the students can observe the different types of pacemakers and further improve their knowledge about the pacemaker with the help of cardiologist. Prepare a note on pacemakers.

82

Consolidation

Evaluation

Pacemaker definition External pacemakers Internal pacemakers

found that SA-Node is not functioning properly and sujjest for artifical pacing Name the device used for artificial pacing What is the principle of this device? Mention its different types

TE A patient admitted to the hospital due to heart disease. On clinical evaluation cardiologist

The learner gets a basic awareness about pacemakers and their functions.

83

3
CARDIO PULMONARY RESUSCITATION & MEDICAL ETHICS

84

UNIT AT A GLANCE

Unit 3 : CPR and Medical Ethics

Content/area Activities/learning strategies Discussion, chart preparation, observation, Role play Reference books, Chart Animated CD, Prepared chart PE Materials Products/ Outcome Evaluation

Curriculum objectives

1 To understand the first aid CPR measures in the case of CPR in adults

cardiac arrest, through discussion, chart preparation, observation and role play Discussion Reference books, Expert opinion Report CT

2 To get a brief idea about Medical Ethics medical ethics, through discussion

85

CARDIO PULMONARY RESUSCITATION & MEDICAL ETHICS

Introduction
CPR is an emergency first aid measure done when there is massive cardiac arrest. Many cardiac arrest are purely managed because of the disorganization of the cardiac arrest team and a lack of knowledge about the recommended procedures by its members. The main objective of this unit is to create an awareness in students about the first aid measure to be done in cardiac arrest.

Process
The teacher can initiate a discussion by using references test and divide the students into four groups.
Discussion points;
l l

What is cardiac arrest? What should you do the patient collapses How do I perform basic life support (BLS)

Curriculum Objectives
3.1 To get an idea about the first aid measures though the discussion, field visit /OJT/animated Cds, expert opinion ,Role play

By using an animated CDs and prepared charts the students can observe the various first aid procedures. Note the points in a diary. Other Activities Role Play Ask 2 or 3 students to perform a role play in cardiopulmonary resuscitation CPR definition First aid measures in adult

Syllabus
Learning activities Discussion and using animated cds, charts preparation observation and role play. Reference text, animated Cds, prepared charts. http://www.nlm.nih.gov/ medlineplus/ency/article/ 000010.htm

Learning Materials Website -

Consolidation

86

Out come:

Curriculum objectives
3.2 To get a brief idea about the medical ethics though discussion.

The students get an awareness about the CPR procedure

Evaluation:

A healthy normal person suddenly unconscious before you. What first aid measures will you give before transporting him to ICU?

Syllabus
Medical ethics Learning Strategy Discussion Learning material Medical laboratory T echnology CMC Vellore

Medical Ethics
Introduction

Medical professions governed by a cord of ethics Medical ethics deals with the moral Principles which should guide the member of medical profession in their dealings with each other, their patients and the state. In this unit the learner should gets an idea about the rules and regulations to be followed by a technician in paramedical field.

Discussion
Points:
l l

Dedicated to the service of humanity All reports on patients as confidential information to be communicated only to the physicians

l l

Consolidate the topic with the help of a Teacher.

87

AMT

1
PURE TONE AND SPEECHAUDIOMETRY

88

UNIT AT A GLANCE

Unit 1 : Pure Tone and Speech Audiometry

Content/area Audiometers Parts Demonstration, Discussion, chart preparation Audiometer, Notes Reference books, Block diagram, Chart, instruction manuals Activities/learning strategies Materials Products/ Outcome Evaluation

Curriculum objectives

1 To understand different parts and working of pure tone audiometers using for audiological evaluation through demonstration, discussion and chart preparation Pure tone audiometry Principle Procedure Audiogram Brain storming, data collection, observation, discussion and practical/OJT Report Reference Text; Operation manuals, Audiometer, Audiogram

PE CT

2 To understand operation of pure tone audiometer and procedure of ploting audiogram through brain storming data collection, observation, discussion and practical/OJT Play audiometry Discussion, field visit/ OJT Reference books; Expert opinion Note

