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Kejela E, Tesfaye G, Getachew A, Rose ES, Winful T, Eyayu Z, Martin MH, Sileshi B. Evaluation of Knowledge, Attitudes, and Practice in an Online Faculty Development Course for Anesthesia Educators in East Africa. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:274-278. [PMID: 37185663 DOI: 10.1097/ceh.0000000000000493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Faculty in low-resourced communities often have limited training on teaching and learning. An innovative, online, 13-week course using a flipped classroom model was developed for junior faculty anesthesiologists at teaching hospitals in East Africa and piloted in Ethiopia and Tanzania. METHODS Quantitative and qualitative data were collected and analyzed to evaluate potential change in participants' knowledge, skills, and attitudes as well as the feasibility of e-learning in the region. RESULTS Analysis of data revealed that top areas of change in participants' knowledge were in the flipped classroom approach (increased by 79%), effective mentoring practices (67%), and elements of effective course goals and objectives (58%). Leading areas of change in skills were in developing goals and objectives (72%), using case-based learning (67%), and engaging learners through PowerPoint (64%). Change in attitudes was largest in the areas of effective mentoring and strong leadership (27%), using course and lecture learning objectives (26%), and student-centered learning theory (26%). Qualitative data revealed that participants were satisfied with the course; found the structure, presentations, and delivery methods to be effective; and appreciated the flexibility of being online but experienced challenges, particularly in connectivity. DISCUSSION This evaluation demonstrated the efficacy of using e-learning in East Africa and highlights the innovation of online faculty development in a region where it has not been done before. By using participants as future instructors, this course is scalable in the region and worldwide, and it can help address limited access to training by providing a critical mass of trainers competent in teaching, mentoring, and leading.
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Affiliation(s)
- Edosa Kejela
- Dr. Kejela: Assistant Professor, Department of Anesthesiology, Jimma University, Jimma, Ethiopia. Dr. Tesfaye: Assistant Professor, Department of Anesthesiology, Bahir Dar University, Bahir Dar, Ethiopia. Dr. Getachew: Assistant Professor, Department of Anesthesiology, Bahir Dar University, Bahir Dar, Ethiopia. Dr. Rose: Global Health Education Specialist, Vanderbilt University Medical Center, Institute for Global Health, Nashville, Tennessee. Winful: Graduate Student, Department of Anthropology, Vanderbilt University, Nashville, Tennessee. Dr. Eyayu: Assistant Professor, Department of Anesthesiology, Critical Care and Pain Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia. Dr. Martin: Associate Professor, Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee. Dr. Sileshi: Associate Professor, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
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Dejene D, Stekelenburg J, Versluis M, Ayalew F, Molla Y. Assessment of core teaching competency of health professional educators in Ethiopia: an institution-based cross-sectional study. BMJ Open 2022; 12:e059502. [PMID: 36171038 PMCID: PMC9528671 DOI: 10.1136/bmjopen-2021-059502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Understanding the competency of educators is key to informing faculty development, recruitment and performance monitoring. This study aimed to assess the core teaching competency of nursing, midwifery and biomedical educators, and associated factors in Ethiopia. DESIGN An institution-based cross-sectional study was conducted in January 2020 using structured tools adapted from the WHO's nurse and midwifery educator competency frameworks. SETTING Two health science colleges and nine student practice sites in Ethiopia. PARTICIPANTS All classroom instructors and clinical preceptors of nursing, midwifery and biomedical technician training programmes, and all the graduating class students. MEASURES Overall teaching competency scores, teaching domain competency scores, competency gaps and performance gaps of educators were outcome measures. Past training on teaching skills courses, teaching experiences and sociodemographic characteristics of educators are associated factors. RESULTS Most educators were not trained in teaching methods (82%). The teaching competency scores of classroom instructors and clinical preceptors were 61.1% and 52.5%, respectively. Competency gaps were found in using active learning methods, performance assessment, feedback and digital learning. Professional background of classroom instructors had a significant and strong association with their competency score (p=0.004; V=0.507). Age and teaching experience of clinical preceptors had significant associations with their competency score (p=0.023 and p=0.007, respectively) and had strong associations (V=0.280 and 0.323, respectively). Sex of students and their perceptions of how well the educators give education resources had a significant and strong association (p<0.001; V = 0.429). CONCLUSIONS Nursing, midwifery and biomedical educators lacked the competency to undertake important teaching roles, which could contribute to the low quality of education. More attention should be given to strengthening faculty development.
