Ministry of Health and Family Welfare

Allied Health Section 2015-16

Model Curriculum Handbook

OPERATION THEATRE
TECHNOLOGY
Model Curriculum Handbook
OPERATION THEATRE
TECHNOLOGY

Ministry of Health and Family Welfare

Allied Health Section
Contents
Contributors to drafting and review .................................................................................................................... 2
List of Abbreviations ................................................................................................................................................ 4
Chapter 1: Introduction to the Handbook ......................................................................................................... 8
Who is an Allied and Healthcare Professional? .................................................................................................. 8
Scope and need for allied and healthcare professionals in the Indian healthcare system ............................ 8
Learning goals and objectives for allied and healthcare professionals............................................................ 9
Introduction of new elements in allied and healthcare education ................................................................. 15
Competency-based curriculum.................................................................................................................. 15
Promoting self-directed learning of the professionals ........................................................................ 15
Credit hours vs traditional system ............................................................................................................ 16
Integrated structure of the curriculum .................................................................................................... 16
Introduction of foundation course in the curriculum ......................................................................... 17
Learning methodologies .............................................................................................................................. 17
Assessment methods..................................................................................................................................... 18
Chapter 2: Methodology of curriculum development .................................................................................. 22
Chapter 3: Background of the profession ........................................................................................................ 26
Statement of Philosophy– Why this profession holds so much importance............................................... 26
About Operation Theatre Technology .............................................................................................................. 26
Scope of practice ................................................................................................................................................... 26
Recognition of Title and qualification................................................................................................................ 27
Definition of Operation Theatre Technologist ................................................................................................ 28
Education of the operation theatre technologist ............................................................................................. 28
Entry requirements ............................................................................................................................................... 29
Course Duration .................................................................................................................................................... 29
Teaching Faculty and Infrastructure .................................................................................................................. 29
Chapter 4: Model Curriculum ............................................................................................................................. 34
Background ............................................................................................................................................................ 34
Diploma in Operation Theater Technology ..................................................................................................... 38
Introduction ..................................................................................................................................................... 38
Eligibility for admission .............................................................................................................................. 38
Duration of the course .................................................................................................................................. 39
Medium of instruction: ................................................................................................................................ 39
Attendance: ...................................................................................................................................................... 39
Assessment: ..................................................................................................................................................... 39
Model Curriculum Outline ...................................................................................................................... 39
Skills based outcomes and monitorable indicators for Operation Theatre Technologist ....... 55
B. Sc. in Operation Theater Technology ........................................................................................................... 60
Introduction: .................................................................................................................................................... 60
Eligibility for admission .............................................................................................................................. 60
Duration of the course .................................................................................................................................. 61
Medium of instruction:................................................................................................................................. 62
Attendance: ...................................................................................................................................................... 62
Assessment: ..................................................................................................................................................... 62
Model Curriculum Outline ................................................................................................................... 62
Skills based outcomes and monitorable indicators for Operation Theatre Technologist ....... 83
Chapter 5: Job Description for all levels.......................................................................................................... 88
Annex- 1...................................................................................................................................................................... 90
References ........................................................................................................................................................ 93

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Contributors to drafting and review

OPERATION THEATRE TECHNOLOGY TASKFORCE

1. Dr. (Prof.) Mridula Pawar, Safdarjung Hospital, Delhi. --------------Taskforce Chairperson
2. Mr. Manoj Kumar, Post Graduate Institute of Medical Education and Research,
Chandigarh
3. Mr. Sanjay Kumar, G B Pant Hospital, Delhi.
4. Dr. Anoop Raj Gogia, Safdarjung Hospital, Delhi.
5. Prof. Y K Batra, Post Graduate Institute of Medical Education and Research,
Chandigarh
6. Dr. Sarla Hooda, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical
Sciences Rohtak
7. Sri Prasad V.G, Amrita Centre for Allied Health Sciences, Amrita University, Kochi.
8. Dr. Chhavi Sawhney, Jai Prakash Narayan Apex Trauma Center, AIIMS, Delhi
9. Dr. Vijay Vohra, Medanta the Medicity, Delhi.
10. Dr. Rajiv Juneja, Medanta the Medicity, Delhi.
11. Dr. Deep Arora, Fortis Memorial Research Institute, Delhi.
12. Dr. Rajeev Uppal, G B Pant Hospital, Delhi.
13. Dr M H Hanumantha Rao, SVIMS, Tirupati.
14. Dr Raghu D, Narayana Health.

NATIONAL CURRICULA REVIEW COMMITTEE

1. Mr. Ali R. Rizvi, Joint Secretary, Ministry of Health & Family Welfare (MoHFW)-
Chairman
2. Prof. Sanjay Srivastava, DDG(ME), MoHFW
3. Mr. B. S Murthy, Director (AHS), MoHFW
4. Dr. Arun Kr. Agarwal, Ex-Dean, MAMC
5. Dr. B.V. Adkoli, Educationalist, Ex-AIIMS
6. Dr. Bipin Batra, Executive Director, NBE
7. Dr. Subhash Salunke, Senior Advisor, PHFI
8. Dr. T K Jena, Professor, School of Health Sciences, IGNOU
9. Dr. Zenab Zaidi, Director, Health Sector Skill Council
10. Ms. Kavita Narayan, Director- NIAHS - TSU

Moderator- Dr Nilesh Kokane

Project Director- Ms. Kavita Narayan
Content Writer and Organizer – Mr. Sutirtha Mazumder

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List of Abbreviations

AED Automated External Defibrillator

AHP allied and healthcare Professionals
AIDS Acquired Immuno Deficiency Disease
BLS Basic life support
BOTT Bachelor in Operation Theatre Technology
BMW Bio Medical Waste
BVM Bag Value Masks
CATS Credit Accumulation and Transfer System
CBC Complete Blood Count
CBCS Choice-Based Credit System
CbD Case-based discussion
CEX Case Evaluation Exercise
CHC Community Health Centre
CMP Comprehensive Metabolic Panel
CPR Cardiopulmonary Resuscitation
CPU Central Processing Unit
CSF Cerebrospinal fluid
CSSD Central Sterile Supplies Department
DH District Hospital
DOTT Diploma in Operation Theatre Technology
DOPs Direct observation of procedures
ECG Electro cardiogram
ESWL Extracorporeal shock wave therapy
HIS Hospital Information System
HOD Head of Department
HSSC Healthcare Sector Skill Council
ILO International Labor Organization
JCI Joint Commission International
LFT Liver Function Tests
CEX Mini Case Evaluation Exercise
NAAC National Assessment and Accreditation Council
NABH National Accreditation Board for Hospitals & Healthcare
NCRC National Curricula Review Committee
NIAHS National Initiative for Allied and Healthcare Sciences
NSDA National Skills Development Agency
NSQF National Skills Qualification Framework
OBG Obstetrics and Gynecology
OSCE Objective Structured Clinical Examination
OT Operation Theatre
OTT Operation Theatre Technology
OSLER Objective Structured Long Examination Record
OSPE Objective Structured Practical Examination
PPE Personal Protective Equipment

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PHC Primary Health Centre
RFT Renal Function Tests
SDL Self-directed learning
SCA Sudden Cardiac Arrest
SC Sub Centre
SDH Sub District Hospital
TFT Thyroid Function Test
TURP Transurethral Resection of the Prostate
TURBT Transurethral Resection of Bladder Tumors
UGC University Grants Commission
UHC Universal Health Coverage
WWW World Wide Web

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Chapter 1
Introduction to the Handbook

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Chapter 1: Introduction to the Handbook

The report ‘From Paramedics to Allied Health Professionals: Landscaping the Journey and Way
Forward’ that was published in 2012, marked the variance in education and training practices for
the allied and healthcare courses offered by institutions across the country. This prompted the
Ministry of Health and Family Welfare to envisage the creation of national guidelines for
education and career pathways of allied and healthcare professionals, with a structured
curriculum based on skills and competencies. Thus, this handbook has been designed to
familiarize universities, colleges, healthcare providers as well as educators offering allied and
healthcare courses with these national standards.
Individually, created for different professional groups of allied and healthcare, this handbook
aims to reduce the variation in education by comprising of a standardized curriculum, career
pathways, nomenclature and other details for each profession. The change from a purely didactic
approach will create better skilled professionals and improve the quality of overall patient care.
In the absence of a national standard-setting authority, this handbook can also guide the
thousands of young adults who choose healthcare as a profession – not as doctors or nurses but
to play several other critical roles – on the appropriate course of action to enable them to be
skilled allied and healthcare professionals of the future.
Who is an Allied and Healthcare Professional?

The Ministry of Health and Family Welfare, accepted in its entirety the definition of an allied and
healthcare professional based on the afore-mentioned report, though the same has evolved after
multiple consultations and the recommended definition is now as follows-
‘Allied and healthcare professionals (AHPs) includes individuals involved with the delivery of health or healthcare related
services, with qualification and competence in therapeutic, diagnostic, curative, preventive and/or rehabilitative interventions.
They work in multidisciplinary health teams in varied healthcare settings including doctors (physicians and specialist), nurses
and public health officials to promote, protect, treat and/or manage a person(‘s) physical, mental, social, emotional,
environmental health and holistic well-being.’1

Since the past few years, many professional groups have been interacting and seeking guidance
on all those who would qualify under the purview of “allied and healthcare professionals”. In the
healthcare system, statutory bodies exist for clinicians, nurses, pharmacists and dental
practitioners; but a regulatory structure for around 50 professions is absent in India. Currently,
the Government is considering these professions (as listed Annex-1) under the ambit of the
allied and healthcare system. However, this number is subject to changes and modifications over
time, particularly considering how quickly new technologies and new clinical avenues are
expanding globally, creating newer cadres of such professionals.
Scope and need for allied and healthcare professionals in the Indian healthcare
system

The quality of medical care has improved tremendously in the last few decades due to the
advances in technology, thus creating fresh challenges in the field of healthcare. It is now widely
recognized that health service delivery is a team effort involving both clinicians and non-
clinicians, and is not the sole duty of physicians and nurses.1 Professionals that can competently
handle sophisticated machinery and advanced protocols are now in high demand. In fact,

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diagnosis is now so dependent on technology, that allied and healthcare professionals (AHPs) are
vital to successful treatment delivery.

Effective delivery of healthcare services depends largely on the nature of education, training and
appropriate orientation towards community health of all categories of health personnel, and their
capacity to function as an integrated team. For instance in the UK, more than 84,000 AHPs, with
a range of skills and expertise, play key roles within the National Health Service, working
autonomously, in multi-professional teams in various settings. All of them are first-contact
practitioners and work across a wide range of locations and sectors within acute, primary and
community care. Australia’s health system is managed not just by their doctors and nurses, but
also by the 90,000 university-trained, autonomous AHPs vital to the system.2,3

As the Indian government aims for Universal Health Coverage, the lack of skilled human
resource may prove to be the biggest impediment in its path to achieve targeted goals. The
benefits of having AHPs in the healthcare system are still unexplored in India. Although an
enormous amount of evidence suggests that the benefits of AHPs range from improving access
to healthcare services to significant reduction in the cost of care, though the Indian healthcare
system still revolves around the doctor-centric approach. The privatization of healthcare has also
led to an ever-increasing out-of-pocket expenditure by the population. However, many examples
assert the need of skilled allied and healthcare professionals in the system, such as in the case of
stroke survivors, it is the support of AHPs that significantly enhance their rehabilitation and long
term treatment ensures return to normal life. AHPs also play a significant role to care for
patients who struggle mentally and emotionally in the current challenging environment and
require mental health support; and help them return to well-being.2 Children with
communication difficulties, the elderly, cancer patients, patients with long term conditions such
as diabetes people with vision problems and amputees; the list of people and potential patients
who benefit from AHPs is indefinite.
Thus, the breadth and scope of the allied and healthcare practice varies from one end to another,
including areas of work listed below:

 Across the age span of human development from neonate to old age;
 With patients having complex and challenging problems resulting from systemic
illnesses such as in the case of diabetes, cardiac abnormalities/conditions and elderly
care to name a few;
 Towards health promotion and disease prevention, as well as assessment,
management and evaluation of interventions and protocols for treatment;
 In a broad range of settings from a patient's home to community, primary care
centers, to tertiary care settings; and
 With an understanding of the healthcare issues associated with diverse socio-
economies and cultural norms within the society.

Learning goals and objectives for allied and healthcare professionals

The handbook has been designed with a focus on performance-based outcomes pertaining to
different levels. The learning goals and objectives of the undergraduate and graduate education
program will be based on the performance expectations. They will be articulated as learning goals
(why we teach this) and learning objectives (what the students will learn). Using the framework,

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students will learn to integrate their knowledge, skills and abilities in a hands-on manner in a
professional healthcare setting. These learning goals are divided into nine key areas, though the
degree of required involvement may differ across various levels of qualification and professional
cadres:

Clinical care
1. Communication
2. Membership of a multidisciplinary health team
3. Ethics and accountability at all levels (clinical, professional, personal and social)
4. Commitment to professional excellence
5. Leadership and mentorship
6. Social accountability and responsibility
7. Scientific attitude and scholarship (only at higher level- PhD)
8. Lifelong learning

1. Clinical Care4
Using a patient/family-centered approach and best evidence, each student will organize and
implement the prescribed preventive, investigative and management plans; and will offer
appropriate follow-up services. Program objectives should enable the students to:

 Apply the principles of basic science and evidence-based practice

 Use relevant investigations as needed
 Identify the indications for basic procedures and perform them in an appropriate
manner
 Provide care to patients – efficiently and in a cost-effective way – in a range of
settings, and maintain foremost the interests of individual patients
 Identify the influence of biological, psychosocial, economic, and spiritual factors on
patients’ well-being and act in an appropriate manner
 Incorporate strategies for health promotion and disease prevention with their patients

2. Communication4,5
The student will learn how to communicate with patients/clients, care-givers, other health
professionals and other members of the community effectively and appropriately.
Communication is a fundamental requirement in the provision of health care services. Program
objectives should enable the students to:

 Provide sufficient information to ensure that the patient/client can participate as

actively as possible and respond appropriately to the information
 Clearly discuss the diagnosis and options with the patient, and negotiate appropriate
treatment plans in a sensitive manner that is in the patient’s and society’s best
interests
 Explain the proposed healthcare service – its nature, purpose, possible positive and
adverse consequences, its limitations, and reasonable alternatives wherever they exist

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 Use effective communication skills to gather data and share information including
attentive listening, open-ended inquiry, empathy and clarification to ensure
understanding
 Appropriately communicate with, and provide relevant information to, other
stakeholders including members of the healthcare team
 Use communication effectively and flexibly in a manner that is appropriate for the
reader or listener
 Explore and consider the influence that the patient’s ideas, beliefs and expectations
have during interactions with them, along with varying factors such as age, ethnicity,
culture and socioeconomic background
 Develop efficient techniques for all forms of written and verbal communication
including accurate and timely record keeping
 Assess their own communication skills, develop self-awareness and be able to
improve their relationships with others
 Possess skills to counsel for lifestyle changes and advocate health promotion

3. Membership of a multidisciplinary health team6

The student will put a high value on effective communication within the team, including
transparency about aims, decisions, uncertainty and mistakes. Team-based health care is the
provision of health services to individuals, families, and/or their communities by at least two
health providers who work collaboratively to accomplish shared goals within and across settings
to achieve coordinated, high quality care. Program objectives will aim at making the students
being able to:

 Recognize, clearly articulate, understand and support shared goals in the team that
reflect patient and family priorities
 Possess distinct roles within the team; to have clear expectations for each member’s
functions, responsibilities, and accountabilities, which in turn optimizes the team’s
efficiency and makes it possible for them to use division of labor advantageously, and
accomplish more than the sum of its parts
 Develop mutual trust within the team to create strong norms of reciprocity and
greater opportunities for shared achievement
 Communicate effectively so that the team prioritizes and continuously refines its
communication channels creating an environment of general and specific
understanding
 Recognize measurable processes and outcomes, so that the individual and team can
agree on and implement reliable and timely feedback on successes and failures in
both the team’s functioning and the achievement of their goals. These can then be
used to track and improve performance immediately and over time.

4. Ethics and accountability

Students will understand core concepts of clinical ethics and law so that they may apply these to
their practice as healthcare service providers. Program objectives should enable the students to:

 Describe and apply the basic concepts of clinical ethics to actual cases and situations

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 Recognize the need to make health care resources available to patients fairly,
equitably and without bias, discrimination or undue influence
 Demonstrate an understanding and application of basic legal concepts to the practice
 Employ professional accountability for the initiation, maintenance and termination of
patient-provider relationships
 Demonstrate respect for each patient's individual rights of autonomy, privacy, and
confidentiality

5. Commitment to professional excellence7

The student will execute professionalism to reflect in his/her thought and action a range of
attributes and characteristics that include technical competence, appearance, image, confidence
level, empathy, compassion, understanding, patience, manners, verbal and non-verbal
communication, an anti-discriminatory and non-judgmental attitude, and appropriate physical
contact to ensure safe, effective and expected delivery of healthcare. Program objectives will aim
at making the students being able to:

 Demonstrate distinctive, meritorious and high quality practice that leads to excellence
and that depicts commitment to competence, standards, ethical principles and values,
within the legal boundaries of practice
 Demonstrate the quality of being answerable for all actions and omissions to all,
including service users, peers, employers, standard-setting/regulatory bodies or
oneself
 Demonstrate humanity in the course of everyday practice by virtue of having respect
(and dignity), compassion, empathy, honour and integrity
 Ensure that self-interest does not influence actions or omissions, and demonstrate
regards for service-users and colleagues

6. Leadership and mentorship8

The student must take on a leadership role where needed in order to ensure clinical productivity
and patient satisfaction. They must be able to respond in an autonomous and confident manner
to planned and uncertain situations, and should be able to manage themselves and others
effectively. They must create and maximize opportunities for the improvement of the health
seeking experience and delivery of healthcare services. Program objectives should enable the
students to:

 Act as agents of change and be leaders in quality improvement and service

development, so that they contribute and enhance people’s wellbeing and their
healthcare experience
 Systematically evaluate care; ensure the use of these findings to help improve
people’s experience and care outcomes, and to shape clinical treatment protocols and
services
 Identify priorities and effectively manage time and resources to ensure the
maintenance or enhancement of the quality of care
 Recognize and be self-aware of the effect their own values, principles and
assumptions may have on their practice. They must take charge of their own personal

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and professional development and should learn from experience (through
supervision, feedback, reflection and evaluation)
 Facilitate themselves and others in the development of their competence, by using a
range of professional and personal development skills
 Work independently and in teams. They must be able to take a leadership role to
coordinate, delegate and supervise care safely, manage risk and remain accountable
for the care given; actively involve and respect others’ contributions to integrated
person-centered care; yet work in an effective manner across professional and agency
boundaries. They must know when and how to communicate with patients and refer
them to other professionals and agencies, to respect the choices of service users and
others, to promote shared decision-making, to deliver positive outcomes, and to
coordinate smooth and effective transition within and between services and agencies.

