Dias nummer 1

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Standardized case Record Concept and
Application Dr Anand Kapse, MD (Hom) Director,
Rural Homoeopathic Hospital, Palghar
2
Evolution of Homoeopathic Philosophy

• Hahnemann
• Boenninghausen
• Kent
• Boger
• M L Dhawale
• Guru Shishya Parampara

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Dr.Samuel Hahnemann (1755 -18 43) The father of
Homoeopathy
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Von Boenninghausen(1785 - 1864)The great
Generalist
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James Tyler Kent 1849 1916 The great Artist
A humble tribute to a teacher who opened fresh
vistas of clinical experience and knowledge
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DR. C. M. BOGER (1861 1935)
MASTER OF SYNTHESIS
A PHILOSOPHER-CLINICIAN
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Dr. M. L. Dhawale (1927 - 1987) A Born Teacher
Integration
Standardization
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Standardized Case Record (SCR)
Philosophy Practice
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Tri-coordinate Care The ICR way
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ACTION LEARNING
T
C ? A ? R
F
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SCR Integrated Approach

• Homoeopathic Philosophy
• Hahnemann
• Boenninghausen
• Kent
• Boger
• Clinical Knowledges
• Psychology/Psychiatry
• Indian Philosophy Geeta

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OBJECTIONS TO SCR

• Is it necessary to do all these complex things
  for treating the patient with Homoeopathy? Do we
  need all these knowledges for simple
  prescriptions?
• Where is the time?
• How can we take so much effort for one case?
• Why should we spend so much money on a case
  record?

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Pursuit of Excellence Yogah Karmasu Kaushalam

• Costs of doing a thing
• Money
• Effort
• Time
• Costs of not doing a thing
• Destroy the finest instrument nature has evolved
  after millions of years of experimentation The
  Human Mind
• Yukta as described in Geeta
• 1-6 Aphorisms of Organon
• Integrity as a way of life living

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Standardized Homoeopathic PracticePerceiving
the Totality consistently What it demands of a
Homoeopath?

• Sensitivity
• Empathy
• Capacity of resolution as well as discrimination
• Idealistic bent of mind
• Strong determination
• Disciplined mind
• Shun subjectivity steer towards objectivity

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Standardization of Individualization

• Objectivity implies standardization of response
  to a stimulus
• Mind as an instrument (Physician)
• Mind as an object of study (Patient)
• Sensitivity Controlled / Refined /
  Sensitizations
• Standards? Personal vs. Functional Fundamental
• Role of an Observer External / Internal
• Group Learning Case discussion

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SCR System Training of a Homoeopath

• Knowledge
• General
• Specific
• Skills
• Physical Examination
• Investigations
• IPD
• Attitude Care thru self dispersal not self
  development

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Evolution of a Homoeopath

• Scientific
• Artistic
• Intuitive

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MODEL STEPS IN MANAGING A CASE THROUGH THE SCR
SYSTEM
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MODEL STEPS IN MANAGING A CASE THROUGH THE SCR
SYSTEM
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MEDICAL HISTORY FOR HOMOEOPATHIC
TREATMENTDirections for a written submission

• INTRODUCTION
• 1. For finding a correct homoeopathic remedy lot
  of information with regard to the
• (i) Complaints
• (a) Main as well as
• (b) Subsidiary and
• (ii) The person of the patient is
  required.
• 2. Incomplete information will make correct
  choice difficult. You are therefore requested to
  supply all information without keeping back
  anything as irrelevant or of little importance.
  The information you supply in the Note forms the
  basis of further enquiry designed to assist you
  in the further delineation of the problem. Full
  co-operation therefore is requested. All
  information supplied is, of course , strictly
  confidential.
• Since the enquiry can be time consuming process
  and a lot of information is being collected we
  require to record it systematically and at times
  we may find it necessary to administer to you
  further tests in which you are called upon to
  write out further. To facilitate this we have
  evolved a special procedure in which the
  preliminary study is carried out by a physician
  specially assigned to this job and when your Case
  Record is ready we examine it to find out if it
  is sufficient for instituting treatment or it
  requires further detailed processing of
  information and study of your case. If so we give
  you a further suitable appointment for finalising
  the line of treatment.
• We are sure you be fully co-operating with us in
  rendering you the best possible service.