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Affiliation(s)
- Daniel Dejene
- Department of Health Sciences, Groningen University Medical Center, Groningen, The Netherlands
- Health Workforce Improvement Program, Jhpiego-Ethiopia, Addis Ababa, Ethiopia
| | - Jelle Stekelenburg
- Department of Obstetrics and Gynaecology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
- Department of Health Sciences, Global Health, Universitair Medisch Centrum Groningen, Groningen, The Netherlands
| | - Marco Versluis
- Department of Health Sciences, Groningen University, Groningen, The Netherlands
| | - Firew Ayalew
- Health workforce improvment program, Jhpiego, Addis Ababa, Ethiopia
| | - Yohannes Molla
- Health workforce improvment program, Jhpiego, Addis Ababa, Ethiopia
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Okezue MA, Adeyeye MC, Byrn SJ, Abiola VO, Clase KL. Impact of ISO/IEC 17025 laboratory accreditation in sub-Saharan Africa: a case study. BMC Health Serv Res 2020. [DOI: https:/doi.org/10.1186/s12913-020-05934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Abstract
Background
The number and severity of nonconformities generated during an audit of a medicine testing laboratory indicates its level of quality compliance. Quality standards are established and maintained to ensure the reliability of laboratory test reports. The National Medicines Regulatory Authority (NMRA) Quality Control laboratories assess the quality of medicines used by the populace as part of their regulatory function. Although countries desire to have reliable medicine testing facilities, accrediting a national laboratory to international standards poses financial and technical challenges for many low-income countries. Sharing the benefits of laboratory accreditation could help more countries within sub-Saharan Africa overcome existing challenges to achieve accreditation and robust quality systems. This study investigated the impact of ISO/IEC 17025 accreditation on the performance of an NMRA Quality Control laboratory to provide evidence of improved quality compliance within a low-resource setting.
Methods
Pre- and post- accreditation audits of nonconformities for management and technical requirements of the ISO/IEC17025:2005 standards were evaluated from a Quality Control laboratory in the National Agency for Food and Drug Administration and Control (NAFDAC), located in Nigeria, West Africa. The following research questions were addressed: “does accreditation impact the adherence to quality standards?” and “does accreditation decrease the severity of nonconformities in Quality Control laboratory audits?”
Results
Statistical analysis of the pre- to post- accreditation audits from the years 2013 through 2017 revealed a significant decrease in the total number of nonconformities (χ2 = 74, p-value = 9.99e-05, r = 0.67). Further examination of audits from the years 2013 through 2018 audits also revealed a reduction in the number of nonconformities (χ2 = 53, p-value = 9.99e-05, r = 0.62). A reduction in the number of major observations and a decrease in the severity of nonconformities was also observed.
Conclusions
A higher level of quality compliance was exhibited for the laboratory during the post-accreditation years. Overall, ISO/IEC 17025 accreditation of the NMRA Quality Control laboratory resulted in improved reliability of test reports and enhancement of the laboratory quality system.