PE TE

3 To get an idea about the play audiometry through discussion, filed visit/OJT Prepare notes Speech audiometry SRT SDS Discussion, Field Visit/ OJT

OT

4 To understand the procedure of speech audiometry through discussion, OJT/ Field visit and practicals

Reference books; Speech audiometer

Report

PE OT

89

PURE TONE AND SPEECHAUDIOMETRY

Introduction
Audiometry is an important investigation for auditory dysfunction. It not only gives an idea about the hearing handicap and the degree of deafness, but it is also a valuable method for diagnosing ear disease. Pure tone Audiometry is an instrument of comparison which indicates the difference between the sound pressure level required to produce hearing in the individual under test and that required to produce hearing in an average normal young person. Speech audiometry is aimed at evaluating the listeners response to speech. It is helpful in evaluating the functional state of auditory system, to predict the outcome of otologic surgery and to assess the value of therapeutic measures, such as auditory training or selection of hearing aid. In this unit working and operation of pure tone and speech audiometers are discussed This unit enables the students to identify the parts of audiometers and to understand the procedure of audiometric test.
l l

To understand operation and procedure of pure tone audiometry and to plot audiogram though brain storming, demonstration, discussion, practical, OJT. Prepare an assignment To get a brief idea about play audiometry through discussion, field visit, OJT and practicals. Prepare note To understand the procedure of Speech audiometry though discussion, OJT, data collection, Practicals. Prepare notes.

Syllabus
l l

Audiometer Procedure of pure tone audiometry (Including play audiometry), Plotting the audiogram. Speech audiometry

Parts of audiometer

Learning activity Demonstration, discussion, chart preparation

Learning materials Audiometer, prepared charts, instruction manuals Reference text Martin F.N.- Introduction to audiology. -

To understand different parts and working of pure tone Audiometer used for audiological evaluation through demonstration, discussion and chart preparation. Prepare note.

90

Process:
Activity -1

1.2 Pure tone Audiometry (Operation and procedure)

Learning activity Brain storming, Data collection, observation, discussion, practical, OJT Operation Manual, Audiometer, Audiogram Katz J. etal Handbook of clinical audiology.

Teacher demonstrates the parts of the pure tone audiometer in the lab using a prepared chart and the learner can discuss the following points using operation manuals
Points:

Learning Materials -

Function switch mode switch frequency dial Intensity dial Masking dial patient signal switch head phones bone conduction vibrator
Activity -2

Reference text -

Teacher displays the block diagram of audiometer in the class. Divide the students in to groups of five. Let them discuss the functions of each block using reference books Prepare a note based on the above activities Other activities Prepare a chart that showing the parts of the audiometer Oscillator Amplifier Microphones Earphone Bone conduction vibrator

Process
Recollection of previous knowledge though a brain storming session. Points 1. 2. 3. 4. Ask the learner to collect the print outs relating to the procedure of pure tone audiometry from library. Observe the procedure of P.T.A with the help of teacher Teacher divide the students into groups of 5 and discuss the following points
Points
l l l l

Pure tone Audiometers Parts and working of PTA

Consolidation

Outcome

Students identify the parts of the audiometer

Need of P.T.Audiometry Principles Test frequency Procedure of Threshold determination Symbols, Plotting Audiogram Interpretations

Evaluation
C.T

Prepare a block diagram showing the parts of audiometer.

P.E

l l

Identifying the parts of Audiometer

Ask the group leaders to prepare a report and present them in the class room.

91

Ask the leaners to submit an assignment based on the above activities Practicals: Students independently perform the P.TA Test in the lab
Consolidation

Reference Maryanne Tate malt by and Pameela Knight.

Process
The learner can collect the print outs relating this topic from library. Discuss the following points in groups
Discussion points
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Degree of hearing loss and type Principles Procedure Interpretation of audiogram

Need of play audiometry Selection of age Procedure of play audiometry

The learner practise procedure of P.T.A though OJT

Out come

The students acquire the skill in performing pure tone audiometry and ploting audiogram.

