A patient has chills and a fever. Students at Columbia University School of Nursing discuss the diagnosis with their classmates. But they also talk to people in a little box--the medical team at a clinic in La Romana in the Dominican Republic.
Norma Hannigan said she got the idea while she was at the clinic last April. Why not discuss medical cases and learn from each other?
"We're a little stronger on the primary care chronic illness end of the spectrum, and they're much stronger on the infectious disease," Hannigan, an assistant professor of clinical nursing.
The students were presented a patient with diabetes and everyone had to figure out how they'd solve it together.
"The way we manage the case here versus the way they would manage the case in the Dominican Republic is very different," Stephanie Paine, a nurse practitioner student, explained.
It was surprising to learn, for example, they almost never do a test called Hemoglobin A1C. It's too expensive, but in the U.S., that test is done for diabetics all the time.
Students can also learn about cultural differences. In Washington Heights, many of the residents are from the Dominican Republic.
"It's a way to improve the way we treat patients," said Dr. Leonel Lerebours, the medical director of La Clinica de Familia in La Romana, Dominican Republic.
Lerebours says they have learned to work with fewer resources.
"We rely more on clinical features than lab," he said.
This is the first long distance webinar, but they say it won't be the last.
"Maybe incorporate more people from the school of public health from the school of medicine," Hannigan suggested.
"It's really good," Martha Yepes said. "We're able to have this exchange, especially with the technology that we have now."
There were, of course, some technical challenges; the connection was slow at times, and it's hard to capture excitement or enthusiasm when you're doing it over the web.
But there were also funny moments. Where what we consider a problem here, La Romana's medical team thinks it's normal.
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