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Okezue MA, Adeyeye MC, Byrn SJ, Abiola VO, Clase KL. Impact of ISO/IEC 17025 laboratory accreditation in sub-Saharan Africa: a case study. BMC Health Serv Res 2020; 20:1065. [PMID: 33228675 PMCID: PMC7686690 DOI: 10.1186/s12913-020-05934-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/17/2020] [Indexed: 11/14/2022] Open
Abstract
Background The number and severity of nonconformities generated during an audit of a medicine testing laboratory indicates its level of quality compliance. Quality standards are established and maintained to ensure the reliability of laboratory test reports. The National Medicines Regulatory Authority (NMRA) Quality Control laboratories assess the quality of medicines used by the populace as part of their regulatory function. Although countries desire to have reliable medicine testing facilities, accrediting a national laboratory to international standards poses financial and technical challenges for many low-income countries. Sharing the benefits of laboratory accreditation could help more countries within sub-Saharan Africa overcome existing challenges to achieve accreditation and robust quality systems. This study investigated the impact of ISO/IEC 17025 accreditation on the performance of an NMRA Quality Control laboratory to provide evidence of improved quality compliance within a low-resource setting. Methods Pre- and post- accreditation audits of nonconformities for management and technical requirements of the ISO/IEC17025:2005 standards were evaluated from a Quality Control laboratory in the National Agency for Food and Drug Administration and Control (NAFDAC), located in Nigeria, West Africa. The following research questions were addressed: “does accreditation impact the adherence to quality standards?” and “does accreditation decrease the severity of nonconformities in Quality Control laboratory audits?” Results Statistical analysis of the pre- to post- accreditation audits from the years 2013 through 2017 revealed a significant decrease in the total number of nonconformities (χ2 = 74, p-value = 9.99e-05, r = 0.67). Further examination of audits from the years 2013 through 2018 audits also revealed a reduction in the number of nonconformities (χ2 = 53, p-value = 9.99e-05, r = 0.62). A reduction in the number of major observations and a decrease in the severity of nonconformities was also observed. Conclusions A higher level of quality compliance was exhibited for the laboratory during the post-accreditation years. Overall, ISO/IEC 17025 accreditation of the NMRA Quality Control laboratory resulted in improved reliability of test reports and enhancement of the laboratory quality system. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-05934-8.
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Affiliation(s)
- Mercy A Okezue
- School of Agricultural & Biological Engineering, Biotechnology Innovation & Regulatory Science, Purdue University, West Lafayette, USA. .,Bindley Bioscience Centre, Purdue University, 1203 W State St, West Lafayette, IN, 47907, USA.
| | - Mojisola C Adeyeye
- National Agency for Food and Drug Adm. & Control, NAFDAC, Abuja, Nigeria
| | - Steve J Byrn
- Department of Industrial & Physical Pharmacy, Purdue University, West Lafayette, USA
| | - Victor O Abiola
- National Agency for Food and Drug Adm. & Control, NAFDAC, Abuja, Nigeria
| | - Kari L Clase
- School of Agricultural & Biological Engineering, Biotechnology Innovation & Regulatory Science, Purdue University, West Lafayette, USA
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Herzig van Wees S, Sop Sop MD, Betsi E, Olongo SA, Jennings M. The role of faith-based health professions schools in Cameroon's health system. Glob Public Health 2020; 16:895-910. [PMID: 33019905 DOI: 10.1080/17441692.2020.1828985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Faith-based health professions schools contribute to the training of staff in many Sub-Saharan African countries. Yet little is known about these actors, their role in the health system, potential comparative advantages and challenges faced. This is a qualitative study drawing on 24 qualitative interviews and 3 focus group discussions. Participants included faith-based health professions schools, staff at faith-based health professions schools, Ministry of Health officials and donors. Thematic analysis was used to analyse the data. The findings reveal that understanding of faith-based health professions schools held by donors and the Ministry of Health rest on a set of assumptions rather than evidence-backed knowledge and that knowledge on key aspects is missing (not least on the market share of such actors). This suggests that collaboration with and oversight of these non-state schools is limited, raising questions about the balance of state regulation and control in the public-private mix for training health workers. Linked to this weak oversight, the findings also raise concerns over a number of problematic activities at these schools, unaccredited training programmes and the presence of missionary volunteers whose presence and actions are rarely interrogated.