Note the points in a diary. During field visit or OJT the learner can collect more information with the help of experts
Consolidation

Evaluation
CT

Evaluation

A person comes to you with deafness.After preliminary investigations the doctor asked for pure tone audiometry. How will you perform this test?
PE

6-9 years of age To bring out the concentration of Childs

OT

Speech Audiometry
Learning activity Discussion, OJT and practicals Leaning Materials Reference texts, audiometer Reference text: Handbook of clinical audiology Katz

Evaluating the practical skill in

l l l l l

Operating an audiometer Head phone placement Procedure Threshold determination

Play audiometry
Learning Strategy: Discussion, field visit, OJT Reference Text, expert opinion Learning Materials :

Process
The teacher divide the students into group. The learner collect print outs of this topic from the library and discuss the following points.

92

l l l l l

Need for performing speech audiometry Principle of speech audiometry Procedure Interpretation

During field visit and OJT the students improve their knowledge with the help of an audiologist
Prepare notes

Practicals The learner can independently perform speech audiometric test in the laboratory.

Consolidate the discussion points with help of teacher

Consolidation Out Come

Ability to understand speech principle Spondee words, phonetically balance words SRT SDS

The students acquire skill in performing speech audiometry

Evaluation
PE

Evaluating the Practical skill in performing speech audiometry.

93

2
ASSESSMENTOF HEARING LOSS

94

UNIT AT A GLANCE

Unit 2 : Assessment of Hearing loss

Content/area Data collection, discussion, OJT Reference books; Collected data PE OT Case histories prepared by students Activities/learning strategies Materials Products/ Outcome Evaluation

Curriculum objectives

To get a brief idea about Case history case history evaluation evaluation, through data collection, Format discussion and OJT. Prepare notes Screening of adults Discussion, Data collection Reference books; Chart, tuning fork Chart OT

To understand the screening procedure for evaluating hearing loss through, data collection, discussion. Prepare charts Rinnes test Weber test Schwaback test ABC test Discussion Demonstration Practicals Reference books: Tuning fork 512Hz Charts Seminar

To understand the various tuning forktest used for audiological evaluation through discussion, demonstration, practicals Overview of different types of audiometers Group discussion, field visit, Assignment

OT

4 To understand different types of audiometers through group discussion, field visit. Prepare an assignment

Reference Text; Martin F.N Introduction to audiology

Assignment

OT

95

96 Content/area Observation, discussion, field visit, OJT Audiogram, reference books Handbook of clinical audiology by Katz Notes Reference Text; Handbook Clinical audiology Katz J. etal Assignment TE TE Activities/learning strategies Materials Products/ Outcome Evaluation Data collection, Group discussion, Field visit/ OJT Special audiometric test ABLB SISI test Discussion, note preparation, Practical observation Reference text Introduction to audiology Martin F.N Note OT

Curriculum objectives

To understand the need Maskingand concept of masking Definition through observation, Rules for masking discussion, field visit, OJT. Prepare notes and charts 6 To familiarize with Objective tests Impedance various objective audiometry measurements for BSERA audiological evaluation OAE through data collection, group discussion, Field visit/ OJT. Prepare an assignment

To get an awareness about the special audiometric tests used for differentiating sensory loss from retrocochlear disorders, through discussion, Practicals and observation. Prepare notes

ASSESSMENT OF HEARING LOSS

2.5 To understand the need and concept of masking through observation, discussion field visit/OJT. 2.6 To familiarize with various objective measurement for audiological evaluation through data collection, field visit / OJT. Prepare an assignment. 2.7 To get an awareness about the special audiometric tests used for differentiating sensory loss from retro cochlear disorders through discussion, Practicals and observations. Prepare notes.

Introduction
Sound is one of the most important factors in our environment. In the form of speech, it is the most convenient form of communication. It is often a source of pleasure, as when we listen to music. When sound becomes excessive, distracting or even Painful, such as the din of machinery in a factory, the blax of an unwanted radio or the scream of a jet engine we have the Problem of noise. Without sound, our world seems empty and dead. If we know something of the nature of sound and its relationship to hearing, we can understand how our hearing may be measured and how such measurements can be used by an otologist to determine the nature of his Patients loss and then what assistance can be provided.

