Experimentation in self-directed distance education using the new

Information Technology

Prof Neil WhiteRespiratory Clinic, UCT and Groote Schuur

Hospital.

UCT Lung Institute

HEALTH 803

Development and evaluation of guidelines and materials for the technology transfer of

x-ray reading skills to clinicians in the mining industry

Objectives of the session.

• To provide background and introduce participants to the use of the ROLDS CD Rom.

ACKNOWLEDGEMENTS

• Jill Murray

• Ray Glyn Thomas

• Albert Solomon

• Khanya Mashao

• Mary Ross• Steve Benningfield• Stephen Bredenkamp• Mohammed Jaffer• And the participants..• And others…

•Hillel Goodman

•Lindiwe Ndelu

•Elmien Le Roux

•Gavin Churchyard

•Rajen Naidoo

Diagnosis of Pneumoconiosis

• History and nature of exposure. – Duration, quantity and time lag.

• Pneumoconiotic x-ray pattern.– Progression of the x-ray pattern over time.– Chronic nature of the disease.

• Exclusion of other diseases with a similar pattern.

R.O.L.D.S.

Radiological

Occupational

Lung

Disease

Surveillance

What is ROLDS?

Radiological Occupational Lung Disease Surveillance (ROLDS) is a planned programme of repeated health screening. ROLDS refers to any programme for medical surveillance carried out in South Africa as a result of risk assessment or because it is required in terms of the Mine Health and Safety Act (or the Occupational Health and Safety Act).

The purpose of a programme of ROLD Surveillance is:

• to detect and appropriately refer occupational lung disease at the earliest possible stage;

• to establish a base line against which subsequent changes in health status of employees can be evaluated;

• to identify other medical conditions incidentally detected that require further referral for appropriate evaluation and treatment of conditions identified;

• to provide information concerning the prevalence or incidence of abnormalities that will enable the employer to eliminate, control and minimise the health risk for which the programme is being conducted.

Why is ROLDS important?

• Pneumoconiosis, tuberculosis and other lung diseases pose a major challenge in SA. ROLDS is part of an overall strategy to identify and control these conditions.

• Radiology is the current standard for Pn diagnosis, but is an imperfect screening instrument for OLD.

• Provision of ROLDS by employers is a legal requirement in certain industries.

• Radiology and consequent medical therapies are significant costs to industry.

How do practitioners learn about ROLDS?

• Not part of the undergraduate curriculum

• DOH

• Occasional courses

• Books? NIOSH examples?

• B reader courses.

The Curriculum.

• The ROLDS curriculum was developed as an iterative process amongst the Faculty members early on in the project.

• The curriculum outlines the knowledge base for ROLDS.

• Thorough understanding provides an approach to challenges in the field.

• However, testing this understanding may give no indication of proficiency in ROLDS.

The Training Product

• “The Symposium”– 19 lectures, 501 slides, 7 hrs audio time

• “The Simulation”• Scanning exercise (50)

– Approx 10 - 15% abnormal

• Confirmatory exercise (25)– >50% abnormal

• Files documenting use can be returned to UCTLI.