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Affiliation(s)
- Sibylle Herzig van Wees
- Department of Women's and Children's Health, UGHRIS - Uppsala Global Health Research on Implementation and Sustainability, Uppsala University, Uppsala, Sweden
| | | | - Emmanuel Betsi
- Independent health systems researcher, Ngaoundéré, Cameroon
| | | | - Michael Jennings
- Department of Development Studies, SOAS - University of London, London, UK
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Harper BD, Nganga W, Armstrong R, Forsyth KD, Ham HP, Vincuilla J, Keenan WJ, Palfrey JS, Russ CM. Global Gaps in Training Opportunities for Pediatricians and Pediatric Subspecialists. Acad Pediatr 2020; 20:823-832. [PMID: 31812783 DOI: 10.1016/j.acap.2019.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/28/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A comprehensive, well-trained pediatric workforce is needed to ensure high-quality child health interventions around the globe. Further understanding of pediatric workforce training capacity would assist planning at the global and country level. The purpose of this study was to better understand the availability and process of training programs for pediatricians and pediatric subspecialists worldwide, as well as in-country presence of subspecialists. METHODS A survey was developed and distributed by e-mail to national pediatric leaders across the globe. The survey asked about the number of pediatric training programs, duration and logistics of training, and whether practicing pediatric subspecialists and subspecialty training programs were available in their country. RESULTS We received responses from 121 of the 166 countries contacted (73%). Of these, 108 countries reported the presence of one or more general pediatric postgraduate training programs, ranging from 1 to 500 programs per country. The number of training programs did not vary significantly by gross domestic product but did vary by region, with the fewest in Africa (P < .001). Most countries identified national guidelines for training (82% of countries) and accreditation (84% of countries). Availability of pediatric subspecialists varied significantly by income and region, from no subspecialties available in 4 countries to all 26 queried subspecialties available in 17 countries. Neonatology was most common, available in 88% of countries. Subspecialty training programs were less available overall, significantly correlating with country income. CONCLUSION Education for general pediatrics and pediatric subspecialties is quite limited in many of the countries surveyed, particularly in Africa. The creation of additional educational capacity is a critical issue challenging the adequate provision of pediatrics and pediatric subspecialty services.
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Affiliation(s)
- Beth D Harper
- Boston Children's Hospital (BD Harper, J Vincuilla, JS Palfrey, and CM Russ), Boston, Mass; Harvard Medical School (BD Harper, JS Palfrey, and CM Russ), Boston, Mass.
| | - Waceke Nganga
- Aga Khan University (W Nganga and R Armstrong), Nairobi, Kenya
| | - Robert Armstrong
- Aga Khan University (W Nganga and R Armstrong), Nairobi, Kenya; Global Pediatric Academic Alliance (R Armstrong and KD Forsyth), Adelaide, Australia
| | - Kevin D Forsyth
- Global Pediatric Academic Alliance (R Armstrong and KD Forsyth), Adelaide, Australia; Flinders University (KD Forsyth), Adelaide, Australia
| | - Hazen P Ham
- Global Pediatric Education Consortium (HP Ham), Chapel Hill, NC
| | - Julie Vincuilla
- Boston Children's Hospital (BD Harper, J Vincuilla, JS Palfrey, and CM Russ), Boston, Mass
| | | | - Judith S Palfrey
- Boston Children's Hospital (BD Harper, J Vincuilla, JS Palfrey, and CM Russ), Boston, Mass; Harvard Medical School (BD Harper, JS Palfrey, and CM Russ), Boston, Mass
| | - Christiana M Russ
- Boston Children's Hospital (BD Harper, J Vincuilla, JS Palfrey, and CM Russ), Boston, Mass; Harvard Medical School (BD Harper, JS Palfrey, and CM Russ), Boston, Mass
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Odongo CO, Talbert-Slagle K. Training the next generation of Africa's doctors: why medical schools should embrace the team-based learning pedagogy. BMC MEDICAL EDUCATION 2019; 19:403. [PMID: 31699081 PMCID: PMC6836381 DOI: 10.1186/s12909-019-1845-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 10/18/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND As far back as 1995, the Cape Town Declaration on training Africa's future doctor recognized the need for medical schools to adopt active-learning strategies in order to nurture holistic development of the doctor. However, medical education in Africa remains largely stuck with traditional pedagogies that emphasize the 'hard skills' such as knowledge and clinical acumen while doing little to develop 'soft skills' such as effective