Syllabus
Assessment of hearing loss.
l l l l l l

Case history evaluation. Screening procedure for hearing evaluation Tuning fork test Overview of audiometry Orientation to masking Need for masking

Curriculum Objectives
2.1 To get a brief idea about case history evaluation through data collection, discussion and OJT. Prepare notes. 2.2 To understand the screening procedure for evaluating hearing loss through data collection, discussion. 2.3 To understand the various tuning fork test used for audiological evaluation through discussion, demonstration, practicals. Prepare seminar. 2.4 To understand different types of audiometers through group discussion, field visit and assignment

Orientation to free field audiometry and objective measurements such as tympanometry Reflexometry. BSERA, OAE

2.1Case History Evaluation

Learning activity: - Data collection, discussion and OJT Learning materials: Reference book: Principle of Hearing aid Audiology By Maryantate, Collected data.
97

Process:
The students collect the general format of case history from nearest audiology lab. Divide the students in to groups. Let them discussing it the following points.
Discussion points

Out Come

Learner gets an idea about case history.

Evaluation:
OT

2.2

Screening procedure for hearing evaluation

Data collection Discussion Reference text - Martin F.N. Introduction to audiology.

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.

Learning activity

Learning materials

Process

During field visit or OJT, the students can observe the preparation of case histories. Prepare a note on the general format of case history.
Consolidation

The learner can collect the general format related to this topic from library or an audiology lab. Discuss the matter in groups with the help of teacher

98

During hospital visit the learner can observe the various case histories with the permission of an audiologist.
Consolidation

99

Other activities Prepare a chart showing the general format of this topic.
Out come

The learner can strengthen the knowledge about this topic during field visit with the help of a doctor. Students are instructed to perform the above tests till they get sufficient practice Ask the group leaders to conduct a seminar on this topic.

Practicals: -

The learner get a brief idea about the screening procedure

Evaluation

Out come

OT

2.3

Tuning Fork test

Demonstration,

Learning activity Discussion, practicals Learning materials -

The learner acquire a skill in performing screening tests.

Evaluation
PE

Charts, Tuning fork (512Hz)

Evaluating the practical skill in performing tuning fork test

Reference text Martin F.N Introduction to audiology.

2.4

Overview of Audiometry.
Group discussion, field visit Reference text -Martin.F.N Introduction to audiology, Audiometers.

Learning activity Learning materials

Process:
Demonstration: - Demonstration of tuning fork tests by the teacher Teacher divides the students in to groups (4) Using reference materials groups can discuss the following points.
l l l l

Process
Divide the students into 5 groups. Ask them to collect the reference materials from the library and discuss the following points.
l l l l l l

Rinnes test - Group I Weber test - Group II ABC test - Group III Schwaback test - Group IV

Consolidate the discussion points with the help teacher. Ask them to present the report (one among each group)
Consolidation

Pure tone audiometry Speech audiometry Impedance audiometry Evoked Response Audiometry Free field audiometry

Tuning fork test - Rinnes, Weber test, ABC, Schwabach (Principle, procedure, interpretation)

During field visit/OJT the learner can improve his knowledge with the help of experts consolidate the discussion with the help of the teacher prepare an assignment

100

Consolidation:

the concept by going through clinical tests Prepare notes

Consolidation

Out come

Free field -open or an area with boundaries that are negligible for the test. Impedene audiometry The instrument used to assess the middle ear status Procedures

Masking-Definition Cross over effect Masking for AC and BC

Prepare a note based on the above activities Other activities: Prepare a chart showing the rules of maskingn and display in laboratory.
Out come

The students get a brief idea about the different audiometers.