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PRELIMINARY INFORMATION

• Please supply the following information as
  standard routine
• Name in full, Address, Date of Birth, Sex,
• Status (Single / Married / Widow-ed since /
  Divorcee since),
• Religion /Community/Sect, Vegetarian /
  Non-vegetarian / Eggs,
• Addictions, Tobacco, chewing/smoking, Tea,
  Coffee, Beer, Whisky and liquors (please state
  the quantity consumed daily )
• Educational career and qualifications.
• Occupation, current and previous with a full
  description of responsibilities and job
  satisfaction, address and tel. no.
• Description of the current family set-up, full
  description pertaining to all the members their
  ages, location, work they are doing and your
  relationship with responsibilities for them.
  Include in your list those who have died stating
  the age of death, the year and cause of the same.
• Your daily routine from getting up in the morning
  to retiring at night. Include in this your
  dietary schedule furnishing full details in
  respect of the quantities consumed.
• Financial responsibilities and strains (present
  as well as past). Difficulties experienced, Place
  of work / Family set-up Social, give a full
  account.

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CHIEF COMPLAINT

• Describe what bothers you most. Each trouble
  should be detailed as under
• 1. Full description of the trouble right from
  the time of onset. Its subsequent development and
  spread and response to treatments taken. This
  should give full idea of
• (i) Area affected location, extension, direction
  of spread the march of events.
• (ii) Sensation experienced in the area of
  trouble.
• (iii) Conditions that have brought on the
  trouble examine the circumstance that obtained
  just before or at the time of onset, paying
  attention to physical as well as emotional
  factors.
• (iv) Conditions that increase the trouble or
  those that afford relief.
• (v) Other troubles experienced at the same time
  along with the main trouble for example
• .....perspiration/nausea/vomiting/gas
  /with pains.
• OTHER COMPLAINTS
• Describe here all other troubles you might be
  having or have in the past experienced.
• Each should be described fully as suggested above
  for the 'CHIEF COMPLAINT'.

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PERSONAL DATA

• Give a full account of the following
• (1) Physical description of self
• (2) Emotional nature and intellectual
  attainments and aspirations. Indicate to what
  extent you have been able to realise them. Give a
  clear cut picture of relationships with the
  family members, friends and associations. Give a
  full idea of your responsibilities in life and
  what you feel about them.
• (3) Reactions to surroundings.
• (a) Food desires and aversions, foods
  that do not suit etc.
• (b) General environment weather,
  temperature, bath, recreations, addictions etc.
• (c) Sleep and dreams
• (d) Sex ( inclusive of menstrual and
  obstetric history ).

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• PREVIOUS ILLNESS
• Give a resume of the various illnesses you had
  and to what extent these have any bearing on
  present troubles.
• FAMILY HISTORY
• Data concerning the parents, brothers and
  sisters. State details concerning the health of
  wife and children.
• GENERAL COMMENTS
• Include here any items which have not been
  included above.
• ENCLOSURES
• 1. Medical Report and opinion on your
  state of health from physician.
• 2. Copies of Reports of investigations
  done.
• 3. X-ray plates, Electrocardiograms,
  etc.

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SCR 10 MAIN DIVISIONS

• HISTORY PRESENT PAST
  
• PHYSICAL EXAMINATION
• PROVISIONAL DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
  
• INVESTIGATION
• EVOLUTIONARY HAHNEMANNIAN TOTALITY
• ESSENTIAL EVOLUTIONARY TOTALTY
• REPERTORIAL TOTALITY
• PLANNING PROGRAMMING OF CASE
• THERAPEUTIC PROBLEM DEFINITION RESOLUTION
• CASE FOLLOW UP PROGRSS RECORD

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(No Transcript)
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III
C
D TO H
I
B
A

• EMOTIONAL
• INTELLECTUAL
• REACTIONS
• - EMOTIONS
• - INTELLECTUAL ACTIVITY
• - LIFE SITUATION
• ACTION
• - BEHAVIOUR
• - FUNCTIONING

II
APPEARANCE DIGESTION ELIMINATIONS MENSTRUAL
FUNCTION SEXUAL FUNCTION PREGNANCY, LABOUR,
PUERPERIUM DEVELOPMENT LANDMARKS PROBLEMS

• - PHYSICAL EXPRESSION
• ?
• MENTAL STATE
• INTERPRETATION

FIGURE 2 S C R M A J O R A R E A S
- P R E S E N T H I S T O R Y
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Chief Complaint Associated Complaints