7. Social Accountability and Responsibility9

The students will recognize that allied and healthcare professionals need to be advocates within
the health care system, to judiciously manage resources and to acknowledge their social
accountability.10 They have a mandate to serve the community, region and the nation and will
hence direct all research and service activities towards addressing their priority health concerns.
Program objectives should enable the students to:

 Demonstrate knowledge of the determinants of health at local, regional and national

levels and respond to the population needs
 Establish and promote innovative practice patterns by providing evidence-based care
and testing new models of practice that will translate the results of research into
practice, and thus meet individual and community needs in a more effective manner
 Develop a shared vision of an evolving and sustainable health care system for the
future by working in collaboration with and reinforcing partnerships with other
stakeholders, including academic health centres, governments, communities and
other relevant professional and non-professional organizations
 Advocate for the services and resources needed for optimal patient care
8. Scientific attitude and Scholarship10
The student will utilize sound scientific and/or scholarly principles during interactions with
patients and peers, educational endeavors, research activities and in all other aspects of their
professional lives. Program objectives should enable the students to:
 Engage in ongoing self-assessment and structure their continuing professional
education to address the specific needs of the population
 Practice evidence-based by applying principles of scientific methods
 Take responsibility for their educational experiences
 Acquire basic skills such as presentation skills, giving feedback, patient education and
the design and dissemination of research knowledge; for their application to teaching
encounters

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9. Lifelong learning11
The student should be committed to continuous improvement in skills and knowledge while
harnessing modern tools and technology. Program objectives will aim at making the students
being able to:

 Perform objective self-assessments of their knowledge and skills; learn and refine
existing skills; and acquire new skills
 Apply newly gained knowledge or skills to patient care
 Enhance their personal and professional growth and learning by constant
introspection and utilizing experiences
 Search (including through electronic means), and critically evaluate medical literature
to enable its application to patient care
 Develop a research question and be familiar with basic, clinical and translational
research in its application to patient care
 Identify and select an appropriate, professionally rewarding and personally fulfilling
career pathway

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Introduction of new elements in allied and healthcare education
Competency-based curriculum

A significant skill gap has been observed in the professionals offering healthcare services
irrespective of the hierarchy and level of responsibility in the healthcare settings. The large
variation in the quality of services is due to the diverse methodologies opted for healthcare
education and the difference in expectations from a graduate after completion of a course and at
work. What one is expected ‘to perform’ at work is assumed to be learned during the course,
however, the course design focuses on what one is expected ‘to know’. The competency-based
curriculum thus connects the dots between the ‘know what’ and ‘do how’.

The efficiency and effectiveness of any educational programme largely depends on the
curriculum design that is being followed. With emerging medical and scientific knowledge,
educators have realized that learning is no more limited to memorizing specific lists of facts and
data; in fact, by the time the professional aims to practice in the healthcare setting, the acquired
knowledge may stand outdated. Thus, competency-based education is the answer; a curricular
concept designed to provide the skills that professionals need. A competency-based program is a
mix of skills and competencies based on individual or population needs (such as clinical
knowledge, patient care, or communications approaches), which is then developed to teach
relevant content across a range of courses and settings. While the traditional system of education
focuses on objectives, content, teacher-centric approach and summative evaluation; competency-
based education has a focus on competencies, outcomes, performance and accomplishments. In
such a case, teaching activities are learner-centered, and evaluation is continuous and formative
in structure. The competency-based credentials depend on the demonstration of a defined set of
competencies which enables a professional to achieve targeted goals. Competency frameworks
comprise of a clearly articulated statement of a person’s abilities on the completion of the
credential, which allows students, employers, and other stakeholders to set their expectations
appropriately.12 13

Considering the need of the present and future healthcare delivery system, the curriculum design
depicted in this handbook thus will be based on skills and competencies.

Promoting self-directed learning of the professionals

The shift in the focus from traditional to competency-based education has made it pertinent that
the learning processes may also be revisited for suitable changes. It is a known fact that learning
is no more restricted to the boundaries of a classroom or the lessons taught by a teacher. The
new tools and technologies have widened the platform and introduced innovative modes of how
students can learn and gain skills and knowledge. One of the innovative approaches is learner-
centric and follows the concept of self-directed learning.

Self-directed learning, in its broadest meaning, describes a process in which individuals take the initiative with or
without the help of others, in diagnosing their learning needs, formulating learning goals, identifying resources for
learning, choosing and implementing learning strategies and evaluating learning outcomes (Knowles, 1975).14
In self-directed learning, learners themselves take the initiative to use resources rather than
simply reacting to transmissions from resources, which helps them learn more in a better way. 15
Lifelong, self-directed learning (SDL) has been identified as an important ability for medical

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graduates (Harvey, 2003)16 and so is applicable to other health professionals including AHPs. It
has been proven through many studies worldwide that the self-directed method is better than the
teacher-centric method of learning. Teacher-directed learning makes learners more dependent
and the orientation to learning becomes subject-centred. If a teacher provides the learning
material, the student is usually satisfied with the available material, whereas if a student is asked
to work on the same assignment, he or she invariably has to explore extensive resources on the
subject.15
Thus the handbook promotes self-directed learning, apart from the usual classroom teaching and
opens the platform for students who wish to engage in lifelong learning.

Credit hours vs traditional system

Recently the National Assessment and Accreditation Council (NAAC) and the University Grants
Commission (UGC) have highlighted the need for the development of a Choice-Based Credit
System (CBCS), at par with global standards and the adoption of an effective grading system to
measure a learner’s performance.17 All the major higher education providers across the globe are
operating a system of credits. The European Credit Transfer System (ECTS), the ‘National
Qualifications Framework’ in Australia, the Pan-Canadian Protocol on the Transferability of
University Credits, the Credit Accumulation and Transfer System (CATS) in the UK as well as
the systems operating in the US, Japan, etc. are examples of these. Globally, a need now exists
for the use of a fully convertible credit-based system that can be accepted at other universities. It
has now become imperative to offer flexible curricular choices and provide learners mobility due
to the popularity of initiatives such as ‘twinning programmes’, ‘joint degrees’ and ‘study abroad’
programmes.18

In order to ensure global acceptability of the graduates, the current curriculum structure is
divided into smaller sections with focus on hours of studying which can be converted into credit
hours as per the international norms followed by various other countries.

Integrated structure of the curriculum

Vertical integration, in its truest sense, is the interweaving of teaching clinical skills and
knowledge into the basic science years and, reinforcing and continuing to teach the applications
of basic science concepts during the clinical years. (Many efforts called ‘vertical integration’
include only the first half of the process).
Horizontal integration is the identification of concepts or skills, especially those that are clinically
relevant, that cut across (for example, the basic sciences), and then putting these to use as an
integrated focus for presentations, clinical examples, and course materials. e.g. Integration of
some of the basic science courses around organ systems, e.g., human anatomy, physiology,
pathology; or incorporating ethics, legal issues, finance, political issues, humanities, culture and
computer skills into different aspects of a course like the Clinical Continuum.
The aim of an integrated curriculum is to lead students to a level of scientific fluency that is
beyond mere fact and concept acquisition, by the use of a common language of medical science,
with which they can begin to think creatively about medical problems.19
This innovative new curriculum has been structured in a way such that it facilitates horizontal
and vertical integration between disciplines; and bridges the gaps between both theory &

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practice, and between hospital-based practice and community practice. The amount of time
devoted to basic and laboratory sciences (integrated with their clinical relevance) would be the
maximum in the first year, progressively decreasing in the second and third year of the training,
making clinical exposure and learning more dominant.11 However it may differ from course to
course depending on the professional group.

Introduction of foundation course in the curriculum

The foundation course for allied and healthcare professions is an immersive programme
designed to impart the required knowledge, skills and confidence for seamless transition to the
second semester of a professional allied and healthcare course. Post admission, the foundation
course is designed for a period of 6 months to prepare a student to study the respective allied
and healthcare course effectively and to understand the basics of healthcare system. This aims to
orient the student to national health systems and the basics of public health, medical ethics,
medical terminologies, communication skills, basic life support, computer learning, infection
prevention and control, environmental issues and disaster management, as well as orientation to
the community with focus on issues such as gender sensitivity, disability, human rights, civil
rights etc. Though the flexibility to the course designers have been provided in terms of –
modifying the required numbers of hours for each foundation subject and appropriate placement
of the subject across various semesters.

Learning methodologies

With a focus on self-directed learning, the curriculum will include a foundation course that
focuses on communication, basic clinical skills and professionalism; and will incorporate clinical
training from the first year itself. It is recommended that the primary care level should have
sufficient clinical exposure integrated with the learning of basic and laboratory sciences. There
should also be an emphasis on the introduction of case scenarios for classroom discussion/case-
based learning.
Healthcare education and training is the backbone of an efficient healthcare system and India's
education infrastructure is yet to gain from the ongoing international technological revolution.
The report ‘From Paramedics to Allied Health: Landscaping the Journey and way ahead’, indicates that
teaching and learning of clinical skills occur at the patient’s bedside or other clinical areas such as
laboratories, augmented by didactic teaching in classrooms and lecture theatres. In addition to
keeping up with the pace of technological advancement, there has been a paradigm shift to
outcome-based education with the adoption of effective assessment patterns. However, the
demand for demonstration of competence in institutions where it is currently limited needs to be
promoted. The report also mentions some of the allied and healthcare schools in India that have
instituted clinical skill centres, laboratories and high-fidelity simulation laboratories to enhance
the practice and training for allied and healthcare students and professionals. The report
reiterates the fact that simulation is the replication of part or all of a clinical encounter through
the use of mannequins, computer-assisted resources and simulated patients. The use of
simulators addresses many issues such as suboptimal use of resources and equipment, by
adequately training the manpower on newer technologies, limitations for imparting practical
training in real-life scenarios, and ineffective skills assessment methods among others.1 The table
mentioned below lists various modes of teaching and learning opportunities that harness
advanced tools and technologies.

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Table 1 Clinical learning opportunities imparted through the use of advanced techniques1,20

Teaching modality Learning opportunity examples

Patients Teach and assess in selected clinical scenarios
Practice soft skills
Practice physical examination
Receive feedback on performance
Mannequins Perform acquired techniques
Practice basic procedural skills
Apply basic science understanding to clinical problem solving
Simulators Practice teamwork and leadership
Perform cardiac and pulmonary care skills
Apply basic science understanding to clinical problem solving
Task under trainers As specific to Operation Theatre Technology

Assessment methods

Traditional assessment of students consists of the yearly system of assessments. In most

institutions, assessments consist of internal and external assessments, and a theory examination
at the end of the year or semester. This basically assesses knowledge instead of assessing skills or
competencies. In competency-based training, the evaluation of the students is based on the
performance of the skills as per their competencies. Hence, all the three attributes – knowledge,
skills, and attitudes – are assessed as required for the particular competency.

Several new methods and tools are now readily accessible, the use of which requires special
training. Some of these are given below:

 Objective Structured Clinical Examination(OSCE), Objective Structured Practical

Examination (OSPE), Objective Structured Long Examination Record(OSLER)
 Mini Case Evaluation Exercise(CEX)
 Case-based discussion(CBD)
 Direct observation of procedures(DOPs)
 Portfolio
 Multi-source feedback
 Patient satisfaction questionnaire

An objective structured clinical examination (OSCE) is used these days in a number of allied and
healthcare courses, e.g. Optometry, Physiotherapy, and Radiography. It tests the performance
and competence in communication, clinical examination, and medical procedures/prescriptions.
In physiotherapy, orthotics, and occupational therapy, it tests exercise prescription, joint
mobilization/manipulation techniques; and in radiography it tests radiographic positioning,
radiographic image evaluation, and interpretation of results. The basic essential elements consist
of functional analysis of the occupational roles, translation of these roles (“competencies”) into
outcomes, and assessment of trainees' progress in these outcomes on the basis of demonstrated

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performance. Progress is defined solely by the competencies achieved and not the underlying
processes or time served in formal educational settings. Most methods use predetermined, agreed
assessment criteria (such as observation check-lists or rating scales for scoring) to emphasize on
frequent assessment of learning outcomes. Hence, it is imperative for teachers to be aware of
these developments and they should suitably adopt them in the allied and healthcare education
system.21

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Chapter 2
Methodology of Curriculum
Development

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Chapter 2: Methodology of curriculum development

With the release of the report ‘From Paramedics to Allied Health: Landscaping the journey and
the way ahead’, the Ministry of Health and Family Welfare prioritized the key recommendations
and concerns raised by various allied and healthcare professionals groups and experts as
indicated in the report. One of the major recommendations in the report was the need for
standardization of curriculum and pedagogic requirements for the major allied and healthcare
professional courses.
The MoHFW has identified 12 priority professional streams in the phase-I for the purpose of
standardization. The expertise of over 50 leading public and private allied and healthcare
educational institutions for 12 different disciplines has been sought as part of this exercise.
Additionally, international experts from Canada, Sweden, USA and UK are also being roped in,
to arrive at a comprehensive and globally acceptable set of educational standards based on a
skills and competencies approach. The opinions were sought from experts for all the courses,
though curricula for the following two professions were not redesigned as they fall under the
ambit of regulatory body- Rehabilitation Council of India governed by Ministry of Social Justice
and Empowerment –

 Audiology and Speech Pathology

 Orthotics and Prosthetics

The National Skills Development Agency has also developed the National Skills Qualification
Framework (NSQF). Under the aegis of the NSDA, the Healthcare Sector Skill Council (HSSC)
has undertaken a similar process for a few entry level allied and healthcare courses (Certificate
and Diploma level). The focus of Ministry of Health and Family Welfare is thus to preempt
duplication of efforts and arrive at a comprehensive set of minimum standards for the allied and
healthcare professions but for higher level professional qualifications. This would ensure that the
key considerations and obligations of both the public and the private sector are adequately
addressed.
In view of the above, the Ministry of Health and Family Welfare instituted 12 National Curricula
Redesign Taskforce groups comprising of academicians and professionals from the best
institutes and colleges across the country. These people served as subject experts and redesigned
the curricula based on a standardized framework developed by the NIAHS TSU (National
Initiative for Allied Health Sciences-Technical Support Unit), which is the technical arm
supporting this project. The final curriculum has been reviewed and approved by the National
Curricula Review Committee (NCRC), (constituted by the MoHFW), that consists of experts
with versatile and immense experience in their respective streams, to assess the applicability of
the curricula drafted in view of the healthcare system as a whole.
Steps undertaken in the curricula review process –
1. Curricula were sought from various States and institutions across the country in response
to which the NIAHS TSU reviewed–
a. 118 curricula of allied and healthcare courses (different levels and different
professions) from 10 states across the country;
b. 133 curricula of various allied and healthcare courses collected during phase-I of
the NIAHS project.

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2. Literature review – a comprehensive literature review was undertaken resulting in a
detailed curriculum of the allied and healthcare courses, which included competency and
skills-based models followed nationally as well as internationally, methodologies of
curriculum development, assessment protocols, and many such aspects of curriculum
development. The literature review helped the TSU to develop a reference document that
comprised of a standard framework for a competency-based curriculum to be followed
for the curricula review and redesign. A detailed mapping of all the resources was
undertaken and shared with the taskgroup experts via email.
3. Constitution of the National Curricula Redesign Taskforces for various professional
groups – Specific taskforces were then instituted comprising of technical as well as
subject experts who were engaged in the process of redesigning the curriculum.
4. Constitution of the National Curricula Review Committee (NCRC) – The NCRC
comprising of experts with versatile and immense experiences of their respective domain,
was then constituted for final review and approval on the curriculum drafted by the
taskforce and NIAHS TSU.
5. National Curricula Redesign Taskforce Consultations– a series of consultations were
conducted with subject experts including both regional and national taskgroup experts to
develop a ‘skill and competency’ framework for education and career pathways. The
consultations were facilitated by the NIAHS TSU members and were led by the
chairperson of the group. Post this, the draft version and recommendations were
compiled by the TSU members and sent to the experts for final review and consent.
6. Local consultations – These were also conducted in different hospitals and other
healthcare settings to get suggestions, feedbacks and ideas from the subject experts for
their respective curricula.
7. Response draft – Comments and suggestions were received on the draft and a response
draft curriculum was prepared, which was then re-circulated for final consent and
validation by the taskgroup experts.
8. Submission and approval of draft curriculum – The final draft of the curriculum
handbook was then submitted by the taskforce chairman to the National Curricula
Review Committee for approval and final sign-off.
9. Public opinion – The handbook was uploaded to seek public opinion from national and
international experts, students, faculty, and practitioners of the respective professional
groups.
10. Final approval by the NCRC- The comments and suggestions by the public were then
reviewed and considered for any possible modification by the taskforce group. The final
approval and sign off for the overall structure was then sought from NCRC.
11. Dissemination- The final handbook (guidelines) is disseminated by the Ministry of
Health and Family Welfare for further adoption and incorporation by
institutes/universities as applicable to ensure standardization.