Evaluation:
O.T

2.5 Orientation to masking-need for masking

Learning activities Observation, Group discussion, field visit/OJT Audiograms
TE

The students get an idea about the masking and need for masking
Evaluation

Learning materials Reference text Hand book of clinical audiology by Katz

Masking is essential for bone conduction test commend on this statement

2.6
-

Objective Audiometric Test

Data collection, group discussion Field visit/OJT. Reference text- Hand book of clinical audiology by Katz

Learning activities

Process:
Let the students to observe an audiogram with masking and without masking. Ask them to compare the thresholds obtained for each time. Teacher divide the students in to 5 groups supply reference materials and discuss the following Points
l l l l l

Learning materials -

Process
Ask the learner to collect data from library regarding this topic. Arrange a group discussion.
Points

What is masking Need of masking Methods of masking Rules for masking

Objective measurements such as

l l l l l

Tympanometry Reflexometry Evoked response audiometry OAE

Note the points in a diary Field visit /OJT helps the learner to strength

101

During field visit / OJT the students can collect more information about the objective tests. Ask the students to present the report in the form of an assignment.
Consolidation:-

Learning materials Reference books Introduction to audiology By Martin.F.N

Process:
Teacher distributes the print out materials of this topic to the groups.
Points
l l l l l l

Out come:

Principle of objective test Applications

Purpose of special audiometric tests. Retro cochlear &cochlear deafness. Recruitment ABLB test SISI test

The learner gets an idea about the above objective test Tests.
Evaluation

TE

The learner can note the points with the guidance of teacher Students strengthen their idea by conducting practicals in lab with help of teacher and observing the clinical test during OJT. Mr. Jamal suffering from hearing loss consulted an ENT specialist. Doctor advised tympanometry. Tympanogram obtained is given above. (a) (b) (c) Comment on the tympanogram What is the principle of this test Clinical applications of tympanometry. Ask the students to prepare a note based on the above activities
Consolidation :

Recruitment ABLB SISI Out come

2.7

Special Audiometric tests (ABLB, SISI)

Discussion, practical, observation

Definition to detect recruitment in unilateral deafness to differentiate cochlear from retrocochlear Lesions. Procedure

Learning activity

Students understand the special audiological tests and their applications

Evaluation

OT

102

3
HEARING AIDS

103

UNIT AT A GLANCE

104 Content/area Hearing aids, Principle, Application Discussion, data collection, chart preparation Chart Notes TE Models, instruction manual, photographs, prepared charts Reference text; Maryanne tate Circuit diagram, working model, block diagram Report PE Activities/learning strategies Materials Products/ Outcome Evaluation Hearing aid, Circuit details Demonstration, Discussion Type of hearing aid AC types Digital and programmable hearing aids Data collection, group discussion, expert opinion, field visit & OJT Data collection, chart preparation and discussion Instruction manuals Report OT Reference Text Assignment CT

Unit 3 : Hearing Aids

Curriculum objectives

1 To understand the need

and working of hearing aid through discussion, data collection and chart preparation. Prepare notes 2 To familiarize with the circuit details of hearing aids through demonstration and discussion. Prepare models 3 To understand different types of hearing aid through data collection, chart preparation and discussion

4 To get an idea about the Assistive devices assistive devices for for hearing impaired hearing impaired, through data collection, group discussion, expert opinion, field visits & OJT. Prepare notes

Curriculum objectives Care and maintenance of hearing aids Group discussion, observation, field visit/ OJT, Assignment Reference Text hearing aids Instruction manual Assignment CT

Content/area

Activities/learning strategies

Materials

Products/ Outcome

Evaluation

5 To get an awareness about the care and maintenance of hearing aid through group discussion, observation during field visit/ OJT. Prepare an assignment

6 To get an idea about

Cochlear implants Journals, reference text, Animated CDs

cochlear implants through data collection and discussion

Data collection, discussion

Report

CT

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HEARING AIDS

Introduction
Hearing aid is a device that brings sound to the ear more effectively. It is a miniature audio amplifier specially designed for improving human communication. Any individual who has a hearing problem that cannot be helped by medical or surgical means is a candidate for hearing aid. There are very few deaf people who have no hearing whatsoever; It is much more usual to have some residual hearing. A hearing aid system enable a hearing impaired person to make maximum use of this residual hearing area, and provide maximum speech clarity and useful information from environmental sound. In this unit the working of hearing aid, its parts, components and types of hearing aids are discussed. By going through this unit the learner get an awareness about hearing aid system and its applications. 3.3 To understand different types of hearing aids through data collection, chart preparation and discussion. 3.4 To get an idea about the assistive devices for hearing impaireds, through data collection, group discussion, expert opinion, field visit and OJT 3.5 To create an awareness about the care and maintenance of hearing aid through group discussion and observation. 3.6 To get an idea about cochlear implants through data collection and discussion.