communication, teamwork, critical thinking or life-long learning skills. By reviewing literature on Africa's epidemiologic and demographic transitions, we establish the need for increasing the output of well-trained doctors in order to match the continent's complex current and future healthcare needs. Challenges that bedevil African medical education such as outdated curricula, limited educational infrastructure and chronic resource constraints are presented and discussed. Furthermore, increased student enrollments, a trend observed at many schools, coupled with chronic faculty shortages have inadvertently presented specific barriers against the success of small-group active-learning strategies such as Problem-Based and Case-Based Learning. We argue that Team-Based Learning (TBL) offers a robust alternative for delivering holistic medical education in the current setting. TBL is instructor-driven and embodies key attributes that foster development of both 'hard' and 'soft' skills. We elaborate on advantages that TBL is likely to bring to the African medical education landscape, including increased learner enthusiasm and creativity, accountability, peer mentorship, deep learning and better knowledge retention. As with all new pedagogical methods, challenges anticipated during initial implementation of TBL are discussed followed by the limited pilot experiences with TBL in Africa. CONCLUSION For its ability to enable a student-centered, active learning experience delivered at minimum cost, we encourage individual instructors and African medical schools at large, to adopt TBL as a complementary strategy towards realizing the goal of training Africa's fit-for-purpose doctor.
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Affiliation(s)
- Charles Okot Odongo
- Department of Pharmacology & Therapeutics, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda
| | - Kristina Talbert-Slagle
- Department of Internal Medicine, Yale School of Medicine, P.O. Box 208364, New Haven, CT 06510 USA
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Woodward A, McLernon-Billows D. Undergraduate medical education in Sierra Leone: a qualitative study of the student experience. BMC MEDICAL EDUCATION 2018; 18:298. [PMID: 30526576 PMCID: PMC6286603 DOI: 10.1186/s12909-018-1397-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sierra Leone, a low-income and post-conflict country, has an extreme shortage of qualified medical doctors. Given the complex challenges facing medical education in this country and the need for context-specific knowledge, the aim of this paper is to explore the undergraduate medical education experience in Sierra Leone through qualitative interviews with recent graduates. METHODS In-depth interviews were conducted with purposively sampled junior doctors (n = 15) who had graduated from the only medical school in Sierra Leone. Additionally, semi-structured interviews were held with senior teaching staff at the School (n = 7). Interviews were conducted in October 2013. Results were thematically analysed. RESULTS The analytical framework consisted of four themes. Medical school experiences (Theme 1) were described as 'stressful and tedious' but also 'interesting and enjoyable'. Various constraints were experienced linked to the Medical school capacity (Theme 2), including human (limited number of teachers, teaching skills), organisational (departmental differences, curriculum related challenges), physical (lacking teaching facilities on campus, transportation problems) and financial capacity (inadequate remunerations for teachers, most students receive scholarships). Medical school culture (Theme 3) was by some participants perceived as fearful and unfair. Findings suggest various coping strategies (Theme 4) were used at school ('creatively' hire extra teaching staff, teaching schedule upon availability of staff), staff (juggle multiple roles, teach flexibly), and student levels (comply with 'hidden' rules, negotiate teaching support from less qualified health personnel). CONCLUSIONS This study has provided an insight into the student perspective on medical education in Sierra Leone. Numerous capacity related concerns were identified; which are unsurprising for an educational institution in a low-income and conflict affected country. While the School, staff and students have found creative ways to deal with these constraints, participants' accounts of stress imply more is needed. For example, findings suggest that: students could be better supported in their self-directed learning, more effort is required to ensure basic needs of students are met (like shelter and food), and the power imbalance between staff and students could be addressed. Also better alignment amongst learning objectives and assessment methods will likely diminish student distress and may, consequently, reduce exam failure and possibly drop-out.