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Chapter 3
Background of the profession

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Chapter 3: Background of the profession
Statement of Philosophy– Why this profession holds so much importance

A latest study by the Harvard School of Public Health has found that while the South-East Asia
region has just 2.6 OTs per 1 lakh population, the number is as low as 1.3 OT per 1 lakh
population in India and Pakistan. Whereas, developed regions like Eastern Europe have the
highest number of OTs per 1 lakh population - 25.1, followed by Asia Pacific (high income
countries) 24.3, Central Europe 15.7, Western Europe 14.7, North America and Australasia 14.3,
Central Asia 11.7 and the Caribbean 10.4 OTs). So we may interpret that there is an enormous
scope and need for the profession not only in India as well as in other developing countries but
at the same time along with skilled manpower we need adequate manpower.
Moreover, a variety of electrical and electronic equipment are in use in modern operation
theatres for monitoring anesthesia & surgical procedures, the success of the procedures and
safety of patients depend largely on the reliability, smooth and trouble free performance of these
equipment’s and ability of skilled manpower to operate the same. Thus, there is increased need
for qualified and trained professionals in the system. This course is aimed at satisfying this need.

About Operation Theatre Technology

An operation theatre (OT) technologist forms an intrinsic part of any hospital. To become a
trained professional one must undertake operation theatre technology course. An OT
professional is the one, who facilitates the surgical procedures, planned and emergency both, by
preparing in advance the equipment that are necessary for any surgical procedures. He/she also
looks after all the work and management of the operation theatre which includes managing the
patients in & out of operation theatre, looking after all the surgical equipment, arrangement of
operation theatre table, dressing table, anesthesia table as well as management of the staff. As the
surgical branch has various specialty including General Surgery, OBG, Cardiac, Ortho and
genito-urinary, the OT technologist needs to know about these various specialties.

Scope of practice

a. Setup, check, and maintain anesthesia machine, monitors life support equipment like airway
equipment, ventilator, emergency equipment, defibrillator, anesthetic and resuscitation drugs.
b. Orders, Maintains and keep records of all anesthesia equipment and drug.
c. Assist Anesthetist in patient procedures like setting up of invasive lines, airway
management, setting up of monitors and administer anesthesia to patient
d. Assists during emergency situations by assisting in basic and advanced life support, critical
events
e. Prepares and maintains operation table, light, electric cautery, tourniquets etc.
f. Management of central sterile services department. Packing of equipment and linen.
Sterilization procedures like autoclaving, plasma sterilization and disinfection procedures as
per guidelines, checking, storage and dispatch.
g. Management in Intensive Care unit and emergency department of equipment like ventilators,
monitors, infusion pumps, defibrillators etc.
h. Assist disaster team in disaster situations and national emergencies on field and safe transport
in ambulance.
i. Assist anesthesia and surgical team in all kinds of surgical disciplines.
j. Assist anesthetist during anesthesia procedures outside operation theatres like CT and MRI
suits, Cardiac catheterization laboratory, pain relief procedures etc.

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Recognition of Title and qualification

Within the multidisciplinary team, the professional responsible for the facilitation and
preparation of the surgical procedures is the Operation theatre technologist.
The recommended title thus stands as the Operation Theatre Technologist with the
acronym - OTT for this group of professionals.
It is a known fact that with the career advancement, the nomenclature will also vary and will
also depend on the sector and profile of the professional. Considering the 10 NSQF levels
designed by the NSDA, the following level progression table has been proposed by the
taskforce to map the nomenclature, career pathways and progression in different sectors of
professional practice for Operation theatre technologist. The proposed progression is for
further discussion and deliberation, the implementation time of the same may vary
depending on the current system and regulations in place.
The table 2 below indicates the various channels of career progression in three distinct sectors
such as clinical setting, academic and industry (management/sales or technical) route. It is
envisaged that the OTT will have two entry pathways – students with diploma or baccalaureate.
The level of responsibility will increase as the career progresses and will starts with level four (4)
for diploma holders and level five (5) for baccalaureate holders. The table also indicates the
corresponding level of qualification with experience required by the professional to fulfill the
requirements of each level. Considering the degree of patient dealing in operation theatre
technology and such other professions, government aims to phase out the Diploma and PG
Diploma level courses and promote Bachelors’ and Masters’ degree courses. In the academic
front, as per UGC guidelines, to work at the position of a Lecturer/Assistant Professor the
candidate must attain master degree. At present there are limited master degree seats in
Operation Theatre Technology in India, and thus it has been decided that eventually provisions
will be made to provide bridge courses for PG Diploma holder for certain number of years to
bring them at par with the master level courses and universities will be promoted to start master
degree courses. The table also indicates that career progression is upto the level 10, however it
needs to be stated that the ultimate signatory authority on patient documentation stands with
the surgeon on role, the chief technical officer of the OT unit (clinical route) will be the
ultimate authority for the management responsibilities, the final authority for the clinical
decisions will be with the doctor.

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Table 2 Nomenclature based on career progression for Operation Theatre Technologist
(Proposed)
Nomenclature in various sectors Qualification and experience
Levels Clinical Academic Industry
Level 4 Operation Technical  Diploma OTT with 0 - 5 years post
Theatre Assistant associate Diploma OTT experience
Level 5 Junior Operation Demonstr Junior  BSc OTT with 0-5 years post BSc
Theatre ator Operation OTT
Technologist Theatre  Diploma OTT with 6-10 years post
Technologist OTT (only for Industry pathway)
Level 6 Senior Operation Tutor Senior  PGDOTT with 0-5 years post

Career progression
Theatre Operation PGDOTT
Technologist Theatre  BSc OTT with 6-10 post BSc OTT
Technologist  Diploma OTT 11-15 years’ experience
with General B.Sc. (only for Industry
pathway)
Level 7 Junior Technical Clinical Chief OT  PGDOTT with 6-10 years post
Officer Instructor Technologist PGDOTT
 BSc OTT with 11-15 years (Only
clinical/industry role) post BSc OTT
Level 8 Senior Technical - Deputy  PGDOTT with 11-15 years post
Officer Manager for PGDOTT
OT  BSc OTT with 16-20 years (only
clinical/industry role) post BSc OTT
Technology
Level 9 Chief Operation - Additional  PGDOTT with 16-20 years post
Theatre Officer Director for PGDOTT
OT  BSc OTT with 21-25 years (only
clinical/industry role) post BSc OTT
Technology
Level Chief Operation - Director for  PGDOTT with 21-25 years post
10 Theatre Manager OT PGDOTT
Technology  BSc OTT with 26-30 years (only
clinical/industry role) post BSc OTT
PGDOTT- Post Graduate Diploma for Operation Theatre Technology, this has been included in this
table considering the fact that some MSc course or PG Diploma course may exist or/and can be
developed for the Operation Theatre technology professionals. So the probable progression will be as
indicated in the table 2 above.
Definition of Operation Theatre Technologist

Operation theatre Technologist is a member of a multidisciplinary team in operation theatres who

prepare and maintain an operating theatre. Assists anaesthetist and surgical team during peri-
operative period and provides support to patients in the recovery room.
Education of the operation theatre technologist

When developing any education programme it is necessary that programme planning should be
outcome-based, meeting local and national manpower requirements, personal satisfaction and

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career potential for the professionals with supporting pathway in the development of the
profession. One of the major changes is the shift from a focus based on traditional theoretical
knowledge and skills to competency based education and training. Optimal education/training
requires that the student is able to integrate knowledge, skills and attitude in order to be able to
perform a professional act adequately in a given situation.

Thus, the following curriculum aims to focus on skills and competencies based approach for
learning and is designed accordingly. The curriculum is prescriptive and is designed with an aim
to standardize the content across the nation.

Entry requirements
It is recommended that the students entering the OTT programme should have completed the
recognized secondary school studies as the qualification, stipulated for OTT course
(diploma/degree) is 10+2 or equivalent examination with science subject from a recognized
university or board which would provide the foundation for and prepare them for higher
education studies with minimum 50% aggregate marks at HSC for open category and minimum
45% aggregate marks for reserve category.

Course Duration

It is recommended that any programme developed from this curriculum should have a minimum
of the following duration to qualify as an entry level professional in OTT -
 2.5 year programme (including 6 months of clinical training/internship)-
Diploma level
 4 year programme (including 1 year of clinical training /internship)- Bachelor’s
degree level

The emphasis initially should be on the academic content establishing a strong scientific basis
and in the latter year on the application of theory to clinical/reflective practice. In Bachelor
degree programme minimum one year should be devoted to clinical practice and this should be
on a continuum of rotation from theory to practice over the programme. The aim of the 4 year
degree programme is to enable the development of the OTT as a key member of the
multidisciplinary team and to enable him/her to execute his/her role with ensuring quality.

With the change in the disease dynamics and multifold increase in the, it is imperative that a well-
structured programme of postgraduate education is also encouraged so as to enhance research
capacity within the country to widen the scope of clinical practice for the profession. Thus, a
master’s degree programme is recommended with minimum of two years of education in
specialized field. The post graduate students can contribute significantly in research and
academics. Presently, there are limited master degree courses in the country and institutes and
universities should be encouraged to start such courses.

Teaching Faculty and Infrastructure

The importance of providing an adequate learning environment for the students cannot be over
emphasized. Both the physical infrastructure and the teaching staff must be adequate.

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Teaching areas should facilitate different teaching methods. Where students share didactic
lectures with other disciplines (e.g. nurses) large lecture theatres may be appropriate, but smaller
teaching areas should also be provided for tutorial and problem/case-based learning approaches.
In all venues where students are placed the health and safety standards must be adhered to.

The recommended teachers to student ratio in the UG level should be -1:25.

Job availability

As per ILO documentation, employers worldwide are looking for job applicants who not only
have technical skills that can be applied in the workplace, but who also can communicate
effectively, including with customers; can work in teams, with good interpersonal skills; can solve
problems; have good ICT skills; are willing and able to learn; and are flexible in their approach to
work.22 After completion of the courses mentioned in following chapters, the individual will find
a challenging career in a hospital, nursing homes, trauma / emergency centers, Intensive Care
units, CSSD etc. Graduates are eligible for employment overseas where their qualifications,
training and experience are highly regarded. With further experience, graduates may be employed
by medical equipment manufacturers and development specialists.
Graduates have good employment prospects, and will enter a field in which the demand for
professionals has increased in recent years and will keep on increasing due to changing
environment and conditions.

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Chapter 4
Model Curriculum of Operation
Theatre Technology (OTT)
Courses

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Chapter 4: Model Curriculum
Background

The need for accuracy in preparation and delivery is a critical component of modern technology
driven healthcare and requires knowledge and understanding of the basic sciences as well as the
interaction between the technology used in operation theatres and the site within the body that
needs the surgical intervention. In an era of greater complexity of technology and techniques, the
role of the operation theatre technologist (OTT) and his/her level of responsibility is continually
evolving and expanding. Education programmes should provide the OTT with the scientific
theoretical foundation of the profession and enable them, as practitioners, to be able to
synthesize, evaluate and apply their knowledge in a clinical setting.

The aims of the recommended curriculum are to produce OTTs who are
- Technically and clinically competent;
- Aware of safety issues and the importance of quality assurance;
- Understand the theoretical basis for evidence based practice;
- Effective members of the multidisciplinary team;
- Prepared to participate in or initiate research into practice;
- Can work according to registration requirements on the respective continents.

All aspects of operation theatre technology have been considered in the development of this
curriculum together with the identification of the roles expected for different levels based on
their qualification and experience. The need for connecting the dots between the education and
employment practices has been the road map for devising this curriculum.

The National Curriculum Taskforce on Operation theatre technology has successfully designed
the career and qualification map indicating the growth opportunities for a professional in the
career pathway based on the level as indicated in the National Skills Qualification Framework
(NSQF). The career pathway indicates level 4 as the entry level after the completion of a
minimum 2.5 years of diploma level programme on operation theatre technology (Diploma in
Operation Theatre Technology) as well as level 5 as the entry level after completion of a
minimum 4 years of Baccalaureate level programme on operation theatre (Bachelor in Operation
Theatre Technology). The component of the programmes starting from diploma and above has
been detailed out in the coming chapters.

Foundation course has also been designed to bring all the students at the same level of
understanding with respect to basic healthcare related norms before the start of a career in a
healthcare professional course. The foundation course is mandatory for all the allied and
healthcare professional courses and for both entry level courses – diploma as well as degree. If a
diploma holder has completed the foundation course and is willing to pursue the degree course,
the candidate will directly get entry for next semester, however a pre- qualifier skill test will have
to be satisfactorily completed, if not, then the candidate will have to undergo the first semester
of foundation course again.

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4.1 Diploma in Operation
Theatre Technology

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Diploma in Operation Theater Technology
Introduction
The operation theatre (OT) technologist is an integral person in the dynamic operating theatre
team. The success of the procedures and safety of patients depends largely on the reliability of
the OT technologist. This course aims in providing the technical and interpersonal skills required
to work under the supervision of anesthetists and surgical personnel.

Learning Objectives: At the completion of this course, the student should -

1. Be able to understand the basics of -Ethics, Discipline, Layout, and Equipment in
OT.
2. Be able to understand the basics of Anesthesia related modalities and procedures.
3. Be able to position the patients in different operating procedures and for anesthesia.
4. Have knowledge of basic principles of IV line, fluids, transfusion and C.P.R.
5. Demonstrate knowledge and skills related to routine care and endoscopes Anesthetic
Machines, Monitors etc.
6. Demonstrate knowledge and skilled related to Sterilization of OT Room,
Instruments, Endoscopes, CSSD.
7. Demonstrate knowledge and skilled related to Disposal of waste.
8. Be able to keep records and stock maintenance.
9. Be able to collect data and compute information.

Expectation from the future diploma holders:

1. The coursework is designed to train students to work in conjunction within the OT
team including surgeon, anesthesiologist, nurses and other members.
2. The student will be skilled in surgical preparation, supporting the team in peri
operative procedure and also ensure patient support.
3. Employment opportunities can be found in hospitals in both private and public
sectors as well as in independent trauma centre.
4. Diploma holder is encouraged to pursue further qualification to attain senior position
in the professional field, also to keep abreast with the advance and new technology,
the professional should opt for continuous professional education credits offered by
national and international institutes.

Eligibility for admission

Selection procedure
1. Candidate should have passed 10 + 2 with Science.
2. Minimum percentage of marks: 50% aggregate in PCB/M
3. Reservation for SC/ST/OBC categories: As per Govt. of India rules

Provision of Lateral Entry:

Lateral entry at Diploma level will not be there, as this is the basic entry level for the
professionals.

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Duration of the course
Duration of the course is of 2.5 years or 5 semesters (inclusive of six months of internship) with
740 hours of Theory & 1420 hours of Practical Classes and another 720 hours dedicated for
internship.
Total number of hours – 2880 for the total course

Medium of instruction:
English shall be the medium of instruction for all the subjects of study and for examination of
the course.
Attendance:
A candidate has to secure minimum -
1. 75% attendance in theoretical
2. 80% in Skills training (practical) for qualifying to appear for the final examination.

No relaxation, whatsoever, will be permissible to this rule under any ground including
indisposition etc.
Assessment:
Assessments should be completed by the academic staff, based on the compilation of the
student’s theoretical & clinical performance throughout the training programme. To achieve this,
all assessment forms and feedback should be included and evaluated.

Model Curriculum Outline 23 24 25 26

First Semester– Foundation Course
Sl. No. Course Titles Hours
Theory Practical Total
DOTT-001 Introduction to Healthcare Delivery System in India 60 0 60
DOTT-002 Basic computers and information Science 10 40 50
DOTT-003 Communication and soft skills 20 10 30
DOTT-004 Medical Terminology and Record keeping (including 40 0 40
anatomical terms)
DOTT-005 Medical Law and Ethics 40 0 40
DOTT-006 Introduction to Quality and Patient safety (including Basic 40 60 100
emergency care and life support skills, Infection prevention
and control, Biomedical waste management, Disaster
management and Antibiotic resistance)
DOTT-007 Professionalism and values 20 0 20
DOTT-008 Research Methodology and Biostatistics 40 20 60
DOTT-009 Principals of Management 40 0 40
DOTT-010 Community orientation and clinical visit (including related 0 100 100
practical to course 001)*
TOTAL 310 230 540
Teaching resources (tutors) should be made available at every institute for basic subjects such as
– Biology and English for students who wish to undertake the extra classes for the same.