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III PATIENT AS A PERSON

• PHYSICAL CHARACTERISTICS
• Appearance
• Digestion
• Eliminations
• Menstrual Function
• Sexual Function
• Pregnancy, Labour, Puerperium
• Developmental Landmarks Problems
• Diet Daily Routine

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B. MENTAL STATE

• 1. Emotional
• 2. Intellectual
• 3. Reactions
• - Emotions
• - Intellectual Activity
• - Life-Situation
• 4. Action
• - Speech
• - Behaviour
• - Functioning
• Sleep Dreams
• Diagnostic net
• Mental State Interpretation Psychodynamic
  Psychosomatic

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• C REACTIONS PHYSICAL FACTORS
• TIME
• POSITION AND MOTION
• METEREOLOGICAL
• SENSORY INPUTS
• PHYSIOLOGICAL FUNCTIONS
• D FEVER TOTALITY
• E ORIGINAL UNMODIFIED PICTURE
• F CHRONOLOGICAL SEQUENCE
• PAST HISTORY PERSONAL/FAMILY
• PHYSICAL EXAMINATION
• PROVISIONAL CLINICAL DIAGNOSIS DIFFERENTIAL
  DIAGNOSIS
• INVESTIGATIONS

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PROCESSING OF THE CASE

• Classification of Symptoms
• Evolutionary Hahnemannian Totality (Page 74)
• Conceptual Image and Miasmatic Expression (Pages
  75-83)
• Essential Evolutionary Totality (Page 84-85)
• Repertorial Totality (Page 86-89)
• Remedy Correspondences and Selection (Page 90-93)
• Planning and Programming of Treatment (Page
  94-99)
• Therapeutic Problem Definition and Resolution
  (Page 100-101)

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LIST OF STANDARD NOTATIONS

• Aggr lt
• Amel gt
• Present
• Absent A
• Changeable C
• Decrease D
• Erratic E
• Fluctuating F
• Good G
• Increased I
• Same S
• lt Followed by Status Quo S
• gt Followed by Status Quo
• lt Followed by gt
• Abrupt disappearance of symptoms

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RECOMMENDED READINGS

• In order to operate successfully the SCR System,
  the Homoeopathic physician will need to be fully
  conversant with all the works of Hahnemann,
  Boenninghausen, Hering, Kent, Close, Boger and
  Roberts.
• An efficient Research Worker will have read
  all these in the original, inclusive of
  translation and with full comprehension. Persons
  with less time and energy at their disposal
  should be in a position to have an effective
  compromise by reading the following
• Dhawale, M. L. Principles and Practice of
  Homoeopathy Volume 1 Homoeopathic Philosophy and
  Repertorization
• 2. Dhawale, M.L. (Ed) I. C. R. Symposium Volume
  Hahnemannian Totality

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Standardized Homoeopathic PracticeICR
Publications
36
ICR PUBLICATIONS
37
INSTITUTE OF CLINICAL RESEARCH PUBLICATIONS

• 1. Principles and Practice of Homoeopathy
  Volume1 Homoeopathic Philosophy and
  Repertorization
• 2. I. C. R. Operational MANUAL
• 3. Life Living
• 4. I.C.R. Symposium Volume on Integrated
• Hahnemannian Totality
• 5. Perceiving - 1
• 6. Paediatrics In Homoeopathy An Approach
• 7. First I. C. R. Conference On Education Theme
  
• Action Learning

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I. C. R. EDUCATIONAL PRACTICE Series

• 1 Continued Homoeopathic Medical Education The
  I.C.R. Approach
• 2 Concept of Man and Homoeopathic Medical
  Education
• 3 Integrated Homoeopathic Practice
• 4 Standardized Case Record 1984
• 7 Perceiving Man I.C.R. Training Groups.
• 8 Correspondence Learning Program
• 9 Principles Practice of Professional
  Competence The I. C. R. Way
• 10 Professional Education Training

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PRINCIPLES PRACTICE OF HOMOEOPATHY PART I
HOMOEOPATHIC PHILOSOPHY REPERTORIZATION

• 1.A Unique, masterly, Scientific presentation of
  Hahnemannian Homoeopathy as evolved by
  Boenninghausen, Kent, Close, Boger, Tyler and
  Roberts.
• 2.Extensive presentation of Repertorization with
  Case - Demonstrations.
• 3.Presentation of Standardized homoeopathic
  Practice with the S.C.R. System at the I.C.R.
• 4.Effective Management of Structural Disorders
  through better utilization of Potency-energy in
  effecting restoration of co-ordinate balance
  between Form, Function and Structure.