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Gladding SP, McGann PT, Summer A, Russ CM, Uwemedimo OT, Matamoros Aguilar M, Chakraborty R, Moore M, Lieh-Lai M, Opoka R, Howard C, John CC. The Collaborative Role of North American Departments of Pediatrics in Global Child Health. Pediatrics 2018; 142:peds.2017-2966. [PMID: 29895523 DOI: 10.1542/peds.2017-2966] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2018] [Indexed: 11/24/2022] Open
Abstract
Appeals for health equity call for departments of pediatrics to improve the health of all children including those from underserved communities in North America and around the world. Consequently, North American (NA) departments of pediatrics have a role in global child health (GCH) which focuses on providing health care to underserved children worldwide. In this review, we describe how NA departments of pediatrics can collaboratively engage in GCH education, clinical practice, research, and advocacy and summarize best practices, challenges, and next steps for engaging in GCH in each of these areas. For GCH in low- and middle-income countries (LMICs), best practices start with the establishment of ethical, equitable, and collaborative partnerships with LMIC communities, organizations, and institutions engaged in GCH who are responsible for the vast majority of work done in GCH. Other best practices include adequate preparation of trainees and clinicians for GCH experiences; alignment with local clinical and research priorities; contributions to local professional development and ongoing monitoring and evaluation. Challenges for departments include generating funding for GCH activities; recruitment and retention of GCH-focused faculty members; and challenges meeting best practices, particularly adequate preparation of trainees and clinicians and ensuring mutual benefit and reciprocity in NA-LMIC collaborations. We provide examples of how departments have overcome these challenges and suggest next steps for development of the role of NA departments of pediatrics in GCH. Collaborative implementation of best practices in GCH by LMIC-NA partnerships can contribute to reductions of child mortality and morbidity globally.
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Affiliation(s)
- Sophia P Gladding
- Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis, Minnesota;
| | | | - Andrea Summer
- Division of General Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Christiana M Russ
- Division of Medicine Critical Care, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Omolara T Uwemedimo
- Department of Pediatrics and Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, New York
| | | | - Rana Chakraborty
- Division of Infectious Diseases, Department of Pediatrics, Emory University, Atlanta, Georgia
| | - Molly Moore
- Division of Pediatric Inpatient Medicine, Department of Pediatrics, University of Vermont, Burlington, Vermont
| | - Mary Lieh-Lai
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Robert Opoka
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Cynthia Howard
- Division of Global Pediatrics, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; and
| | - Chandy C John
- Division of Global Pediatrics, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; and.,Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University of Medicine, Bloomington, Indiana
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Abstract
PURPOSE The Mozambique Eyecare Project is a higher education partnership for the development, implementation, and evaluation of a model of optometry training at UniLúrio in Mozambique. There are many composite elements to the development of sustainable eye health structures, and appropriate education for eye health workers remains a key determinant of successful eye care development. However, from the first intake of 16 students, only 9 students graduated from the program, whereas only 6 graduated from the second intake of 24 students. This low graduation rate is attributable to a combination of substandard academic performance and student dropout. The aim of this article was to identify factors affecting the academic performance of optometry students in Mozambique. METHODS Nine lecturers (the entire faculty) and 15 students (9 from the first intake and 6 from the second) were recruited to the study. Clinical competency assessments were carried out on the students, semistructured individual interviews were conducted with the course lecturers, and a course evaluation questionnaire was completed by students. The results were combined to understand the complexities surrounding the optometry student training and performance. RESULTS One student out of nine from the first intake and three students out of six from the second were graded as competent in all the elements of the refraction clinical competency examination. Analysis of data from the interviews and questionnaire yielded four dominant themes that were viewed as important determinants of student refraction competencies: student learning context, teaching context, clinic conditions and assessment, and the existing operating health care context. CONCLUSIONS The evaluations have helped the university and course partners to better structure the teaching and adapt the learning environments by recommending a preparatory year and a review of the curriculum and clinic structure, implementing more transparent entry requirements, increasing awareness of the program, and improving Internet infrastructure.