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Second Semester
Sl. No. Course Titles Hours
Theory Practical Total
DOTT-011 Anatomy 40 80 120
DOTT-012 Physiology 40 80 120
DOTT-013 Lab Sciences 40 60 100
DOTT-014 Principles of Management 20 20 40
OTT Directed Clinical Education – part I (studentship) - 160 160
TOTAL 140 400 540

Third Semester
Sl. No. Course Titles Hours
Theory Practical Total
DOTT-015 Applied Anatomy 40 60 100
DOTT-016 Applied Physiology 40 60 100
DOTT-017 Clinical Pharmacology 40 60 100
DOTT-018 Principles of Anesthesia 60 80 140
OTT Directed Clinical Education – part II (studentship) - 100 100
TOTAL 180 360 540

Fourth Semester
Sl. No. Course Titles Hours
Theory Practical Total
DOTT-019 CSSD Procedures 50 100 150
DOTT-020 Basic Anesthetic techniques 30 80 110
DOTT-021 Regional Anesthetic techniques 30 80 110
OTT Directed Clinical Education – part III (studentship) - 170 170
TOTAL 110 430 540

Fifth Semester
Sl. No. Course Titles Hours
Theory Practical Total
OTT Internship 720 720

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First Semester- Foundation course

Introduction to National Healthcare System

The course provides the students a basic insight into the main features of Indian health care
delivery system and how it compares with the other systems of the world. Topics to be covered
under the subject are as follows:

1. Introduction to healthcare delivery system

a. Healthcare delivery system in India at primary, secondary and tertiary care
b. Community participation in healthcare delivery system
c. Health system in developed countries.
d. Private Sector
e. National Health Mission
f. National Health Policy
g. Issues in Health Care Delivery System in India
2. National Health Programme- Background objectives, action plan, targets, operations,
achievements and constraints in various National Heath Programme.
3. Introduction to AYUSH system of medicine
a. Introduction to Ayurveda.
b. Yoga and Naturopathy
c. Unani
d. Siddha
e. Homeopathy
f. Need for integration of various system of medicine
4. Health scenario of India- past, present and future
5. Demography & Vital Statistics-
a. Demography – its concept
b. Vital events of life & its impact on demography
c. Significance and recording of vital statistics
d. Census & its impact on health policy
6. Epidemiology
a. Principles of Epidemiology
b. Natural History of disease
c. Methods of Epidemiological studies
d. Epidemiology of communicable & non-communicable diseases, disease
transmission, host defense immunizing agents, cold chain, immunization, disease
monitoring and surveillance.
Medical terminologies and record keeping

This course introduces the elements of medical terminology. Emphasis is placed on building
familiarity with medical words through knowledge of roots, prefixes, and suffixes. Topics
include: origin, word building, abbreviations and symbols, terminology related to the human
anatomy, reading medical orders and reports, and terminology specific to the student’s field of
study. Spelling is critical and will be counted when grading tests. 27Topics to be covered under the
subject are as follows:

1. Derivation of medical terms.

2. Define word roots, prefixes, and suffixes.

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3. Conventions for combined morphemes and the formation of plurals.
4. Basic medical terms.
5. Form medical terms utilizing roots, suffixes, prefixes, and combining roots.
6. Interpret basic medical abbreviations/symbols.
7. Utilize diagnostic, surgical, and procedural terms and abbreviations related to the
integumentary system, musculoskeletal system, respiratory system, cardiovascular system,
nervous system, and endocrine system.
8. Interpret medical orders/reports.
9. Data entry and management on electronic health record system.
Basic computers and information science

The students will be able to appreciate the role of computer technology. The course has focus on
computer organization, computer operating system and software, and MS windows, Word
processing, Excel data worksheet and PowerPoint presentation. Topics to be covered under the
subject are as follows:

1. Introduction to computer: Introduction, characteristics of computer, block diagram of

computer, generations of computer, computer languages.
2. Input output devices: Input devices(keyboard, point and draw devices, data scanning
devices, digitizer, electronic card reader, voice recognition devices, vision-input devices),
output devices(monitors, pointers, plotters, screen image projector, voice response
systems).
3. Processor and memory: The Central Processing Unit (CPU), main memory.
4. Storage Devices: Sequential and direct access devices, magnetic tape, magnetic disk,
optical disk, mass storage devices.
5. Introduction of windows: History, features, desktop, taskbar, icons on the desktop,
operation with folder, creating shortcuts, operation with windows (opening, closing,
moving, resizing, minimizing and maximizing, etc.).
6. Introduction to MS-Word: introduction, components of a word window, creating,
opening and inserting files, editing a document file, page setting and formatting the text,
saving the document, spell checking, printing the document file, creating and editing of
table, mail merge.
7. Introduction to Excel: introduction, about worksheet, entering information, saving
workbooks and formatting, printing the worksheet, creating graphs.
8. Introduction to power-point: introduction, creating and manipulating presentation,
views, formatting and enhancing text, slide with graphs.
9. Introduction of Operating System: introduction, operating system concepts, types of
operating system.
10. Computer networks: introduction, types of network (LAN, MAN, WAN, Internet,
Intranet), network topologies (star, ring, bus, mesh, tree, hybrid), components of
network.
11. Internet and its Applications: definition, brief history, basic services (E-Mail, File
Transfer Protocol, telnet, the World Wide Web (WWW)), www browsers, use of the
internet.
12. Application of Computers in clinical settings.
Practical on fundamentals of computers -

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1. Learning to use MS office: MS word, MS PowerPoint, MS Excel.
2. To install different software.
3. Data entry efficiency
Medical law and ethics

Legal and ethical considerations are firmly believed to be an integral part of medical practice in
planning patient care. Advances in medical sciences, growing sophistication of the modern
society’s legal framework, increasing awareness of human rights and changing moral principles of
the community at large, now result in frequent occurrences of healthcare professionals being
caught in dilemmas over aspects arising from daily practice.28
Medical ethics has developed into a well based discipline which acts as a "bridge" between
theoretical bioethics and the bedside. The goal is "to improve the quality of patient care by
identifying, analyzing, and attempting to resolve the ethical problems that arise in practice".28
Doctors are bound by, not just moral obligations, but also by laws and official regulations that
form the legal framework to regulate medical practice. Hence, it is now a universal consensus
that legal and ethical considerations are inherent and inseparable parts of good medical practice
across the whole spectrum. Few of the important and relevant topics that need to focus on are as
follows:
1. Medical ethics - Definition - Goal - Scope
2. Introduction to Code of conduct
3. Basic principles of medical ethics – Confidentiality
4. Malpractice and negligence - Rational and irrational drug therapy
5. Autonomy and informed consent - Right of patients
6. Care of the terminally ill- Euthanasia
7. Organ transplantation
8. Medico legal aspects of medical records – Medico legal case and type- Records and
document related to MLC - ownership of medical records - Confidentiality Privilege
communication - Release of medical information - Unauthorized disclosure - retention of
medical records - other various aspects.
9. Professional Indemnity insurance policy
10. Development of standardized protocol to avoid near miss or sentinel events
11. Obtaining an informed consent.

Communication and soft skills

Major topics to be covered under Communication course29 –

1. Basic Language Skills: Grammar and Usage.
2. Business Communication Skills. With focus on speaking - Conversations, discussions,
dialogues, short presentations, pronunciation.
3. Teaching the different methods of writing like letters, E-mails, report, case study,
collecting the patient data etc. Basic compositions, journals, with a focus on paragraph
form and organization.
4. Basic concepts & principles of good communication
5. Special characteristics of health communication
6. Types & process of communication
7. Barriers of communication & how to overcome

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Introduction to Quality and patient safety

1. Quality assurance and management - The objective of the course is to help students
understand the basic concepts of quality in health Care and develop skills to implement
sustainable quality assurance program in the health system.
a. Concepts of Quality of Care
b. Quality Improvement Approaches
c. Standards and Norms
d. Quality Improvement Tools
e. Introduction to NABH guidelines

2. Basics of emergency care and life support skills - Basic life support (BLS) is the
foundation for saving lives following cardiac arrest. Fundamental aspects of BLS include
immediate recognition of sudden cardiac arrest (SCA) and activation of the emergency
response system, early cardiopulmonary resuscitation (CPR), and rapid defibrillation with
an automated external defibrillator (AED). Initial recognition and response to heart
attack and stroke are also considered part of BLS. The student is also expected to learn
about basic emergency care including first aid and triage. Topics to be covered under the
subject are as follows:
a. Vital signs and primary assessment
b. Basic emergency care – first aid and triage
c. Ventilations including use of bag-valve-masks (BVMs)
d. Choking, rescue breathing methods
e. One- and Two-rescuer CPR
f. Using an AED (Automated external defibrillator).
g. Managing an emergency including moving a patient
At the end of this topic, focus should be to teach the students to perform the maneuvers
in simulation lab and to test their skills with focus on airways management and chest
compressions. At the end of the foundation course, each student should be able to
perform and execute/operate on the above mentioned modalities.
3. Bio medical waste management and environment safety- The aim of this section will be
to help prevent harm to workers, property, the environment and the general public.
Topics to be covered under the subject are as follows:
a. Definition of Biomedical Waste
b. Waste minimization
c. BMW – Segregation, collection, transportation, treatment and disposal (including
color coding)
d. Liquid BMW, Radioactive waste, Metals / Chemicals / Drug waste
e. BMW Management & methods of disinfection
f. Modern technology for handling BMW
g. Use of Personal protective equipment (PPE)
h. Monitoring & controlling of cross infection (Protective devices)

4. Infection prevention and control - The objective of this section will be to provide a
broad understanding of the core subject areas of infection prevention and control and to

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equip AHPs with the fundamental skills required to reduce the incidence of hospital
acquired infections and improve health outcomes. Concepts taught should include –
a. Evidence-based infection control principles and practices [such as sterilization,
disinfection, effective hand hygiene and use of Personal protective equipment
(PPE)],
b. Prevention & control of common healthcare associated infections,
c. Components of an effective infection control program, and
d. Guidelines (NABH and JCI) for Hospital Infection Control

5. Antibiotic Resistance-
a. History of Antibiotics
b. How Resistance Happens and Spreads
c. Types of resistance- Intrinsic, Acquired, Passive
d. Trends in Drug Resistance
e. Actions to Fight Resistance
f. Bacterial persistence
g. Antibiotic sensitivity
h. Consequences of antibiotic resistance
i. Antimicrobial Stewardship- Barriers and opportunities, Tools and models in
hospitals

6. Disaster preparedness and management- The objective of this section will be to provide
knowledge on the principles of on-site disaster management. Concepts to be taught
should include-
a. Fundamentals of emergency management,
b. Psychological impact management,
c. Resource management,
d. Preparedness and risk reduction,
e. Key response functions (including public health, logistics and governance,
recovery, rehabilitation and reconstruction), information management, incident
command and institutional mechanisms.
Professionalism and Values

The module on professionalism will deliver the concept of what it means to be a professional
and how a specialized profession is different from a usual vocation. It also explains how relevant
is professionalism in terms of healthcare system and how it affects the overall patient
environment.
1. Professional values- Integrity, Objectivity, Professional competence and due care,
Confidentiality
2. Personal values- ethical or moral values
3. Attitude and behavior- professional behavior, treating people equally
4. Code of conduct , professional accountability and responsibility, misconduct
5. Differences between professions and importance of team efforts
6. Cultural issues in the healthcare environment

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Research Methodology and Biostatistics

The objective of this module is to help the students understand the basic principles of research
and methods applied to draw inferences from the research findings.
1. Introduction to research methods
2. Identifying research problem
3. Ethical issues in research
4. Research design
5. Basic Concepts of Biostatistics
6. Types of Data
7. Research tools and Data collection methods
8. Sampling methods
9. Developing a research proposal
Principals of Management

The course is intended to provide a knowledge about the basic principles of Management.
1. Introduction to management
2. Strategic Management
3. Foundations of Planning
4. Planning Tools and Techniques
5. Decision Making, conflict and stress management
6. Managing Change and Innovation
7. Understanding Groups and Teams
8. Leadership
9. Time Management
10. Cost and efficiency
Community orientation and clinical visit

The objective of this particular section of the foundation course is to sensitize potential learners
with essential knowledge; this will lay a sound foundation for their learning across the under-
graduate program and across their career. Innovative teaching methods should be used to ensure
the attention of a student and make them more receptive such as group activities, interactive
fora, role plays, and clinical bed-side demonstrations. 30
1. The community orientation and clinical visit will include visit to the entire chain of
healthcare delivery system -Sub centre, PHC, CHC, SDH, DH and Medical college,
private hospitals, dispensaries and clinics.
2. The student will also be briefed regarding governance at village level including interaction
and group discussion with village panchayat and front line health workers.
3. Clinical visit to their respective professional department within the hospital.

Second Semester
Basic anatomy
1. Introduction to Anatomy: Basic Anatomical terminology
a. Osteology-
 Upper limb – clavicle, scapula, humerus, radius, ulna,

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 Lower limb - femur, hipbone, sacrum, tibia, fibula &Vertebral column
b. Thorax – Intercostal space, pleura, bony thoracic cage, ribs sternum &thoracic
vertebrae
c. Lungs – Trachea, bronchial tree
d. Heart – Surface anatomy of heart, chambers of the heart, valves of the heart, and
major blood vessels of heart, pericardium, and coronary arteries.
e. Skeleton-muscular system – Muscles of thorax, muscles of upper limb(arm &
fore arm) Flexor and extensor group of muscles (origin, insertion, action)
f. Excretory system – Kidneys, ureters, bladder

Practical-
Mannequins to be provided for Teaching Osteology – Bones identification (right and left side)
and prominent features and muscle attachment of the bone, clavicle, scapula, radius, ulna,
humerus, femur, hip bone, sacrum, tibia, fibula. Surface Anatomy, Radiology, and X-ray Chest
PA view.
Physiology

1. The Cell:
a. Acid base balance and disturbances of acid base balances (Alkalosis, Acidosis)

2. The Blood:
a. Composition of Blood, functions of the blood and plasma proteins, classification
and protein.
b. Pathological and Physiological variation of the RBC.
c. Function of Haemoglobin.
d. Erythrocyte Sedimentation Rate.
e. Detailed description about WBC-Total count (TC), Differential count (DC) and
functions.
f. Platelets – formation and normal level and functions.
g. Blood groups and Rh factor.

3. Cardio-Vascular System:
a. Physiology of the heart.
b. Heart sounds.
c. Cardiac cycle, Cardiac output.
d. Auscultation
e. Arterial pressures, blood pressure.
f. Hypertension.
g. Electro cardiogram (ECG.)
4. Respiratory system:
a. Respiratory ventilation
b. Oxygenation
c. Definitions and Normal values of Lung volumes and Lung capacities.
5. Excretory system:
a. Normal Urinary output
b. Renal function tests, renal disorders.
6. Reproductive system:
a. Formation of semen and spermatogenesis.
b. Brief account of menstrual cycle.
7. Central Nervous system:

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a. Functions of CSF.
8. Endocrine system:
a. Functions of the pituitary, thyroid, parathyroid, adrenal and pancreatic
Hormones.
9. Digestive system (for the students of Diploma in Scope Support Technology)
a. Physiological Anatomy of the GIT.
b. Food Digestion in the mouth, stomach, intestine
c. Absorption of foods
d. Role of bile in the digestion.

Practical-
1. Determination of Blood Groups.
2. Measurement of human blood pressure.
3. Examination of Respiratory system to count respiratory rate and measure inspiration and
respiration.
Lab Sciences - Bio-chemistry
1. Vitamins & Minerals: Fat soluble vitamins(A,D,E,K) – Water soluble vitamins – B-
complex vitamins- principal elements(Calcium, Phosphorus, Magnesium, Sodium,
Potassium, Chlorine and sulphur)- Trace elements – Calorific value of foods – Basal
metabolic rate(BMR) – respiratory quotient(RQ)
2. Acids and bases: Definition, pH, Henderson – Hassel Balch equation, Buffers, Indicators,
Normality, Molarity, Molality.

Practical-
1. Arterial blood gases
2. Blood sugar
Lab Sciences - Pathology
1. Cellular adaptation, Cell injury & cell death.
a. Introduction to pathology.
b. Overview: Cellular response to stress and noxious stimuli. Cellular adaptations of
growth and differentiation.
c. Overview of cell injury and cell death.
d. Causes of cell injury. Mechanisms of cell
injury.
e. Reversible and irreversible cell injury.
f. Examples of cell injury and necrosis.
2. Inflammation.
a. General features of inflammation Historical highlights
b. Acute inflammation
c. Chemical mediators of inflammation Outcomes of acute inflammation
Morphologic patterns of acute inflammation Summary of acute inflammation
d. Chronic inflammation
3. Immunity disorders.
a. General features of the immune system Disorders of the
immune system
4. Infectious diseases.
a. General principles of microbial pathogenesis viral infections.
b. Bacterial infections-Rheumatic heart disease.
c. Fungal infections.

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d. Parasitic infections.
5. Neoplasia.
a. Definitions Nomenclature.
b. Biology of tumour growth benign and malignant neoplasms Epidemiology.
c. Carcinogenic agents and their cellular interactions Clinical features of tumours.
6. Environmental and nutritional disorders.
a. Environmental and disease.
b. Common environmental and occupational exposures Nutrition and
disease.
c. Coronary artery disease.
Principles of management
1. Principles of management:
a. Development of Management: Definitions of Management – Contributions of
F.W. Taylor, Henry Fayol and others.
b. Functions of Management: Planning – Organizing – Directing – Controlling
Planning: Types of planning – Short–term and long plans – Corporate or
Strategic Planning – Planning premises – Polices – Characteristics and sources –
principles of policy making – Strategies as different from policies – Procedures
and methods– Limitations of planning.
c. Organizing: Importance of organization – Hierarchy – Scalar chain –
Organization relationship – Line relationship – Staff relationship - Line staff
relationship – Functional relationship - Committee organization – Management
committees – Depart mentation.
d. Motivation: Motivation theories – McGregor’s theory X and theory Y –
Maslow’s and Herzberg’s theory – Porter and Lawler model of complex view of
motivation– Other theories – Diagnostic signs of motivational problems –
Motivational Techniques.
e. Communication: Types of communication – Barriers of effective
communication– Techniques for improved communication.
f. Directing: Principles relating to Direction process – Principles and theories of
leadership – Leadership Styles – Delegation of authority.
g. Controlling: Span of control – Factors limiting effective span of control – Supper
management, General managers, Middles managers and supervisors – Planning
and controlling relationships – Management control process – Corrective
measures– Strategic control points – Budgetary control – Types of budgets.
h. Co-ordination: Co-ordination and co-operation – Principles of co-ordination –
Techniques of co-ordination charts and records – Standard procedure
instructions.

2. Personnel management:
Objective of Personnel Management – Role of Personnel Manager in an organization –
Staffing and work distribution techniques – Job analysis and description – Recruitment
and selection processes – Orientation and training – Coaching and counselling –
disciplining – Complaints and grievances – Termination of employees – Performance
appraisal – Health and safety of employees - Consumer Protection Act as applicable to
health care services.

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3. Financial management:
Definition of financial Management – Profit maximization – Return maximization–
wealth maximization – Short term Financing – Intermediate Financing – Long term
Financing – leasing as a source of Finance – cash and Security Management – Inventory
Management – Dividend policies – Valuations of Shares – Financial Management in a
hospital – Third party payments on behalf of patients. Insurance – health schemes and
policies.
OTT Directed Clinical Education – part I (studentship)
Students will observe the basic operations of the operation theatre while interacting with the
multidisciplinary team members involved in providing optimal care to patients. The student will
be introduced to surgical terminologies, equipment, and techniques used for interventions.

Third Semester
Applied anatomy and physiology related to anesthesia
1. Respiratory system
a. Structure and function of the respiratory tract in relation to respiratory
system.
 Nose - Role in humidification,
 Pharynx - Obstruction in airways.
 Larynx- Movement or vocal cords, Cord palsies.
 Trachea & Bronchial tree - vessels, nerve supply, respiratory tract,
reflexes, and bronchospasm.
 Alveoli - Layers, Surfactants
b. Respiratory Physiology.
 Control or breathing.
 Respiratory muscles - diaphragm, intercostal
 Lung volumes - dead space, vital capacity, FRC etc.
 Pleural cavity – intra-pleural pressure, pneumothorax.
 Work of breathing - airway resistance, compliance
 Respiratory movements under anesthesia.
 Tracheal tug - signs, hiccup.
c. Pulmonary Gas Exchange and Acid Base Status.
 Pulmonary circulation -Pulmonary edema,
 Pulmonary hypertension.
 Pulmonary function tests.
 Transfer of gases - oxygen &Carbon dioxide.
 Acid base status, definitions, acidosis types, Alkalosis types, buffers in
the body.
d. Oxygen: properties, storage, supply, hypoxia. Oxygen therapy
e. Respiratory failure, type, clinical features, causes.