Syllabus
l

Curriculum Objectives
3.1 To understand the need and working of hearing aid through discussion, data collection and chart preparation. Prepare notes 3.2 To familiarize with the circuit details of hearing aids through demonstration and discussion. Prepare notes.
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Hearing aids-Types including digital and programmable aids-Parts of hearing aidGroup amplification system and other assistive listening devices-Brief account of main electro acoustic characteristicsAided audiometry- Ling sound test- Care and maintenance of hearing aidsIntroduction to cochlear implants.

Hearing Aid
Learning activity Discussion, Data collection, Chart preparation. Models, Product Manual, Photographs, Prepared Chart

Learning materials -

Reference text Principles of hearing aid audiology by Maryanne Tate Maltby

Evaluation

TE

Complete the block diagram and explain.

Process
Teacher initiate a discussion on hearing aid by asking questions.
l

Microphone

Receiver

What can be done if a person is having hearing impairment. Do you see any person wearing hearing aid.

3.2 Hearing Aid Circuit Details

Learning Activity Demonstration and Discussion. Circuit Diagram, Working in Model, Block Diagram. Learning Materials

Teacher exhibits the prepared chart showing block diagram of a hearing aid. Divide the students into 4 groups, supply reference materials. Let them identify the function of each block and present in the class.
Discussion points: l l l l

Process
Teacher demonstrates the working of a hearing aid in laboratory with the help of a working model. The block diagram charts and circuit diagram are displayed. Students identify the parts according to block diagram.
Points:

Microphone Amplifier Receiver Battery

Prepare notes based in this discussion Other activities Ask the students to prepare a chart showing the block diagram of Hearing aid. Microphone: Picks up the sound signals and converted in to electric signals

1. 2. 3. 4. 5.

Microphone Amplifier Controls Battery (Power supply) Receiver (Ear piece)

Consolidation:

Out Come

Let the students to draw the circuit diagram and block diagram in their notebook and prepare notes. Other Activities Out Come

The learner gets an awareness about the need and working of hearing aid.

Prepare a working model of low cost hearing aid in laboratory.

Students identify the circuit components of hearing aid

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Evaluation
PE

Out Come

3.3 Various Types of Hearing Aid

Learning Activity Data Collections, preparation, Discussion. Chart

Students understand the working of Hearing aid and its use.

Evaluation:
O.T

3.4 Assistive Devices

Learning Activity Group discussion, Expert Opinion, Field visit/OJT Learning Material Principles of hearing and audiology by Maryanne tate -

Learning Materials Photographs from reference books, Product Manuals,Charts reference books.

Process
Students collect the details of different varieties of hearing aid. Teacher lead them into a discussion on the merits and demerits of each model, on the basis of comfort, cost, effectiveness, problem in using, size. Divide the students into groups of 5. Let each group prepare charts showing one model, its merits and demerits, applications and exhibit it in the laboratory.
Points:

Process
The learner collects the reference materials to create an awareness about this topic. During filed visit/ OJT the learner then collect more information about assistive devices with the help of experts
Group Discussion

Types of
l l

Divide the students into 5 groups and ask to discuss the following points. 1. 2. 3. 4. Ask to prepare a note relating this topic.
Consolidation:

AC Hearing Aid B.C Hearing Aid Digital and programmable hearing aid Advantages and disadvantages of each model

Assistive listening devices and systems Alerting devices Tele communication devices.

Basic varieties in A.C Hearing Aid

l l

Note the points in a diary. Prepare notes based on the above activities
Consolidation:

Body Worn & AC type - Definition BTE ICT

Out Come

Induction loops - Amplitude modulation - Frequency modulation - Alarm clock with flashing lights - TDDS

Other activities Prepare chart showing Hearing aids and their features.