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PRINCIPLES PRACTICE OF HOMOEOPATHY PART I
HOMOEOPATHIC PHILOSOPHY REPERTORIZATION

• 5.Integral Presentation of Homoeopathic Medical
  Education and Training as an expression of
  Patient-Care, Learner-Care and Knowledge-Care.
• 6.A Self-Study Evolutionary Learning System for
  Principles and Practice of Homoeopathy when
  combined with the other I.C.R. Publications.
• 7.Experientially structured on the Philosophy and
  Methodology evolving at the Homoeopathic
  Post-Graduate Association (1952), Bombay
  Homoeopathic Medical College (1968-70), National
  Institute of Homoeopathy (Calcutta), Institute of
  Clinical Research (1975-87) and Fr. Muller's
  Homoeopathic Medical College, Mangalore
  (1985-87).
• Used in many Homoeopathic Colleges as essential
  reading.

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ICR OPERATIONAL MANUAL

• Essential companion for all learners wishing to
  master the S.C.R. SYSTEM. Covers all the
  operational aspects of SCR structure, function
  all the methods employed at ICR during clinical
  enquiry.

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ICR OPERATIONAL MANUAL

• THE THEME
• INTRODUCTION TO SCR SYSTEM
• THE "CASE" IN HOMOEOPATHIC PRACTICE PROBLEM -
  DEFINITION PROBLEM-RESOLUTION
• PROBLEM - DEFINTION, PROBLEM - RESOLUTION,
  INTERVIEW - PLAN RENDERING IT OPERATIONAL
• TRAINING OF THE UNPREJUDICED OBSERVER
• A. TRANSACTIONAL RECORD
• B. 5 COLUMN STRIP ANANLYSIS
• C. C.S.E.F.
• THE STANDARDISED CASE RECORD
• STRUCTURE AND FUNCTION
• RECORDING SECTION
• PROCESSING SECTION
• FOLLOW UP AND FOLLOW UP ANANLYSIS

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ICR OPERATIONAL MANUAL

• PSYCHOLOGICAL ABSRCTION TEST ("PAT" TEST)
• SPHP
• CCF CCE
• STANDARDISED INSTRUCTIONS FOR THE STUDY OF DATA
  PERTAINING TO A PATIENT

44
I.C.R. SYMPOSIUM VOLUME ON HAHNEMANNIAN
TOTALITY

• PART I
• Introduction
• Atlas Contains an excellent ATLAS of Charts on
  Remedies and various aspects of Homoeopathy
• PART II
• Area A- Philosophical Foundations
• Area B- Perceiving The Mental State
• Area C- Perceiving Miasmatic Evolution

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I.C.R. SYMPOSIUM VOLUME ON HAHNEMANNIAN
TOTALITY

• PART III
• Area D- Perceiving Scientific Method
  Repertorization
• PART IV
• Area E- Artificial Drug Disease Production
• Area F- Artificial Drug Disease Perceiving
• PART V
• Area G- Perceiving Practice Standardization of
  Individualization
• Area H-The Standardized Homoeopathic Physician
  Perceiving Production

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I.C.R. SYMPOSIUM VOLUME ON HAHNEMANNIAN
TOTALITY

• The volume is a collection of Papers making a
  significant original contribution to the theory
  practice of Scientific Homoeopathy. The authors
  speak from their rich clinical experience and
  with utter conviction about what they are
  expounding.
• Collectively, all the Areas cover the entire
  field by Homoeopathy its theory, practice and
  education. Each area covers its own central theme
  in depth, as well as establishing links with the
  other areas.