2. Cardiovascular system
a. Anatomy- Chambers of the heart, major vasculature.
 Coronary supply, innervation.

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 Conduction system.
b. Cardiac output - determinants, heart rate, preload, after load.
c. Coronary blood flow& myocardial oxygen supply.
d. ECG- arrhythmias cardiovascular response to anesthetic & surgical
procedures.
e. Hypotension- causes, erects management.
f. Cardio pulmonary resuscitation.
g. Myocardial infarction, hypertension.

3. Fluids and electrolytes

a. Body Fluids - Composition
b. Water, sodium and potassium balance
c. I.V. Fluids - composition & administration
d. Intravenous, Central venous and arterial line insertion

4. Blood transfusion
a. Blood grouping, storage, administration

Clinical pharmacology

1. Antisialagogues: Atropine, Glycopyrrolate.

2. Sedatives I Anxiolytics: Diazepam, Midazolam, Phenergan, Lorazepam,
Chlorpromazine, and Triclofos.
3. Narcotics: Morphine, Pethidine, Fentanyl, Pentazozine, tramadol.
4. Antiemetic’s: Metoclopramide, Ondanseteron, Dexamethasone
5. Induction Agent: Thiopentone, Diazepam, Midazolam, Ketamine, Propofol,
Etomidate.
6. Muscle Relaxants: Depolarizing - Suxamethonium, Non depolarizing -
Vecuronium, Atracurium, rocuranium
7. Inhalational Gases: Gases-02, N20, Air, Agents-Ether ,Halothane, Isofllurane,
Saevoflurane, Desflurane
8. Reversal Agents: Neostigmine, Glycopyrrolate, Atropine, Naloxone,
Flumazenil (Diazepam).
9. Local Anesthetics: Xylocaine, Bupivacaine - Topical, Prilocaine-jelly, Emla -
Ointment, Etidocaine. Ropivacaine.
10. Emergency Drugs : Mode or administration, dilution, dosage and effects
a. Adrenaline, Atropine
b. Ephedrine, Mephentramine
c. Bicarbonate, calcium, potassium.
d. Inotropes: dopamine, dobutamine, amidarone
e. Aminophylline, hydrocortisone, antihistaminic,
f. Antihypertensive –Beta-blockers, Ca-channel blockers.
g. Antiarrhythmic- xylocard
h. Vasodilators- nitroglycerin & sodium nitroprusside
i. Respiratory system- Bronchodilators
j. Renal system- Diuretics, frusemide, mannitol
Principles of anesthesia
1. Medical gas supply
a. Compressed gas cylinders

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b. Color coding
c. Cylinder valves; pin index.
d. Gas piping system
e. Recommendations for piping system
f. Alarms & safety devices.
g. Scavenging of waste anesthetic gases

2. Anesthesia machine
a. Hanger and yoke system
b. Cylinder pressure gauge
c. Pressure regulator
d. Flow meter assembly
e. Vaporizers - types, hazards, maintenance, filling and draining, etc.
3. Breathing system
a. General considerations: humidity & heat
b. Common components - connectors, adaptors, reservoir bags.
c. Capnography
d. Pulse oximetry
e. Methods of humidification.
f. Classification of breathing system
g. Mapleson system - a b c d e f
h. Jackson Rees system, Bain circuit
i. Non rebreathing valves - Ambu valves
j. The circle system
4. Face masks & Airway laryngoscopes
a. Types, sizes
b. Endotracheal tubes - Types, sizes.
c. Cuff system
d. Fixing, removing and inflating cuff, checking tube position, complications.

5. Anesthesia ventilator and working principles.

6. Monitoring
a. Electrocardiography(ECG)
b. Pulse oximetry(Sp02)
c. Temperature- central and peripheral
d. End tidal carbon dioxide( EtCO2)
e. Anesthesia gas monitoring
f. Non-invasive blood pressure (NIPB) and Invasive blood pressure(IBP)
g. Central venous pressure(CVP)
h. PA Pressure, LA Pressure & cardiac output
i. Anesthesia depth monitor
j. Neuromuscular transmission monitor
OTT Directed Clinical Education – part II (studentship)
Students will gain additional skills in the preparation procedures, interaction with patients and
professional personnel. Students apply knowledge from previous clinical learning experience
under the supervision of a registered technical officer. Students are tested on intermediate clinical
preparation skills.

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Fourth Semester
CSSD procedures
1. Waste disposal collection of used items from user area, reception protective clothing
and disinfections sage guards.
2. use of disinfections sorting and classification of equipment for cleaning purposes,
sharps, blunt lighted etc. contaminated high risk baby care - delicate instruments or hot
care instruments,
3. Cleaning process - use of detergents. Mechanical cleaning apparatus, cleaning
instruments, cleaning jars, receivers bowls etc. trays, basins and similar hand ware
utensils. Cleaning of catheters and tubing, cleaning glass ware, cleaning syringes and
needles.
4. Materials used for wrapping and packing assembling pack contents. Types of packs
prepared. Inclusion of trays and gallipots in packs. Method of wrapping and making
use of indications to show that a pack of container has been through a sterilization
process date stamping.
5. General observations principles of sterilization. Moist heat sterilization. Dry heat
sterilization. EO gas sterilization, H202 gas plasma vapor sterilization.

Basic anesthetic techniques

1. History of Anesthesia
a. First successful clinical demonstration:
b. Pre - historic ( ether) era
c. Inhalational anesthetic era
d. Regional anesthetic era
e. Intravenous anesthetic era
f. Modem anesthetic era
g. Minimum standard of anesthesia
h. Who should give anesthesia

2. Pre-Op Preparation:
a. Pre anesthetic assessment~ History –, past history - disease / Surgery / and
personal history - Smoking / alcohol
b. General physical assessment, systemic examination – CVS, RS, CNS

3. Investigations
a. Routine - Hematological - their significance
 Urine
 E.C.G.
 Chest X - ray
b. Special- Endocrine, hormonal assays
 Echocardiography
 Angiography
 Liver function test
 Renal function test
 Others
c. Case acceptance: ASA grading - I, II, III, IV. V

4. Pre - Anesthetic Orders:

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a. Patient-Informed consent.
 Fasting guidelines/ nil per orally
 Premedication - advantages, drugs used
 Special instructions - if any
b. Machine - Checking the machine 02, N20, suction apparatus Laryngoscopes, ET
tubes, airways
 Things for IV accessibility
 Other monitoring systems
c. Drugs-Emergency drugs
 Drugs

5. Intraoperative Management
a. Confirm the identification of the patient
b. Monitoring - minimum
c. Noninvasive & Invasive monitoring
d. Induction - drugs used
e. Endotracheal intubation
f. Maintenance of anesthesia
g. Positioning of the patient
h. Blood / fluid & electrolyte balance
i. Reversal from anesthesia - drugs used
j. Transferring the patient
k. Recovery room – set up and things needed

6. Post-Operative Complications & Management

Regional anesthetic techniques.
1. Local Anesthetic technique
2. Nerve blocks
3. Spinal Anesthesia
4. Epidural Anesthesia
OTT Directed Clinical Education – part III (studentship)
Students will improve their skills in the procedures. Progressive interaction with patients and
professional personnel are monitored as students practice within the operation theatre in a
supervised setting. Additional areas include problem solving, identifying machine components
and basic side effect management will also be taught and tested. Students will demonstrate
competence in beginning, intermediate, and advanced procedures.

Fifth Semester – Internship

The internship time period provides the students the opportunity to continue to develop
confidence and increased skill in simulation and service delivery. Students will demonstrate
competence in beginning, intermediate, and advanced procedures in both areas. Students will
participate in advanced and specialized procedures. The student will complete the clinical training
by practicing all the skills learned in classroom and clinical instruction. The students are expected
to work for minimum 8 hours per day and this may be more depending on the need and the
healthcare setting.

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Skills based outcomes and monitorable indicators for Operation Theatre Technologist
Competency statements
1. Demonstrate ability to prepare and maintain Operation Theater
2. Demonstrate ability to maintain equipment support in an acute care environment
3. Identify and move to maintain a sterile field
4. Follow infection control policies and procedures
5. Manage and maintain theater equipment
6. Demonstrate ability to prepare the patient for operative procedures
7. Provide intra-operative equipment and technical support
8. Demonstrate skills and knowledge to assist anesthetist in handling emergencies outside
of OT Room
9. Manage hazardous waste and follow biomedical waste disposal protocols
10. Ensure availability of medical and diagnostic supplies
11. Monitor and assure quality
12. Act within the limits of one’s competence and authority
13. Work effectively with others
14. Manage work to meet requirements
15. Maintain a safe, healthy, and secure working

S. no. Learning outcomes Knowledge/ Applications / Hours

Comprehension Synthesis /Evaluation
1 Prepare and maintain Be familiar with the Prepare the OT for the 200
Operation Theatre Operation Theatre and operation along with all
all the equipment. the necessary equipment.
Know the protocols Interpret and understand
used in Operation all planning techniques to
Theatre keep an OT functional.
2 Maintain equipment Use basic knowledge of Clean and store 200
support in an acute care surgical procedures to equipment safely
environment assist and identify the Position equipment in
needs of equipment of accordance with set up
Operating teams. procedures

3 Identify and move to Knowledge of safety Perform aseptic 200

maintain a sterile field and environmental techniques in the
aspects related to operating suite.
workplace operation.
Knowledge of relevant Transporting the patient
protocols, good in and out from operation
practices, standards, theatre.
policies and procedures
while transferring the
patient.

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S. no. Learning outcomes Knowledge/ Applications / Hours
Comprehension Synthesis /Evaluation
4 Follow infection control Knowledge of effective Preform the standard 100
policies and procedures infection control precautions to prevent the
strategy that ensures the
spread of infection in
safety of the patient. accordance with
organization
requirements.
5 Manage and maintain Applying a broad Set up equipment and 100
theater equipment knowledge base and a consumables, correctly
range of well-developed position and check in
skills to select, prepare,
accordance with
operate, maintain and
handle equipment organization policy and
within operating suite. procedures and
manufacturer's
specifications.
6 Prepare patient for Knowledge of preparing Safely position patient to 200
operative procedures patients as required meet the requirements of
before the operation. the anaesthetist and
Surgeon.
7 Provide intra-operative Knowledge to assist the Monitoring the 200
equipment and technical anaesthetist and provide performance of
support technical support during equipment used and
surgical procedure. adjusting surgical
equipment.
8 Be able to demonstrate Explain the legal and Promote collaborative 100
professional behavior ethical guidelines related practice
to the
profession
Be aware of your own
competency levels
9 Be able to complete Recognize the Complete the treatment 40
accurate treatment importance of accurate documentation accurately
documentation documentation
10 Manage hazardous waste Knowledge of Handle, Coordinate the hazardous 80
collect and dispose of waste management
the hazardous waste. program.

Properly identify,
segregate, handle, label,
and store waste.
Total 1420

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4.2 B. Sc. in Operation Theatre
Technology

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B. Sc. in Operation Theater Technology
Introduction:

Learning Objectives: At the completion of this course, the student should be -

1. Able to help the anesthesiologist in administering anesthesia, assist in various procedures
and also help in continuous monitoring of patients during surgery.
2. Able to train and develop an individual to independently handle the latest technology and
high end biomedical equipment in Operation Theatre
3. Able to assist anesthesiologists in developing and plummeting patient anesthesia care
plans, including pre-operative, surgical theater, recovery room, and post-operative
intensive care procedures.
4. Able to do- patient data collection, catheter insertion, airway management , assisting the
administration and monitoring of regional and peripheral nerve blockades, support
therapy, adjusting anesthetic levels during surgery, inter-operative monitoring,
postoperative procedures, pain clinics and patient education, and administrative tasks.
5. Able to manage medical gases and pipeline system
6. Able to assist in Intensive care unit
7. Able to manage Central sterile supply department
8. Able to assist during Disaster and emergency situations.

Expectation from the future graduate in the providing patient care.

1. The Course prepares the operating theatre technologist to work as a competent, reliable
member of the health care team under the guidance and supervision of doctors in their
delivery of patient care, training also focuses on the knowledge and skills of monitoring
infection control policy and procedures in the operating theatre.
2. Employment opportunities can be found in hospitals in both private and public sectors
as well as in independent trauma centres.
3. OTT graduate is encouraged to pursue further qualification to attain senior position in
the professional field, also to keep abreast with the advance and new technology, the
professional should opt for continuous professional education credits offered by national
and international institutes.

Eligibility for admission

Selection Procedure

1. He/she has passed the Higher Secondary (10+2) or equivalent examination recognized
by any Indian University or a duly constituted Board with pass marks (50%)in physics,
chemistry, biology/mathematics.
OR
Diploma in Operation Theatre Technology after completing 12th class/ 10 +2 of CBSE
or equivalent with minimum aggregate of 50% marks in physics, chemistry and
biology/mathematics provided the candidate has passed in each subject separately.
2. He/she has attained the age of 17 years as on - (current year) & maximum age limit is 30
years.

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3. Candidates who have studied abroad and have passed the equivalent qualification as
determined by the Association of Indian Universities will form the guideline to determine
the eligibility and must have passed in the subjects: Physics, Chemistry,
Biology/Mathematics and English up to 12th Standard level.
4. The qualifying examination passed by FN/PIO/CIWGC students should be considered
equivalent to eligibility examination by the Association of Indian Universities/Academic
Council
5. He/she has to furnish at the time of submission of application form, a certificate of
Physical fitness from a registered medical practitioner and two references from persons
other than relatives testifying to satisfactory general character.
6. Admission to B.Sc. Operation Theatre Technology course shall be made on the basis of
eligibility and an entrance test to be conducted for the purpose. No candidate will be
admitted on any ground unless he/she has appeared in the admission test and interview.
a. Entrance test, to be conducted by the university as per the syllabus under 10 +2
scheme of CBSE, subject-wise distribution of questions will be as 40% in
Physics, 25% in Biology/25% in Mathematics, 15% in Chemistry, 10% in English
(Language & Comprehension) and 10% in General Awareness about health
related methods.
b. Successful candidates on the basis of written Test will be called for the interview
& shall have face an interview board. The interview board will include the Head
of the Department of Surgery and/or Anesthesia (Chairman of the Board) along
with other nominees, whose recommendations shall be final for the selection of
the students.
c. During subsequent counseling (s) the seat will be allotted as per the merit of the
candidate depending on the availability of seats on that particular day.
d. Candidate who fails to attend the Medical Examination on the notified date(s)
will forfeit the claim for admission and placement in the waiting list except
permitted by the competent authority under special circumstances.
e. The name of the student(s) who remain(s) absent from classes for more than 15
days at a stretch after joining the said course will be struck off from the college
rolls without giving any notice.

Provision of Lateral Entry:

Lateral entry to second year for allied and healthcare science courses for candidates who have
passed diploma program from the Government Boards and recognized by State/Central
University, fulfilling the conditions specified and these students are eligible to take admission on
lateral entry system only if the same subject have been studied at diploma level.

Duration of the course

Duration of the course: 4 years or 8 semesters. (970 hours of Theory & 2270 hours of Practical
Classes) and 1440 hours (minimum) of internship
Total hours - 4680

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Medium of instruction:
English shall be the medium of instruction for all the subjects of study and for examination of
the course.
Attendance:
A candidate has to secure minimum-
1. 75% attendance in theoretical
2. 80% in Skills training (practical) for qualifying to appear for the final examination.

No relaxation, whatsoever, will be permissible to this rule under any ground including
indisposition etc.
Assessment:
Assessments should be completed by the academic staff, based on the compilation of the
student’s theoretical &clinical performance throughout the training programme. To achieve this,
all assessment forms and feedback should be included and evaluated.

Model Curriculum Outline 31 32 33 34 35 36 37 38

First Semester– Foundation Course
Sl. No. Course Titles Hours
Theory Practical Total
BOTT-001 Introduction to Healthcare Delivery System in India 60 0 60
BOTT-002 Basic computers and information Science 10 40 50
BOTT-003 Communication and soft skills 20 10 30
BOTT-004 Medical Terminology and Record keeping (including 40 0 40
anatomical terms)
BOTT-005 Medical Law and Ethics 40 0 40
BOTT-006 Introduction to Quality and Patient safety (including Basic 40 60 100
emergency care and life support skills, Infection prevention
and control, Biomedical waste management, Disaster
management and Antibiotic resistance)
BOTT-007 Professionalism and values 20 0 20
BOTT-008 Research Methodology and Biostatistics 40 20 60
BOTT-009 Principals of Management 40 0 40
BOTT-010 Community orientation and clinical visit (including related 0 100 100
practical to course 001)*
TOTAL 310 230 540
Teaching resources (tutors) should be made available at every institute for basic subjects such as
– Biology and English for students who wish to undertake the extra classes for the same.
Second Semester
Sl. No. Course Titles Hours
Theory Practical Total
BOTT-011 Basic Anatomy and Physiology 80 120 200
BOTT-012 Biochemistry 40 60 100

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Sl. No. Course Titles Hours
Theory Practical Total
BOTT-013 Principles of Management 30 50 80
OTT Directed Clinical Education – part I (studentship) - 160 160
TOTAL 150 390 540

Third Semester
Sl. No. Course Titles Hours
Theory Practical Total
BOTT-014 Pathology 40 80 120
BOTT-015 Medicine 40 80 120
BOTT-016 Principles of Anesthesia 40 100 140
OTT Directed Clinical Education – part II (studentship) - 160 160
TOTAL 120 420 540

Fourth Semester
Sl. No. Course Titles Hours
Theory Practical Total
BOTT-017 Clinical Pharmacology 40 60 100
BOTT-018 Clinical Microbiology 40 60 100
BOTT-019 Basic techniques of Anesthesia 40 120 160
OTT Directed Clinical Education – part III (studentship) 180 180
TOTAL 120 420 540
Fifth Semester
Sl. No. Course Titles Hours
Theory Practical Total
BOTT-020 Basics of Surgical procedures 30 50 80
BOTT-021 CSSD Procedures. 30 70 100
BOTT-022 Advance anesthetic techniques 50 70 120
BOTT-023 Basic Intensive care 30 100 130
OTT Directed Clinical Education – part IV (studentship) 110 110
TOTAL 140 400 540

Sixth Semester
Sl. No. Course Titles Hours
Theory Practical Total
BOTT-024 Specialized surgery and anesthesia 80 200 280
BOTT-025 Electronics and technology in surgery and anesthesia 50 100 150
OTT Directed Clinical Education – part V (studentship) 110 110
TOTAL 130 410 540

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Seventh and Eighth Semester
Sl. No. Course Titles Hours
Theory Practical Total
OTT Internship - 1440 1440
*Internship – minimum 1440 hours (calculated based on 8 hours per day, if 180 working days in a
year). This is the minimum requirement, however depending on the working days/hours, the
total duration of engagement in internship may be more than 1440 hours.