The learner gets an idea about the assistive devices

Evaluation
OT

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3.5

Care and Maintenance of Hearing Aids

Group discussion, Observation, Field visit/OJT Hearing aids, Instruction manuals

3.6 Introduction to Cochlear Implants

Learning Activity Data collection and discussion Learning Material Journals, Reference Text, Animated CDS

Learning Activities

Learning Materials Reference text Introduction to audiology for teachers and professionals by Maryanne tate

Process
The learner collects the informations relating to the topic from Journals and reference text. Divide the students into groups and discuss the following points: 1. 2. 3. 4. Note the points in a diary with the guidance of teacher During field visit or OJT the learner can collect more informations with the help of an expert and using animated websites. Group leaders can present the topic in class. Prepare notes based on the above activities.
Consolidation

Process
The learner can read out the print out relating to the topic and discuss the following points in groups.
Dicussion Points
l l l

Principles of cochlear implants Components of cochlear implants Advantages

Visual check Listening check

The learner can observe the procedures during field visit Ask the learners to prepare an assignment on this topic.
Consolidation:
l

Visual check Cracks in casing, tone hook Wax in the microphone inlet Parts 1. 2. 3.

Devices which converts sound signals into electrical impulse which directly stimulates the cochlea

Microphone Speech processor Electrodes The learner gets an idea about the cochlear Implants and its uses.

Listening Check The battery Listening through a stethoclip

Out Come

Out Come

The learner gets an idea about the care and maintenance of hearing aids.
Evaluation

Evaluation:

OT

OT
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4
EAR MOULDS

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UNIT AT A GLANCE

Unit 4 : Ear Moulds

Content/area Ear moulds, Types, Illustration, Discus- Prepared charts, Note Preparation, Modifi- sion, Field visit/ OJT Photographs, reference textcation AudiologyMarryanne Tate OT Activities/learning strategies Materials Products/ Outcome Evaluation

Curriculum objectives

1 To create an awareness about ear mould, types of ear mould, procedure of making ear moulds and its modifications through illustration, discussion, field visit/ OJT. Prepare notes

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EAR MOULDS

Introduction
The purpose of an ear mould is to secure the aid to the ear and convey sound in to the ear canal. The mould may also have significant effect on the frequency response of the aid. By completing this unit the learner understands the various steps involved in ear mould making and modification.

Process
Teacher exhibit a chart showing the features of an ear moulds in relation to the pinna and illustrate
Points
l l l l

Purpose of ear mould Concept Features

Curriculum objectives
4.1 To create an awareness about ear mould, types, Procedure of making ear mould and its modification through illustration, discussion, field visit / OJT

Students redraw the diagram and prepare notes Activity Divide the students in to 5 groups and supply reference materials to them (5 different portions to each group). Let them discuss the content and List out the points

Syllabus
l l l

Parts and types of ear moulds Procedure of making regular ear moulds Brief note on ear mould modification

Discussion points
l l l l l l

4.1
-

Ear mould

Impression materials-group1 Ear impression equipment-group1 Ear Examination-group2 Ear impression technique-group3 Ear mould materials-group4 Ear mould types-group5 (also prepare charts showing different types)

Learning activity illustration, discussion, field visit / OJT Learning materials Prepared charts photographs, Reference Texts: Principle of Hearing aid audiology by Maryanne tate.

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Leaders of each group present the points in the above given order. Teacher may add the left out points. Note the points in a diary. During OJT / Field visit the learner strengthen the concept by collecting datas. The learner can observe the ear mould preparation during this period. Prepare a final report based on the above activities.

Practicals

Ear mould preparation.