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LIFE LIVING

• This remarkable book presents in a novel way the
  heart of Dr. Dhawale's clinical experience. In
  its first Section he presents the philosophy that
  he evolved as a practicing Clinician rooted in
  the Indian ethos. In the second Section he
  presents 15 word-pictures of the conflicts facing
  some of the remarkable people who came to him for
  treatment.
• Life Living is a unique system of Training in
  Perceiving Man the Unknown. It assumes that Man
  is Knowable provided we acquire the sight to read
  his purpose, the inter-relationships he evolves
  through the Roles in his areas of Work, Family
  and Social life and the correlations he effects
  to achieve integration. This understanding
  permits us to design the Circumstance to which
  the man will respond in a peculiar manner.
  Systematic response-analysis delivers us the
  evidence we need to support our estimates we now
  know an aspect of the man which has been evading
  us. Judicious expansion and intensification of
  our Investigation reveals to us the Man, bit by
  bit. This, provided we do not get disturbed by
  the sights that resemble us too closely

48
LIFE LIVING

• Awareness of our good selves, the book delivers.
  Further, it trains us to evolve Sensitivity as
  well as Sensibility essential for perceiving.
• This is what Mr. Badri Narayan, a well-known
  artist says about the book "The reflections on
  life and living are perhaps attempts to
  articulate a range of experience connected with
  investigation and subsequent treatment of those
  needing a return to a state of well-being in
  totality for the art of healing is concerned
  with action that makes men whole. The healthy
  body and the sound mind are inter-acting forces.

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LIFE LIVING

• The book evolves a concept of a "Consulting
  Physician" more comprehensive than the one
  prevailing in present-day medical practice. The
  present work is especially relevant in these days
  of over-specialization in many disciplines its
  goal is a balanced, pragmatic amalgam of mind,
  spirit and matters that is, the search for the
  transformation of the abject state brought about
  by one's own endeavors at irresponsibility. We
  are also made aware of the complex nature of
  man's most prized tool - the mind - to help solve
  his predicament.
• The journey of life is both outgoing and
  incoming simultaneously in figurative terms, to
  the landscapes of exteriority and the pathways of
  interiority. For, as James Joyce writes in the
  Ulysses ".... every life is many days, day
  after day. We walk through ourselves, meeting
  robbers, ghosts, giants, old men, young men,
  wives, widows, brothers-in-love. But always
  mostly ourselves."

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PERCEIVING - 1

• AREA A PERCEIVING TOTALITY
• AREA B PERCEIVING MAN
• AREA C PERCEIVING GROUPS
• AREA D PERCEIVING EDUCATION
• AREA E PERCEIVING PROFESSIONAL COMPETENCE
• AREA F PERCEIVING RESEARCH
• AREA G PERCEIVING MANAGEMENT
• AREA H PERCEIVING HOMOEOPATHIC MATERIA MEDICA
• AREA I PERCEIVING RURAL HEALTH
• AREA J PERCEIVING LIFE

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PERCEIVING - 1
Perceiving 1 is a collection of Papers and
Lectures, which represent some of Dr. Dhawales
unique insights. The Papers range over a wide
range in the field of Homoeopathic Practice,
Education and Research. Perceiving as a
phenomenon has three aspects 1. The object to be
perceived 2. The Instruments or the medium of
perceiving, and 3. The perceiver. All these
objects can and do influence the process and the
outcome profoundly. Optical illusions are a
result of a deviation or a manipulation in one of
the three. Purification of all three, on the
other hand, will result in an unusual clarity of
vision.   That is perceiving at its best.
52
PERCEIVING - 1
In the clinical setting, perceiving is the most
crucial process. Perceiving what troubles the
patient, perceiving the patient as a person,
perceiving the similimum perceiving
predominates. And who perceives? Perception is
done by the senses through the nerves. It is a
physiological process. Perceiving is done by the
self through the mind it is a psychological
process. What clouds the mind? What clarifies
it? What role does Hahnemanns Unprejudiced
Observer play in this process? How to train the
mind to perceive the patient truly
well? Perceiving 1 handles all these issues and
many others.
53
PERCEIVING - 1
Homoeopathy treats the individual not the
disease. Clinical Research in Homoeopathy,
therefore, has to be based on quality and not
quantification as in other systems of medicine.
Dr. Dilip B. Dikshit in Mumbai worked out the
ideas that Dr. Dhawale was forever propounding,
in the case of Leprosy with phenomenal results.
This can be applied by any individual doctor in
his private clinic, too. The Papers in Area
FPerceiving Research speak of this and put
forward an operable system in this area.
54
PERCEIVING - 1
What links the patient, the physician and the
remedy-portraits in the H.M.M. is the pain, the
suffering of the patient. Dr. Dhawale says,
H.M.M. is a pure record of pathos. The writings
in Area H Perceiving Homoeopathic Materia Medica
focus on the core issues in the perceiving and
application of the HMM. Indeed, these writings
have been the base on which clinicians the world
over have built the further edifice of all the
remedy pictures currently in vogue.
55
PERCEIVING - 1
Dr. Dhawale believed, along with many other
professionals with a social conscience, that
physicians should make an extra effort to reach
our less fortunate brethren and help them through
our medical skills. He also presented that the
rural-tribal population is closer to Nature and
hence more responsive to Homoeopathy, which is a
natural system of medicine. Hence rural
health-care also enriches the participating
clinicians in the experience it affords. Area I
Perceiving Rural Health presents Dr. Dhawales
basic ideas in this area, along with the draft
outline of a whole system for rural-tribal
health-care. We are glad to let you know that we
follow in his footsteps in the rural-tribal belt
of Palghar-Manor near Mumbai.
56
PERCEIVING - 1
The book is a must for a physician busy in his
consulting, the teacher professing the noble task
of influencing young minds in the right direction
that Homoeopathy entails and the clinical
research worker who is on the path to break new
ground in the treatment of a variety of
challenging clinical conditions
57
PAEDIATRICS IN HOMOEOPATHY AN APPROACH