First Semester- Foundation course

Introduction to National Healthcare System
The course provides the students a basic insight into the main features of Indian health care
delivery system and how it compares with the other systems of the world. Topics to be covered
under the subject are as follows:

1. Introduction to healthcare delivery system

a. Healthcare delivery system in India at primary, secondary and tertiary care
b. Community participation in healthcare delivery system
c. Health system in developed countries.
d. Private Sector
e. National Health Mission
f. National Health Policy
g. Issues in Health Care Delivery System in India
2. National Health Programme- Background objectives, action plan, targets, operations,
achievements and constraints in various National Heath Programme.
3. Introduction to AYUSH system of medicine
a. Introduction to Ayurveda.
b. Yoga and Naturopathy
c. Unani
d. Siddha
e. Homeopathy
f. Need for integration of various system of medicine
4. Health scenario of India- past, present and future
5. Demography & Vital Statistics-
a. Demography – its concept
b. Vital events of life & its impact on demography
c. Significance and recording of vital statistics
d. Census & its impact on health policy
6. Epidemiology
a. Principles of Epidemiology
b. Natural History of disease
c. Methods of Epidemiological studies
d. Epidemiology of communicable & non-communicable diseases, disease
transmission, host defense immunizing agents, cold chain, immunization, disease
monitoring and surveillance.

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Medical terminologies and record keeping

This course introduces the elements of medical terminology. Emphasis is placed on building
familiarity with medical words through knowledge of roots, prefixes, and suffixes. Topics
include: origin, word building, abbreviations and symbols, terminology related to the human
anatomy, reading medical orders and reports, and terminology specific to the student’s field of
study. Spelling is critical and will be counted when grading tests.27 Topics to be covered under
the subject are as follows:

1. Derivation of medical terms.

2. Define word roots, prefixes, and suffixes.
3. Conventions for combined morphemes and the formation of plurals.
4. Basic medical terms.
5. Form medical terms utilizing roots, suffixes, prefixes, and combining roots.
6. Interpret basic medical abbreviations/symbols.
7. Utilize diagnostic, surgical, and procedural terms and abbreviations related to the
integumentary system, musculoskeletal system, respiratory system, cardiovascular system,
nervous system, and endocrine system.
8. Interpret medical orders/reports.
9. Data entry and management on electronic health record system.

Basic computers and information science

The students will be able to appreciate the role of computer technology. The course has focus on
computer organization, computer operating system and software, and MS windows, Word
processing, Excel data worksheet and PowerPoint presentation. Topics to be covered under the
subject are as follows:

1. Introduction to computer: Introduction, characteristics of computer, block diagram of

computer, generations of computer, computer languages.
2. Input output devices: Input devices(keyboard, point and draw devices, data scanning
devices, digitizer, electronic card reader, voice recognition devices, vision-input devices),
output devices(monitors, pointers, plotters, screen image projector, voice response
systems).
3. Processor and memory: The Central Processing Unit (CPU), main memory.
4. Storage Devices: Sequential and direct access devices, magnetic tape, magnetic disk,
optical disk, mass storage devices.
5. Introduction of windows: History, features, desktop, taskbar, icons on the desktop,
operation with folder, creating shortcuts, operation with windows (opening, closing,
moving, resizing, minimizing and maximizing, etc.).
6. Introduction to MS-Word: introduction, components of a word window, creating,
opening and inserting files, editing a document file, page setting and formatting the text,
saving the document, spell checking, printing the document file, creating and editing of
table, mail merge.
7. Introduction to Excel: introduction, about worksheet, entering information, saving
workbooks and formatting, printing the worksheet, creating graphs.
8. Introduction to power-point: introduction, creating and manipulating presentation,
views, formatting and enhancing text, slide with graphs.

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9. Introduction of Operating System: introduction, operating system concepts, types of
operating system.
10. Computer networks: introduction, types of network (LAN, MAN, WAN, Internet,
Intranet), network topologies (star, ring, bus, mesh, tree, hybrid), components of
network.
11. Internet and its Applications: definition, brief history, basic services (E-Mail, File
Transfer Protocol, telnet, the World Wide Web (WWW)), www browsers, use of the
internet.
12. Application of Computers in clinical settings.
Practical on fundamentals of computers -
1. Learning to use MS office: MS word, MS PowerPoint, MS Excel.
2. To install different software.
3. Data entry efficiency
Medical law and ethics

Legal and ethical considerations are firmly believed to be an integral part of medical practice in
planning patient care. Advances in medical sciences, growing sophistication of the modern
society’s legal framework, increasing awareness of human rights and changing moral principles of
the community at large, now result in frequent occurrences of healthcare professionals being
caught in dilemmas over aspects arising from daily practice.28
Medical ethics has developed into a well based discipline which acts as a "bridge" between
theoretical bioethics and the bedside. The goal is "to improve the quality of patient care by
identifying, analyzing, and attempting to resolve the ethical problems that arise in practice". 28
Doctors are bound by, not just moral obligations, but also by laws and official regulations that
form the legal framework to regulate medical practice. Hence, it is now a universal consensus
that legal and ethical considerations are inherent and inseparable parts of good medical practice
across the whole spectrum. Few of the important and relevant topics that need to focus on are as
follows:
1. Medical ethics - Definition - Goal - Scope
2. Introduction to Code of conduct
3. Basic principles of medical ethics – Confidentiality
4. Malpractice and negligence - Rational and irrational drug therapy
5. Autonomy and informed consent - Right of patients
6. Care of the terminally ill- Euthanasia
7. Organ transplantation
8. Medico legal aspects of medical records – Medico legal case and type- Records and
document related to MLC - ownership of medical records - Confidentiality Privilege
communication - Release of medical information - Unauthorized disclosure - retention of
medical records - other various aspects.
9. Professional Indemnity insurance policy
10. Development of standardized protocol to avoid near miss or sentinel events
11. Obtaining an informed consent.
Communication and soft skills

Major topics to be covered under Communication course29 –

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1. Basic Language Skills: Grammar and Usage.
2. Business Communication Skills. With focus on speaking - Conversations, discussions,
dialogues, short presentations, pronunciation.
3. Teaching the different methods of writing like letters, E-mails, report, case study,
collecting the patient data etc. Basic compositions, journals, with a focus on paragraph
form and organization.
4. Basic concepts & principles of good communication
5. Special characteristics of health communication
6. Types & process of communication
7. Barriers of communication & how to overcome

Introduction to Quality and patient safety

1. Quality assurance and management - The objective of the course is to help students
understand the basic concepts of quality in health Care and develop skills to implement
sustainable quality assurance program in the health system.
a. Concepts of Quality of Care
b. Quality Improvement Approaches
c. Standards and Norms
d. Quality Improvement Tools
e. Introduction to NABH guidelines

2. Basics of emergency care and life support skills - Basic life support (BLS) is the
foundation for saving lives following cardiac arrest. Fundamental aspects of BLS include
immediate recognition of sudden cardiac arrest (SCA) and activation of the emergency
response system, early cardiopulmonary resuscitation (CPR), and rapid defibrillation with
an automated external defibrillator (AED). Initial recognition and response to heart
attack and stroke are also considered part of BLS. The student is also expected to learn
about basic emergency care including first aid and triage. Topics to be covered under the
subject are as follows:
a. Vital signs and primary assessment
b. Basic emergency care – first aid and triage
c. Ventilations including use of bag-valve-masks (BVMs)
d. Choking, rescue breathing methods
e. One- and Two-rescuer CPR
f. Using an AED (Automated external defibrillator).
g. Managing an emergency including moving a patient
At the end of this topic, focus should be to teach the students to perform the maneuvers
in simulation lab and to test their skills with focus on airways management and chest
compressions. At the end of the foundation course, each student should be able to
perform and execute/operate on the above mentioned modalities.

3. Bio medical waste management and environment safety- The aim of this section will be
to help prevent harm to workers, property, the environment and the general public.
Topics to be covered under the subject are as follows:
a. Definition of Biomedical Waste
b. Waste minimization

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c. BMW – Segregation, collection, transportation, treatment and disposal (including
color coding)
d. Liquid BMW, Radioactive waste, Metals / Chemicals / Drug waste
e. BMW Management & methods of disinfection
f. Modern technology for handling BMW
g. Use of Personal protective equipment (PPE)
h. Monitoring & controlling of cross infection (Protective devices)

4. Infection prevention and control - The objective of this section will be to provide a
broad understanding of the core subject areas of infection prevention and control and to
equip AHPs with the fundamental skills required to reduce the incidence of hospital
acquired infections and improve health outcomes. Concepts taught should include –
a. Evidence-based infection control principles and practices [such as sterilization,
disinfection, effective hand hygiene and use of Personal protective equipment
(PPE)],
b. Prevention & control of common healthcare associated infections,
c. Components of an effective infection control program, and
d. Guidelines (NABH and JCI) for Hospital Infection Control

5. Antibiotic Resistance-
a. History of Antibiotics
b. How Resistance Happens and Spreads
c. Types of resistance- Intrinsic, Acquired, Passive
d. Trends in Drug Resistance
e. Actions to Fight Resistance
f. Bacterial persistence
g. Antibiotic sensitivity
h. Consequences of antibiotic resistance
i. Antimicrobial Stewardship- Barriers and opportunities, Tools and models in
hospitals

6. Disaster preparedness and management- The objective of this section will be to provide
knowledge on the principles of on-site disaster management. Concepts to be taught
should include-
a. Fundamentals of emergency management,
b. Psychological impact management,
c. Resource management,
d. Preparedness and risk reduction,
e. Key response functions (including public health, logistics and governance,
recovery, rehabilitation and reconstruction), information management, incident
command and institutional mechanisms.

Professionalism and Values

The module on professionalism will deliver the concept of what it means to be a professional
and how a specialized profession is different from a usual vocation. It also explains how relevant

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is professionalism in terms of healthcare system and how it affects the overall patient
environment.
1. Professional values- Integrity, Objectivity, Professional competence and due care,
Confidentiality
2. Personal values- ethical or moral values
3. Attitude and behavior- professional behavior, treating people equally
4. Code of conduct , professional accountability and responsibility, misconduct
5. Differences between professions and importance of team efforts
6. Cultural issues in the healthcare environment

Research Methodology and Biostatistics

The objective of this module is to help the students understand the basic principles of research
and methods applied to draw inferences from the research findings.
1. Introduction to research methods
2. Identifying research problem
3. Ethical issues in research
4. Research design
5. Basic Concepts of Biostatistics
6. Types of Data
7. Research tools and Data collection methods
8. Sampling methods
9. Developing a research proposal

Principals of Management

The course is intended to provide a knowledge about the basic principles of Management.
1. Introduction to management
2. Strategic Management
3. Foundations of Planning
4. Planning Tools and Techniques
5. Decision Making, conflict and stress management
6. Managing Change and Innovation
7. Understanding Groups and Teams
8. Leadership
9. Time Management
10. Cost and efficiency

Community orientation and clinical visit

The objective of this particular section of the foundation course is to sensitize potential learners
with essential knowledge; this will lay a sound foundation for their learning across the under-
graduate program and across their career. Innovative teaching methods should be used to ensure
the attention of a student and make them more receptive such as group activities, interactive
fora, role plays, and clinical bed-side demonstrations. 30

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1. The community orientation and clinical visit will include visit to the entire chain of
healthcare delivery system -Sub centre, PHC, CHC, SDH, DH and Medical college,
private hospitals, dispensaries and clinics.
2. The student will also be briefed regarding governance at village level including interaction
and group discussion with village panchayat and front line health workers.
3. Clinical visit to their respective professional department within the hospital.

Second Semester
Anatomy and Physiology of human body

Anatomy is a key component of all education programmes for OTTs and should have a strong
focus on organ position, orientation and relationships. The topics provide the student with an
understanding of the structure and relationships of the systems and organs of the body which is
essential in patient positioning and accurate delivery of intervention.

Similarly Physiology provides the students with knowledge of the function of systems and organs
and their relationships and underpins the understanding of how surgical intervention can modify
the function and structure of outcomes. Physiology is important to all programmes with
increased depth of content required where OTTs are being required to take a more active role in
side effect recognition and management. This may be in departments where OTTs are
increasingly taking some responsibility in this area or in resource constrained environments
where nursing or medical staff are limited.
1. Structure and function of cell; cell division; tissue: definition and classification (Gross
outline)
2. General Anatomical terms and topography of the body-planes regions, positions,
movements.
3. Skeleton & joints- Long bones, vertebrae, pelvic and shoulder girdles, hands and feet,
skull , face and teeth; parts of classical long bone; outline of different joints and type of
movements.
4. Muscles; Classification, structure and function (Gross outline)
5. Brain & spinal cord with its coverings and cavities including cerebrospinal fluids and
pituitary gland (Macroscopic anatomy and surface anatomy only)
6. Head & Neck; Oral cavity & lips, Pharynx, Larynx, Nasal Cavity and Para Nasal sinuses,
Salivary Glands, Ear; Orbit & its content; Thyroid Gland and Nodal Areas (Macroscopic
Anatomy only)
7. Thorax: Structure of Thoracic cage, Oesophagus, Trachea, Lungs & Pleura, The
Mediastinum including Thymus, Heart and Great Vessels and Diaphragm (Macroscopic
and Surface Anatomy)
8. Abdomen: Structure of Abdomen & Peritoneum, Retro Peritoneal structures (including
Kidney), Stomach, Small Intestine, Colon, Liver, Pancreas, Spleen (Macroscopic and
Surface Anatomy)
9. Pelvic and Perineum: Structure of Pelvis, Rectum & Anus, Bladder, Prostate, Female
Genital Tract, Male Genital Tract and Inguinal Femoral Region (Macroscopic and
surface Anatomy)

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10. Lymphatic system and Reticulo-endothelial system (Gross outline only)- Position and
function of Lymph Nodal regions ( Including Neck, Axilla, Mediastinum, para-aortic,
Inguinal) Extra nodal Lymphatic Tissues(Waldeyer’s Ring, Spleen and Liver, Malt, Bone
Marrow, Thymus) and Re System; Lymphatic Drainage.
11. Digestive System- Organs of digestion, histology of the digestive organs (stomach, small
intestine, liver, pancreas), process of digestion, absorption and assimilation of food,
Vitamins and minerals
12. Respiratory System- Organs of respiration and their histology (lungs and trachea),
Respiration (Definition and Mechanism), gas exchange in the lungs, regulation of
respiration, basal metabolic rate
13. The skin (Structure and functions)
14. The excretory system- Organs of excretion (kidneys, ureter, bladder), histology of kidney
and its functions, formation of urine and its composition, structure of nephron
15. Circulatory System- Composition and functions of blood, the heart anatomy and
physiology, the chambers of heart, various vessels and valves present in heart, Circulation
of blood, the cardiac cycle and heart sounds, blood pressure, arteries and veins.
16. Nervous System- Central nervous system (Brain and Spinal cord), Peripheral nervous
system (cranial and spinal nerves), The reflex action and reflex arc, The transmission
of nerve impulse, sense organs (eye, ear, tongue and nose); structure and functions
17. Endocrine System- short description of various endocrine glands and their functions
18. Reproductive System- Male and female reproductive system, Histology of Gonads,
ovarian cycle and ovulation, Fertilization, Fertility control

Biochemistry:
1. Carbohydrates - Glucose and Glycogen Metabolism
2. Proteins-Classification of proteins and functions
3. Lipids- Classification of lipids and functions
4. Enzymes- Definition, Nomenclature, Classification, Factors affecting enzyme activity,
Active site. Coenzyme, Enzyme Inhibition, Units of enzymes, Isoenzymes and Enzyme
pattern in diseases
5. Vitamins & Minerals- Fat soluble vitamins (A, D, E, K), water soluble vitamins, B-
complex vitamins, principal elements (Calcium, Phosphorus, Magnesium, Sodium,
Potassium, Chlorine and Sulphur), trace elements, calorific value of foods, Basal
Metabolic Rate (BMR), Respiratory Quotient (RQ), Specific Dynamic Action (SDA),
balanced diet, Marasmus and Kwashiorkor
6. Acids and bases-Definition, pH, Henderson – Hassel Balch equation, Buffers, Indicators,
Normality, Molarity, Molality
7. Hormones
8. Applied Chemistry:
a. Nomenclature of compounds containing Halogen. Alcohols and Phenols. Ethane,
Propane, Ether, Aldehydes, Ketones, Carboxylic acid, Cyanides, Isocyanides,
Nitrogen compounds and amines.
b. Catalysis.
c. Hemoglobin, Blood and respiration.