Out come

The learner understand the Earmould, its use, procedure of making ear mould and its types

Evaluation
OT

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5
REHABILITATION OFCHILDRENSAND ADULTSWITHHEARINGIMPAIRMENT

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UNIT AT A GLANCE

Unit 5: Rehabilitation of Adults and Childrens with hearing impairment

Content/area Rehabilitation techniques Discussion, Field visit, interview Note Reference books; Katz.J. etal, Handbook of clinical audiology, Expert opinion CT Activities/learning strategies Materials Products/ Outcome Evaluation

Curriculum objectives

1 To understand the various rehabilitation methods adopted for deaf adult and children through discussion, field visit and interview. Prepare notes OT Notes Aural method Signed method cued method Discussion, Field visit/ OJT, interview Reference texts; Katz J. etal, Handbook of clinical audiology, Expert opinion

2 To understand the various education options for hearing impaired through discussion, interview and OJT

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REHABILITATION OF CHILDRENS & ADULTS WITH HEARING IMPAIRMENT

Introduction
Hearing loss is an under estimated impairment that may need to many secondary problems in addition to primary communication difficulties. Suitable rehabilitation must be provided to deaf adult. Specialist teachers of the deaf undertake the rehabilitation of deaf children. The hearing aid audiologist can make a significant contribution to the hearing impireds clients quality of life. The rehabilitation process may be handled entirely by the audiologist. In this unit various rehabilitation process of deaf adult and habilitation of children are discussed. By going though this unit the learner get a idea about the rehabilitation process hearing aid fitting auditory training speech therapy. Learning Material Reference text :- Principles of hearing aid audiology (Maryanne Tate), Expert opinion, (audiologist)

Process
Teacher initiate the discussion on rehabilitation of deaf adult and children through a general discussion.
Points:
l l l l

Handicapped persons in society What we can do for them? Role of Government, Society Deaf adult and children. What can be done for them? .

l l

Curriculum Objectives
5.1 To understand the various rehabilitation methods adopted for deaf adult and children though discussion field visit and interview. 5.2 To understand the various educational options for hearing impared through discussion, interview and OJT
Rehabilitation of Hearing impaired

After the discussion, teacher divide the students in to5 groups. Let the groups to visit the near by deaf school to collect information by observation and interview Teachers give direction on important points to be noted.
Points;l l

Hearing aid and aural rehabilitation Attitude of hearing impaired

Learning activities Discussion, Field visit, interview

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Practical aspects Instruction Insertion and removal of aid Operating the hearing Aid and care training Assistive devices Improving communications Speech reading Lip reading Auditory training Speech therapy

discussion, reference materials expert opinion, OJT , field visit Learning materials Reference text, discussion

l l

Process
The teacher can give the print outs to create an awareness of this topic
Points
l l

Need of educating the hearing impaireds The different methods of educational options.

Rehabilitation of deaf children Rehabilitation process Fitting of H.A to children Cochlear implant Educational provision Divide the portion among the groups. Conduct a discussion and group leaders present the report
l

Notes the points in a diary. During the field visit/ OJT the learner can strengthen his knowledge by arranging an interview with the experts. Consolidate the points of this topic after a group discussion in the classroom. The group leaders can present the report in the form of a seminar.
Consolidation

Teacher consolidate by adding additional points Ask the students to prepare notes based on the above activities Students prepare notes
Outcome:

Outcome

Aural method Signed method Cued method

Students get an idea about the rehabilitation of deaf adult and children
Evaluation

The learner gets an idea about the various educational method

OT

Evaluation
OT

Educational options for hearing impaireds

Curriculum objectives

To understand the various educational options for hearing impaired through

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REFERENCES
ECG 1 An introduction to electrocardiography Colin Schamroth 7th edition Black well science 2 Medical Instrumentation John G. Webster 3rd edition John Wely & Sons INC New York

3 Handbook of biomedical instrumentation R.S Kandpur Tata MC Graw Hell Publishing Company limited 4 ECG made easy John R Hampton

5 Principles of biomedical/ engineering for nursing staff Hans A Von Des Mosel Black well Scientifc Publications 6. Introduction to biomedical equipment technology 4th edition Joseph J Cars John M Brown 7 Biomedical instrumentation Dr. M Arumugham Anuradha Agencies publishers Vidhyal Karuppur Kumbakonam RMS 8 Biomedical instrumentation & Publications Leslie Cromwell Fred J Weibell Erich A Pfeiffer Prentice Hall of India Private Ltd. New Delhi 110001

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9 Foundations of Anatomy & Physiology Roas & Wilson 10 Making sense of the ECG 11 A text book of Medical Instruments Andrew R. Houzhton & David Gray 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 and distributors, 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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