• A distillate of the Homoeopathic expertise of
  Dr. Dilip Dikshit the Paediatric acumen of
  Dr. Ramsubramanian
• A result of 2 1/2 years of hard work by the team
  of I.C.R. Physicians
• Backed by results with Homoeopathic treatment
  that has stood the tests of
• Consistency
• Quality and quantity care
• Cost effectiveness.
• Path-finding, revolutionary therapeutic
  strategies

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PAEDIATRICS IN HOMOEOPATHY AN APPROACH

• Protocols on the Homoeopathic management of
  common Paediatric conditions like
• Acute Diarrhoeal Disorders,
• Lower Respiratory Tract Infections,
• Fevers,
• Atopic Dermatitis Respiratory
  Allergic Disorders,
• Pertussoid Cough,
• Pain in abdomen, Evening Colic,
• Pyoderma etc.
• Explores the role of Homoeopathy in a surgical
  condition like intussusception
• Contains basic Paediatric Information
• Practice-oriented approach
• Invaluable for Homoeopaths, as more than 40 of
  the practice is in Paediatrics
• Useful for Practitioners, Teachers, Students,
  Interns

59
THE I.C.R.EDUCATIONAL PRACTICE SERIES 1 - 10

• The Institute of Clinical Research, Mumbai
  (I.C.R.) was established in 1975 to bring about a
  revolution in the conduct and teaching of
  Homoeopathic Medical Practice, Education
  Research. How was this revolution to be
  initiated? Dr. M. L. Dhawale, the Founder -
  Director, perceived the need for the student of
  Homoeopathy to be thoroughly grounded in
  Scientific Practice based firmly on the
  principles enunciated in the Organon of Medicine
  and subsequently elaborated by giants like
  Boenninghausen, Kent, Boger, Roberts, Close etc.

60
THE I.C.R.EDUCATIONAL PRACTICE SERIES 1 - 10

• At the same time, Dr. Dhawale was a man abreast
  of the times. A master clinician himself, he was
  aware of the rapid developments occurring in the
  field of Clinical Medicine. An avid and inquiring
  reader, he was fully conversant with the latest
  advances in Educational philosophy and
  methodology in general and pertaining to Medical
  Education. He found himself in excellent company
  when he discovered that the Case ----gtgt Concept
  method he was teaching at the ICR in Mumbai was
  the favored approach to Medical Education by the
  Western Reserve University in North America.

61
THE I.C.R.EDUCATIONAL PRACTICE SERIES 1 - 10
Dr. Dhawale thus devised a unique integration at
the ICR comprising of Traditional Homoeopathic
Philosophy, Modern clinical medicine and Advanced
Educational Philosophy Technology. It was clear
to him that the needed to put down the essentials
of this approach for the benefit of a) Those
who wished to acquaint themselves with what the
ICR stands for in Homoeopathic Medical Practice,
Education Research. b) Those who having
joined any of the ICR programs wish to seek a
direction they should adhere to in the course of
their study. c) Finally, those who conduct the
ICR program need to continually develop
themselves and supervise their students to
constantly push back the Frontiers of Knowledge'
so that they remain in the vanguard of change.