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Syllabus for practical
1. Benedict’s test
2. Heat coagulation tests

Principles of management
1. Principles of management:
a. Development of Management: Definitions of Management – Contributions of
F.W. Taylor, Henry Fayol and others.
b. Functions of Management: Planning – Organizing – Directing – Controlling
Planning: Types of planning – Short–term and long plans – Corporate or Strategic
Planning – Planning premises – Polices – Characteristics and sources – principles
of policy making – Strategies as different from policies – Procedures and
methods– Limitations of planning.
c. Organizing: Importance of organization – Hierarchy – Scalar chain –
Organization relationship – Line relationship – Staff relationship - Line staff
relationship – Functional relationship - Committee organization – Management
committees – Depart mentation.
d. Motivation: Motivation theories – McGregor’s theory X and theory Y – Maslow’s
and Herzberg’s theory – Porter and Lawler model of complex view of
motivation– Other theories – Diagnostic signs of motivational problems –
Motivational Techniques.
e. Communication: Types of communication – Barriers of effective
communication– Techniques for improved communication.
f. Directing: Principles relating to Direction process – Principles and theories of
leadership – Leadership Styles – Delegation of authority.
g. Controlling: Span of control – Factors limiting effective span of control – Supper
management, General managers, Middles managers and supervisors – Planning
and controlling relationships – Management control process – Corrective
measures– Strategic control points – Budgetary control – Types of budgets.
h. Co-ordination: Co-ordination and co-operation – Principles of co-ordination –
Techniques of co-ordination charts and records – Standard procedure
instructions.

2. Personnel management:
Objective of Personnel Management – Role of Personnel Manager in an organization –
Staffing and work distribution techniques – Job analysis and description – Recruitment
and selection processes – Orientation and training – Coaching and counselling –
disciplining – Complaints and grievances – Termination of employees – Performance
appraisal – Health and safety of employees - Consumer Protection Act as applicable to
health care services.

3. Financial management:
Definition of financial Management – Profit maximization – Return maximization–
wealth maximization – Short term Financing – Intermediate Financing – Long term
Financing – leasing as a source of Finance – cash and Security Management – Inventory
Management – Dividend policies – Valuations of Shares – Financial Management in a
hospital – Third party payments on behalf of patients. Insurance – health schemes and
policies.

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OTT Directed Clinical Education – part I (studentship)
Students will observe the basic operations of the operation theatre while interacting with the
multidisciplinary team members involved in providing optimal care to the patients. The student
will be introduced to terminologies, equipment, and techniques used for preparation and
management of the OT.

Third Semester
Pathology:
1. Cellular adaptation and cell death
2. Inflammation and repair, infection, circulatory disorders, immune defense
3. Genetics of disease
4. Neoplasia
5. Cell injury and adaptation
6. Atrophy, hypertrophy, metaphase, hyperplasia
7. Classification of tumors, premalignant lesion
8. Types of inflammation & system manifestations of inflammation
9. Disorders of vascular flow & shock (brief introduction)
10. Oedema, hyperemia or congestion, thrombosis, embolism, infarction shock, ischemia,
over hydration, dehydration
11. The response to infection
12. Categories of infectious agents, host barriers to infection
13. How disease is caused
14. Inflammatory response to infectious agents
15. Hematopoietic and lymphoid System
16. Hemorrhage, various types of anemia, leucopenia, leukocytosis, bleeding disorders
coagulation mechanism.
Medicine:
1. Common symptoms of diseases –
a. Pain: pathophysiology, clinical types, assessment and management
b. Fever: clinical assessment and management
c. Cough, chest pain, dyspnoea, hemoptysis
d. Edema, anasarca, ascites
e. Pallor, jaundice
f. Bleeding
g. Anorexia, nausea and vomiting
h. Constipation and diarrhea
i. Hematemesis, malena and hematochezia
j. Common urinary symptoms- dysuria, pyuria, anuria, oliguria, polyuria, nocturia,
enuresis
k. Body pains and joint pains
l. Headache, seizures, fainting, syncope, dizziness, vertigo
m. Disturbances of consciousness and coma
n. Weight loss and weight gain

2. Immune Response and Infections

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a. Approach to infectious diseases – diagnostic and therapeutic principles
b. Immune defense mechanisms
c. Laboratory diagnosis of infections
d. Principles of immunization and vaccine use
e. Immunodeficiency disorders - acquired
f. Immunodeficiency disorders – congenital

3. Systems
a. Cardiovascular system- Clinical examination of the cardiovascular system, major
manifestations of cardiovascular disease
b. Respiratory system - Clinical examination of the respiratory system, major
manifestations of respiratory disease
c. Renal and genito-urinary system- Major manifestations of renal and urinary tract
disease
d. Liver and biliary tract disease - Viral hepatitis, alcoholism.
e. Endocrinology and metabolism - Diabetes mellitus, Hyper - and hypothyroidism.
f. Disorders of the Immune System, Connective Tissue and Joints
g. Disorder of haemopoesis - Anemia - iron deficiencies anemia.

Principles of anesthesia
1. Medical gas supply
a. Compressed gas cylinders
b. Color coding
c. Cylinder valves; pin index.
d. Gas piping system
e. Recommendations for piping system
f. Alarms & safety devices.
g. Scavenging of waste anesthetic gases
2. Anesthesia machine
a. Hanger and yoke system
b. Cylinder pressure gauge
c. Pressure regulator
d. Flow meter assembly
e. Vaporizers - types, hazards, maintenance, filling and draining, etc.
3. Breathing system
a. General considerations: humidity & heat
b. Common components - connectors, adaptors, reservoir bags.
c. Capnography
d. Pulse oximetry
e. Methods of humidification.
f. Classification of breathing system
g. Mapleson system - a b c d e f
h. Jackson Rees system, Bain circuit
i. Non rebreathing valves - Ambu valves
j. The circle system
4. Face masks & Airway laryngoscopes
a. Types, sizes
b. Endotracheal tubes - Types, sizes.
c. Cuff system

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d. Fixing, removing and inflating cuff, checking tube position, complications.
5. Anesthesia ventilator and working principles.
6. Monitoring
a. Electrocardiography(ECG)
b. Pulse oximetry(Sp02)
c. Temperature- central and peripheral
d. End tidal carbon dioxide( EtCO2)
e. Anesthesia gas monitoring
f. Non-invasive blood pressure (NIPB) and Invasive blood pressure(IBP)
g. Central venous pressure(CVP)
h. PA Pressure, LA Pressure & cardiac output
i. Anesthesia depth monitor
j. Neuromuscular transmission monitor

Practical
1. Supply of compressed gases:
a. Types of gases and their chemical and physical properties.
b. Types of containers.
c. Their checking and maintenance.
d. Types of compressors.
e. Structure and mechanism of various type of gauges, liquid oxygen storage and
supply system.
2. Structure of reducing valves-
a. Mechanism of pressure reducing valves.
b. Their maintenance and safety checks
3. Structure and mechanism of flow meters, maintenance and safety checks
4. Volatile anaesthetic agents.
a. Selection of material to be used for containers of the volatile anaesthetic agents.
b. Structure of different types of vaporizers.
c. Principles of various vaporizers, their maintenance and safety precautions.
5. Types of circuits:
a. Open, Semi closed and closed circuits.
b. Non-rebreathing valves.
c. T-piece circuit and its modifications.
d. To and fro system and circle absorber.
6. Types of valves used in the different circuits. Structure and working of Heidbrink’s valve,
Rubin valve nu-man valve etc.

OTT Directed Clinical Education – part II (studentship)

Students will gain additional skills in clinical preparation, interaction with patients and
professional personnel. Students apply knowledge from previous clinical learning experience
under the supervision of a senior technical officer.

Fourth Semester
Clinical pharmacology

1. Antisialagogues: Atropine, Glycopyrrolate.

2. Sedatives I Anxiolytics: Diazepam, Midazolam, Phenergan, Lorazepam, Chlorpromazine,
and Triclofos.
3. Narcotics: Morphine, Pethidine, Fentanyl, Pentazozine, tramadol.

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4. Antiemetic’s: Metoclopramide, Ondanseteron, Dexamethasone
5. Induction Agent: Thiopentone, Diazepam, Midazolam, Ketamine, Propofol, Etomidate.
6. Muscle Relaxants: Depolarizing - Suxamethonium, Non depolarizing - Vecuronium,
Atracurium, rocuranium
7. Inhalational Gases: Gases-02, N20, Air, Agents-Ether ,Halothane, Isofllurane,
Saevoflurane, Desflurane
8. Reversal Agents: Neostigmine, Glycopyrrolate, Atropine, Naloxone, Flumazenil
(Diazepam).
9. Local Anesthetics: Xylocaine, Bupivacaine - Topical, Prilocaine-jelly, Emla - Ointment,
Etidocaine. Ropivacaine.
10. Emergency Drugs : Mode or administration, dilution, dosage and effects
a. Adrenaline, Atropine
b. Ephedrine, Mephentramine
c. Bicarbonate, calcium, potassium.
d. Inotropes: dopamine, dobutamine, amidarone
e. Aminophylline, hydrocortisone, antihistaminic,
f. Antihypertensive –Beta-blockers, Ca-channel blockers.
g. Antiarrhythmic- xylocard
h. Vasodilators- nitroglycerin & sodium nitroprusside
i. Respiratory system- Bronchodilators
j. Renal system- Diuretics, frusemide, mannitol

Clinical Microbiology
1. Morphology
a. Classification of microorganisms, size, shape and structure of bacteria. Use of
microscope in the study of bacteria.

2. Growth and nutrition

a. Nutrition, growth and multiplications of bacteria, use of culture media in
diagnostic bacteriology.
3. Culture media
a. Use of culture media in diagnostic bacteriology, antimicrobial sensitivity test.
4. Sterilization and Disinfection
a. Principles and use of equipment of sterilization namely hot air oven, autoclave and
serum inspissator, pasteurization, antiseptic and disinfectants.
5. Immunology
a. Immunity, vaccines, types of vaccine and immunization schedule, principles and
interpretation of common serological tests namely Widal, VDRL, ASLO, CRP, RF
& ELISA.
b. Rapid tests for HIV and HBsAg (excluding technical details).
6. Systematic Bacteriology
a. Morphology, cultivation, diseases caused, laboratory diagnosis including specimen
collection of the following bacteria (excluding classification, antigenic structure
and pathogenicity),
b. Staphylococci, Streptococci, Pneumococci, Gonococci, Meningococci, C.
diphtheriae, Mycobacteria, Clostridia, Bacillus, Shigella, Salmonella, E. coli,
Klebsiella, Proteus, Vibrio cholerae, Pseudomonas & Spirochetes.
7. Parasitology

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a. Morphology, life cycle, laboratory diagnosis of following parasites: E. histolytica,
Plasmodium, tape worms, Intestinal nematodes.
8. Mycology
a. Morphology, diseases caused and lab diagnosis of following fungi. Candida,
Cryptococcus, Dermatophytes, opportunistic fungi
9. Virology
a. General properties of viruses, diseases caused lab diagnosis and prevention of
following viruses, Herpes, Hepatitis, HIV, Rabies and Poliomyelitis.
Basic techniques of anesthesia
1. Resuscitation techniques:
a. Basic life support (Airway, breathing, circulation) and the equipment used for it.
b. Drugs used in CPR.
c. AED and Defibrillators.
2. Anesthesia drugs and techniques:
a. Principles of anesthesia.
b. Basics of general anesthesia depth, mechanism and intubation.
c. Techniques of general anesthesia.
d. Various intravenous and inhalational agents.
e. Regional anesthesia, spinal and epidural, posture and drugs.
f. Local Anaesthetic agents.
g. Neuro muscular blocking agents.
h. Principles of oxygen administration along with the apparatus.
i. Care of patient in the recovery room.
j. Post-operative pain: evaluation and management.
k. Types of fluid and therapy.
l. Blood and blood components transfusion.
m. Preparation of anesthesia machine, intubation kit, suction machine, anesthesia
drugs.
n. Patient identification, marking, shifting to OT before surgery and out of OT to
recovery room after surgery, complete takeover and handover of the patient with
vital signs recording before and after surgical procedure to the nursing staff.
Practical

1. Anesthesia work station

2. Boyle’s anesthesia apparatus and other Advanced Anesthesia machines.
3. Apparatus and technique of the intravenous injections:
a. Selection of the material used for intravenous injection.
b. Different types of intravenous needles and cannulas.
c. Theoretical study for testing of the toxicity of the materials.
4. Resuscitation equipment and Resuscitation techniques:
a. Endotracheal tubes :
 Selection of the material used for the endotracheal tube
 Study of the structure of various types of the endotracheal tubes. Cleaning and
sterilization of ETT.
b. Connectors: Various connectors, size and material used.
c. Mask: Material, structure and importance of dead space of face mask.
d. Supraglottic airways.
e. Spinal and epidural blocks: equipment, types of spinal and epidural needles, their
structure. Instruments used for spinal and epidural blocks.
f. Laryngeal sprays: Types, structure and material used, mechanism, uses and their
maintenance.

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OTT Directed Clinical Education – part III (studentship)
Students will improve their skills in clinical procedures. Progressive interaction with patients and
professional personnel are monitored as students practice in a supervised setting. Additional
areas include problem solving, identifying machine components and basic side effect
management. Students will demonstrate competence in beginning, intermediate, and advanced
procedures.

Fifth Semester
Basics of surgical procedures
1. Blood Transfusion
a. History of discovery of blood groups and genetics of blood groups.
b. Types of blood groups and Rh factor.
c. Coombs test.
d. Collection of blood, its preservation and standardization.
e. Various types of blood and blood products(Packed cells, PRP, FFP)
f. Pre-transfusion checks.
g. Transfusion reactions.
h. Fluids and electrolytes
i. Body fluid compartments and the effect of fluid administration on them.
j. Types of fluids (crystalloids and colloids) and their chemical composition.
k. Indications of specific fluids and their complications.
2. General surgical procedure and para-surgical equipment
a. Operating tables: structure, material used, maintenance, control, Hydraulic system
and Electrical system.
b. Different types of diathermy machine. Monopole, Bipolar, Ligasure, Harmonic
Scalpel, CUSA- Principle, hazards, prevention, functioning and maintenance.
c. Types of operation lights and light sources: Features, Care, cleaning, sterilization
and maintenance.
d. Operation Theatre sterilization- Different recent advances.
e. LAR/APR--Positioning of patient, care-Prevention of hazards.
f. Total thyroidectomy—with emphasis on proper positioning.
g. Transthoracic esophagectomy—Different approaches.
h. Venesection and Tracheostomy.
i. Laproscopic Cholecystectomy – Pneumoperitonium - Creation and removing,
principles.
j. Nephrectomy.
k. Breast surgery.
l. Positioning of patient for different operations: Problems and hazards.
m. Hypothermia and hyperthermia.

CSSD procedures

1. Principles of sterilization and disinfection.

2. Methods of sterilization
3. Dry Sterilization.
4. Wet sterilization.
5. Gaseous sterilization.
6. Chemical sterilization.

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7. Sterilization by radiation (Gamma rays, ultraviolet rays)
8. Techniques of sterilization of rubber articles. (LMA, FOB, ETT, Laryngoscopes,
Anesthesia machines and circuits.)
9. Technique of sterilization of carbonized articles.
10. Methods of disinfection.
11. Boiling.
12. Chemical disinfection.
13. Hazards of sterilization.
14. Prevention of hazards of sterilization.
15. Precautions to be taken during sterilization.
16. Recent advances in the methods of sterilization.

Advance anesthesia techniques

1. Heart as a pump.
2. Cardiac cycle.
3. Cardiac contractility and stroke volume.
4. Cardiac output and its measurement.
5. Various ECG Leads, their placement and Normal ECG.
6. Cardiac Arrhythmias (atrial fibrillation, ventricular tachycardia, extra systoles)
7. Circulatory shock and its physiology.
8. Cardiac failure.
9. Physics of blood flow and pressure.
10. Measurement of blood flow.
11. Electromagnetic flow meter, ultrasonic flow meter, plethysmography.
12. Regulation of arterial pressure and hypertension (Drugs used for treatment of
hypertension)
13. Arterial circulation including cardiopulmonary bypass.
14. Artificial ventilation and related equipment:
a. Physiology of IPPV (Intermittent positive pressure ventilation)
b. Principles of mechanical ventilation.
c. Various modes of IPPV.
d. Automatic pressure and time cycled ventilators.
e. Operating room ventilators.
f. Other types of ventilators (HFJV, NIV)
g. Complications in patients on ventilators.
h. General care of a patient on ventilator.
i. Disinfection and sterilization of ventilators.
j. Humidification
k. Principles of oxygen administration and methods used to deliver oxygen.
l. Acid base balance.
m. Electrolyte imbalance and its relevance to anesthesia.

Basic Intensive care

1. Care and maintenance of ventilators, suction machine, monitoring devices.
2. Sterilization and disinfection of ventilators.

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3. Care, maintenance and operational capabilities of beds, lights and other apparatus.
4. Air conditioning and control of pollution in ICU.
5. Attachment and intraoperative utility of ventilators and monitoring devices.
6. Care of unconscious adult and pediatric patients.
7. Physiotherapy techniques, feeding, Ryle’s tube insertion and hyper alimentation.
8. Suctioning and posturing of semiconscious and unconscious patients.
9. Oxygen therapy, maintenance of clear Airway.
10. Ventilation of patient in crisis:
11. Mouth to mouth.
12. Mouth to ET Tube.
13. Resuscitator/ bag valve mask assembly
14. Different types of Airways.
15. Short term ventilation/ Transport ventilators.
16. ICU Laboratory; Detection of blood gases of the patient, Principles of ABG machines.
17. Management of asepsis.
18. Management of tetanus patient.
19. Psychological aspects of the patient, relative and staff.
20. Hemofiltration and hemodialysis.
21. Ventilators: Principles of working of different ventilators:
a. Volume cycled/Time cycled/Pressure cycled ventilators.
b. High frequency ventilators and other types.
c. Methods of measuring the expired gases from the patient; Types of spirometers,
Principles of working of spirometers. Clinical application of above apparatus.
d. Apparatus and techniques of measuring of blood pressure and temperature;
Principle and working of direct/indirect blood pressure monitoring apparatus;
structure, principle and working of the oscillotonometer. Principles and working
of aneroid manometer type B.P. instrument.
e. Laryngeal sprays; Types, material, principle and mechanism.
f. Monitoring techniques and equipment; Cardiac monitors, Respiratory monitors,
Spirometers, Temperature monitors.

OTT Directed Clinical Education – part IV (studentship)

The course provides students the opportunity to continue to develop confidence and increased
skill in simulation and treatment delivery. Students will demonstrate competence in beginning,
intermediate, and advanced procedures in both areas. Students will participate in advanced and
specialized treatment procedures.

Sixth Semester

Specialized anesthesia and surgery

1. Cardiovascular and Respiratory System- Techniques, equipment, procedures and

instruments
a. Diseases of cardiovascular and respiratory systems.
b. Types of perfusion machines.
c. Techniques of Perfusion and operational capabilities.
d. Intra-aortic Balloon pump.

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e. Cell saver techniques.
f. Care, maintenance and working of Heart lung Machine.
g. Patient’s record keeping preoperatively, during anesthesia and post-operatively.
h. Principles and techniques of temperature monitoring.
i. Positioning during cardiothoracic surgical procedures.
j. Positioning and techniques for:
 Radial artery cannulation.
 Central venous cannulation/pulmonary artery catheter.
 Femoral artery/venous cannulation.
2. Monitoring Techniques and Equipment:
a. Cardiac monitors, blood pressure and ECG monitoring.
b. Respiratory monitors, respiratory rate, Spirometers, SpO2, and EtCO2.
c. Temperature monitors.
d. TEE and echocardiography machine
e. Non- invasive cardiac output machine
3. Positioning-
a. During various neurosurgical procedures including sitting, prone, lateral and
position for trans-sphenoidal hypo-physectomy.
b. Fixation of head during various neurosurgical procedures.
c. Prone and Knee chest position for spine surgery.
4. Requirements during intubation in a case of cervical spine fracture including fiber- optic
laryngoscopy, awake intubation, LMA family especially ILMA.
5. Anaesthetic and surgical requirements during aneurysm surgery.
6. Surgical and Anaesthetic requirements during micro neurosurgery including types of
microscopes, principle, structural features, microscopic photography and cameras used.
7. Anaesthetic and surgical requirements during thyroid surgery, adrenal surgery.
8. Anaesthetic and surgical requirements during abdominal surgery including Laproscopic
surgery, genitourinary surgery including percutaneous nephrolithotomy, Endoscopic
surgery, TURP, TURBT, Lithotripsy, ESWL (Extracorporeal shock wave therapy)
9. Anaesthetic and surgical requirement during renal transplant donor and recipient surgery
including care and precautions during operative procedures of hepatitis B & hepatitis C
positive patients.
10. Anaesthetic and surgical requirement during pediatric and Neonatal surgical procedures
including emergency procedures like tracheo-esophageal fistula. Sub diaphragmatic hernia,
major abdominal and thoracic procedures. Foreign body bronchus and esophagus.
11. Apparatus and techniques for measuring blood pressure and temperature.
12. Principle and working of direct/Indirect blood pressure monitoring apparatus.
13. Intraoperative and postoperative problems and complications of general surgery.
14. Management of emergency caesarean section.
15. Management of massive obstetrical hemorrhage.
16. Surgical management in major burns and craniofacial surgery.
17. Surgical management of joint replacement and arthroscopy.
18. Surgical management of endoscopies, laryngectomy with RND and cochlear implant.
19. Management of PPV and perforating eye injury.
20. Care and maintenance of Para-surgical equipment (Cautery, OT Lights, OT Table etc.)

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Electronics and technology in surgery and anesthesia

1. Electronics and electro mechanical techniques-

a. Electrical safety precautions in operation theatre. OT tables, OT lights, suction
machines, electrodes, pressure transducers, electrical safety, application, handling
operation.
b. Basic electronics, basic principle, care and maintenance and uses of surgical
diathermy machine, defibrillator, Boyle’s apparatus, anesthesia machine, monitors,
pace-makers and stimulators etc.
c. Engineering aspects of operation theatre equipment, power supplies, CVT, servo-
stabilizers, and ups etc.
2. Book keeping and Stock maintenance.
a. Moral aspects and duties of OT technologist.
b. Indenting, Book keeping and storage procedures of different articles.
c. Co-ordination with all working personal in operation Theatre.
d. Psychological aspects of patient, staff and relatives of the patient.
e. Management of operation theatre in routine and emergency.
3. Computer data processing, software information and Data management
a. Logging on and off, Security concepts, Sending and receiving Emails.
b. Hospital information system.

OTT Directed Clinical Education – part V (studentship)

This course is the final in a series of five directed clinical courses. The student will complete the
clinical training by practicing all the skills learned in classroom and clinical instruction.

Seventh and Eighth Semester

The internship time period provides the students the opportunity to continue to develop
confidence and increased skill in simulation and treatment delivery. Students will demonstrate
competence in beginning, intermediate, and advanced procedures in both areas. Students will
participate in advanced and specialized treatment procedures. The student will complete the
clinical training by practicing all the skills learned in classroom and clinical instruction. The
students are expected to work for minimum 8 hours per day and this may be more depending on
the need and the healthcare setting.

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Skills based outcomes and monitorable indicators for Operation Theatre Technologist
Competency statements
1. Demonstrate ability to prepare and maintain Operation Theater
2. Demonstrate ability to maintain equipment support in an acute care environment
3. Identify and move to maintain a sterile field
4. Follow infection control policies and procedures
5. Manage and maintain theater equipment
6. Demonstrate ability to prepare the patient for operative procedures
7. Provide intra-operative equipment and technical support
8. Demonstrate skills and knowledge to assist anesthetist in handling emergencies outside
of OT Room
9. Manage hazardous waste and follow biomedical waste disposal protocols
10. Ensure availability of medical and diagnostic supplies
11. Monitor and assure quality
12. Act within the limits of one’s competence and authority
13. Work effectively with others
14. Manage work to meet requirements
15. Maintain a safe, healthy, and secure working

S. no. Learning outcomes Knowledge/compreh Applications / synthesis Hours

ension /evaluation
1 Prepare and maintain Be familiar with the Prepare the OT for the 300
Operation Theatre Operation Theatre and operation along with all
all the equipment. the necessary equipment.
Know the protocols Interpret and understand
used in Operation all planning techniques to
Theatre keep an OT functional.
2 Maintain equipment Use basic knowledge of Clean and store 300
support in an acute care surgical procedures to equipment safely
environment assist and identify the Position equipment in
needs of equipment of accordance with set up
Operating teams. procedures

3 Assist anaesthetist in Knowledge of assisting Prepare emergency kit to 300

handling emergencies anaesthetist outside OT handle areas outside OT
outside of OT Room. Room. Room.
Ensure any signs or
symptoms of a clinical
emergency is identified
correctly and reported to
the appropriate clinician.
4 Follow infection control Knowledge of effective Preform the standard 220
policies and procedures infection control precautions to prevent the
strategy that ensures the spread of infection in
safety of the patient. accordance with
organization

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S. no. Learning outcomes Knowledge/compreh Applications / synthesis Hours
ension /evaluation
requirements.

5 Ensure availability of Anticipating demand Maintain adequate 100

medical and diagnostic and ensuring availabilitysupplies of medical and
supplies of adequate medical and diagnostic supplies. Arrive
diagnostic supplies.
at actual demand as
accurately as possible
6 Prepare patient for Knowledge of preparing Safely position patient to 200
operative procedures patients as required meet the requirements of
before the operation. the anaesthetist and
Surgeon.
7 Provide intra-operative Knowledge to assist the Monitoring the 200
equipment and technical anaesthetist and provide performance of
support technical support during equipment used and
surgical procedure. adjusting surgical
equipment.
8 Work effectively with Working with other Identify any problems 100
others people to meet with team members and
requirements other people and take the
initiative to solve these
problems.
Communicating with Communicate with other
other team members people clearly and
and people internal or effectively
external to the
organisation
9 Be able to demonstrate Explain the legal and Promote collaborative 100
professional behavior ethical guidelines related practice
to the
profession
Be aware of your own
competency levels
10 Be able to complete Recognize the Complete the treatment 50
accurate treatment importance of accurate documentation accurately
documentation documentation
11 Manage hazardous waste Knowledge of Handle, Coordinate the hazardous 100
collect and dispose of waste management
the hazardous waste. program.
Properly identify,
segregate, handle, label,
and store waste.

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S. no. Learning outcomes Knowledge/compreh Applications / synthesis Hours
ension /evaluation
12 Maintain a safe, healthy Complying the health, Identify individual 100
and secure working safety and security responsibilities in relation
environment. requirements and to maintaining workplace
procedures for health safety and security
Workplace. requirements.
Follow the organization’s
emergency procedures
promptly, calmly, and
Efficiently.
13 Monitor and assure Monitor treatment Evaluate potential faults 200
quality process/outcomes in treatment procedures.
process/outcomes
Identify problems in Identify breaches in
treatment health, safety and security
procedures.
Solve treatment Follow the organization’s
process/outcome emergency procedures
problems promptly, calmly and
efficiently.
Total 2270

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Chapter 5
Job description

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Chapter 5: Job Description for all levels

Level 4- OT Assistant
1. JOB TITLE - Operation Theatre Assistant
2. JOB PURPOSE

Assisting team in pre-operative arrangements.

Assisting during intra-operative with surgeons &
anesthesiologist.
 Assisting team post-operative.
 Maintenance of machines.
3. ACCOUNTABLE TO - HOD- Anesthesia Department / Senior OT Technologist/ OT
Technologist
4. QUALIFICATION - Diploma in Operation Theatre Technology (2 years)
RESPONSIBILITIES:

 Responsible for the transportation of patients to and from the theatre and wards
 Assist staff with the mobilization of the patient within the Operation Theatre
 Assist with patient procedures as required
 Maintain procedure room/operating theatre equipment so as to ensure a clean, safe and
efficient environment for patients and staff
 Assist in the preparation of patient prior to surgery, e.g. pre-operative shave, patient
positioning.
 Ensure that the patient is positioned securely and safely on the operating table prior to
surgery and on the patient trolley at the completion of surgery
 Provide assistance to medical and nursing staff
 Promote patient safety at all the times
 Assist in other areas within the theatre complex as workload permits
 Maintain good communications with other staff in the theatre complex
 Maintain patient confidentiality at all the times
 Be familiar with the correct operation of all equipment
 Collect and return all necessary equipment for the procedure and patient safety
 Report malfunctioning equipment to person as per protocol
 Follow the hospital’s Health and Safety policies and procedures
 Be aware of the OH&S guidelines for the safe transport of beds and patients throughout
the hospital

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Level 5 onwards – Operation Theatre Technologist
1. JOB TITLE - Operation Theatre Technologist
2. JOB PURPOSE
 Assisting team in pre-operative arrangements.
 Assisting during intra-operative with surgeons &
anesthesiologist.
 Assisting team post-operative.
 Maintenance of machines
3. ACCOUNTABLE TO - HOD/ Senior Operation Theatre Technologist
4. QUALIFICATION - B.Sc. Operation Theatre Technology (3 ½ years including 6
months internship)

RESPONSIBILITIES:
 Supporting the multidisciplinary team in providing a safe, high quality environment for the
carrying out of surgical procedures by:
 Assisting in skin preparation and draping of the surgical field.
 Supporting and observing the patient throughout the operation.
 Assisting in the measurement and recording of fluid input / output.
 Working as part of the multidisciplinary team for the benefit of the patient, appreciating
each member of the team’s needs and role.
 Anticipating the needs of the surgical team and responding effectively.
 Safely handling, recording and used instruments in line with Policy.
 Disposing of clinical waste safely and appropriately in line with Policy.
 Capturing and maintaining patient data / documentation and any information required for
auditing / quality issues. Documentation will be countersigned by the Registered
Practitioner.
 Utilizing communication skills, preparing the environment and equipment and acting as a
link between the surgical team and other parts of the theatre and hospital.
 Assisting the Registered Practitioner in the handover of the patient to the recovery staff,
providing appropriate information and documentation.
 Notifies appropriate health physicians when immediate clinical response is necessary based
on emergency in Operation Theater.
 Involvement in research and development.

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Annex- 1
Allied and Healthcare Professions
Allied and healthcare professionals includes individuals involved with the delivery of health or healthcare related services, with
qualification and competence in therapeutic, diagnostic, curative, preventive and/or rehabilitative interventions. They work in
multidisciplinary health teams in varied healthcare settings including doctors (physicians and specialist), nurses and public health
officials to promote, protect, treat and/or manage a person(‘s) physical, mental, social, emotional, environmental health and
holistic well-being.
The wide variation in the understanding of the concept of allied and healthcare professional, better known as
‘paramedic’, the nomenclature, and functions has led to the poor image of allied and healthcare sciences in
India. The use of the word paramedic itself limits the activities of AHPs in the system. Hence, it is imperative
to adequately compensate these professionals based on their qualifications and specialties. Despite a huge
demand for services from this sector, allied and healthcare sciences is highly fragmented. As per the report
‘From Paramedics to Allied Health Sciences’, in total 138 courses of varied levels were identified during the
process. Although it is estimated that there may be many more courses which are yet to be identified.
Considering the lack of regulatory mechanism following 15 core professional groups (accounting for around
44 professions) has been enlisted below (The list is illustrative of the allied and healthcare professions.
In future there may be addition or removal of certain professions based on the state of their
regulation and standardization). It also needs a mention that most of these professions are not
restricted to the professional groups under which they have been categorized, their role may extend
to other professional services too. Similarly, the categorization is an indicative categorization,
however this may evolve over time based on deeper understanding of the roles and responsibilities
of each professional group:
1. Healthcare Professions
1. Optometry
2. Physiotherapy
3. Occupational Therapy
4. Nutrition Sciences
5. Physician Associate and Assistants

2. Allied Health Professions

6. Cardiology, Vascular and Pulmonary Technology
7. Medical Laboratory Sciences
8. Medical Radiology and Imaging Technology
9. Neurosciences Technology
10. Non- direct and Administrative services
11. Primary Care and Community services
12. Radiation Therapy
13. Renal Technology
14. Surgical and Anesthesia related Technology
15. Trauma Care Services

The above mentioned groups account for over 44 job profiles in the allied and healthcare space,
which are as follows-
A. Healthcare Professions
1. Optometry
a. Optometrist
2. Physiotherapy
a. Physiotherapist
3. Occupational Therapy
a. Occupational Therapist

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4. Nutrition Sciences
a. Nutritionist
b. Dietitian
5. Physician Associate and Assistants
a. Physician Associates and Assistants

B. Allied Health Professions

6. Surgical and anesthesia related technology
a. Anesthesia Assistants and Technologist
b. OT Technologist
c. Endoscopy Technologist
7. Medical Laboratory Sciences
a. Cyto-Technologist
b. Dermatology/STD /Leprosy Lab Technologist
c. Forensic Technologist
d. Hemato-Technologist
e. Histopath-Technologist
f. Phlebotomist
g. Medical and Clinical Lab Technologist
8. Medical Radiology and Imaging Technology
a. Radiographer
b. Radiologic /Imaging Technologist
c. Diagnostic Medical Sonographer
9. Renal Technology
a. Urology Technologist
b. Dialysis Therapy Technologist
10. Radiation Therapy
a. Radiotherapy Technologist
b. Medical Dosimetrist
c. Nuclear Medicine Technologist
11. Trauma Care Services
a. Emergency Medical Technologist (paramedic)
b. Critical Care/ICU Technologist
12. Neurosciences Technology
a. EEG/END Technologist
b. EMG Technologist
c. Neuro Lab Technologist
d. Sleep Lab Technologist
13. Cardiology, Vascular and Pulmonary Technology
a. Cardiovascular Technologist
b. ECG Technologist
c. ECHO Technologist
d. Perfusionist
e. Pulmonary Function (PFT) Technologist
f. Respiratory Therapist
14. Non- direct and Administrative Services
a. Biomedical Engineers and Technologist
b. Medical Assistant
c. Medical Secretaries
d. Medical Transcriptionist
e. Health Information Management Technologist

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15. Primary Care and community services
a. Blood Bank Technologist
b. Counselor- Integrated Behavioral Health Counselors, Palliative counselors etc.
c. Sanitary Health Inspectors

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directed learning. Academic Medicine. 2003; 78(12): 1259-65.

17 Credit-Based-Grading-System for Assessment of Students. Available from:

http://www.presiuniv.ac.in/web/exam_assessment.php.
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http://www.mu.ac.in/1__Manual_SCGS_Arts_09-06-2011.pdf.
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(Internet) (Cited 7rth September 2014) Available from http://www.smfwb.in/Syllabus/DOTT-Syllabus.pdf.

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Operation%20Theratre%20Technician.pdf
26 Prospectus 2014-2015, Christian Medical College (Internet) (Cited 15th September 2014) Available from:

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27 Fremgen B, Frucht S. Medical Terminology: A Living Language: Pearson Education, Inc. Available from:
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%20Theatre%20and%20Anesthesia%20Technology.pdf.
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bsc.

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DETAILS OF INVOLVED/RESPONSIBLE OFFICERS AT THE MINISTRY OF
HEALTH AND FAMILY WELFARE (MOHFW)

1. Mr Ali R.Rizvi, Joint Secretary (Human Resource)

2. Mr B. Sriramachandra Murthy, Director (Allied Health Section)
3. Mr Satish Kumar, Under Secretary (Allied Health Section)

National Initiative for Allied Health Sciences – Technical Support Unit (NIAHS –
TSU)
1. Ms Kavita Narayan, FACHE, Director, NIAHS-TSU at MoHFW, GoI
2. Ms Shivangini Kar Dave , Project Lead Coordinator
3. Ms Natasha D'Lima, Program Coordinator
4. Ms Namita Gupta, Consultant
5. Mr Sutirtha Mazumder, Senior Research Assistant
6. Mr Ashish Arora, Senior Research Assistant (former)
7. Ms Tanu Sri Sahu, Senior Research Assistant
8. Mr Akhilendra Trivedi, Senior Research Assistant
9. Mr Vivek Bhatnagar, Senior Research Assistant
10. Mr Anirooddha Mukherjee, Research Assistant

For additional details or queries, please contact:

1. Mr Uttam Sengupta, SO (AHS),
Room 442 – A,
Nirman Bhavan, New Delhi 110001.
Phone: 23063720, Email: [email protected]

2. NIAHS TSU,
Facilitation Centre, Near Gate No 5,
Nirman Bhavan, New Delhi 110001.
Phone: 011-23061751, Email: [email protected]

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National Initiative for Allied Health Sciences – Technical Support Unit (NIAHS – TSU)
Facilitation Centre, Near Gate No. 5, Nirman Bhavan, New Delhi 110001.
Phone: 011-23061751, Email: [email protected]

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