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Frantz JM, Bezuidenhout J, Burch VC, Mthembu S, Rowe M, Tan C, Van Wyk J, Van Heerden B. The impact of a faculty development programme for health professions educators in sub-Saharan Africa: an archival study. BMC MEDICAL EDUCATION 2015; 15:28. [PMID: 25879491 PMCID: PMC4403756 DOI: 10.1186/s12909-015-0320-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 02/19/2015] [Indexed: 05/09/2023]
Abstract
BACKGROUND In 2008 the sub-Saharan FAIMER Regional Institute launched a faculty development programme aimed at enhancing the academic and research capacity of health professions educators working in sub-Saharan Africa. This two-year programme, a combination of residential and distance learning activities, focuses on developing the leadership, project management and programme evaluation skills of participants as well as teaching the key principles of health professions education-curriculum design, teaching and learning and assessment. Participants also gain first-hand research experience by designing and conducting an education innovation project in their home institutions. This study was conducted to determine the perceptions of participants regarding the personal and professional impact of the SAFRI programme. METHODS A retrospective document review, which included data about fellows who completed the programme between 2008 and 2011, was performed. Data included fellows' descriptions of their expectations, reflections on achievements and information shared on an online discussion forum. Data were analysed using Kirkpatrick's evaluation framework. RESULTS Participants (n=61) came from 10 African countries and included a wide range of health professions educators. Five key themes about the impact of the SAFRI programme were identified: (1) belonging to a community of practice, (2) personal development, (3) professional development, (4) capacity development, and (5) tools/strategies for project management and/or advancement. CONCLUSION The SAFRI programme has a positive developmental impact on both participants and their respective institutions.
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Affiliation(s)
- José M Frantz
- Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.
| | - Juanita Bezuidenhout
- Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
| | - Vanessa C Burch
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa.
| | - Sindi Mthembu
- KwaZulu-Natal College of Nursing, Pietermaritzburg, KwaZulu-Natal, South Africa.
| | - Michael Rowe
- Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.
| | - Christina Tan
- Medical Education & Research Development Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Jacqueline Van Wyk
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - Ben Van Heerden
- Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
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Frambach JM, Manuel BAF, Fumo AMT, Van Der Vleuten CPM, Driessen EW. Students' and junior doctors' preparedness for the reality of practice in sub-Saharan Africa. MEDICAL TEACHER 2015; 37:64-73. [PMID: 25186847 DOI: 10.3109/0142159x.2014.920490] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Evidence tailored to sub-Saharan Africa on outcomes of innovations in medical education is needed to encourage and advance their implementation in this region. AIM To investigate preparedness for practice of students and graduates from an innovative and a conventional medical curriculum in a sub-Saharan African context. METHODS Using mixed methods we compared junior doctors and fifth-year students from two Mozambican medical schools: one with an innovative problem- and community-based curriculum and one with a conventional lecture- and discipline-based curriculum. A questionnaire on professional competencies was administered, semi-structured interviews were conducted, and work diaries were collected. The findings were integrated in a conceptual model. RESULTS Six areas of tension between global health care ideals and local health care practice emerged from the data that challenged doctors' motivation and preparedness for practice. Four elements of the innovative curriculum equipped students and graduates with skills, attitudes and competencies to better cope with these tensions. Students and graduates from the innovative curriculum rated significantly higher levels on various competencies and expressed more satisfaction with the curriculum and its usefulness for their work. CONCLUSION An innovative problem- and community-based curriculum can improve sub-Saharan African doctors' motivation and preparedness to tackle the challenges of health care practice in this region.
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Mahat A, Bezruchka SA, Gonzales V, Connell FA. Assessment of graduate public health education in Nepal and perceived needs of faculty and students. HUMAN RESOURCES FOR HEALTH 2013; 11:16. [PMID: 23621945 PMCID: PMC3640966 DOI: 10.1186/1478-4491-11-16] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 04/06/2013] [Indexed: 05/30/2023]
Abstract
BACKGROUND Despite the large body of evidence suggesting that effective public health infrastructure is vital to improving the health status of populations, many universities in developing countries offer minimal opportunities for graduate training in public health. In Nepal, for example, only two institutions currently offer a graduate public health degree. Both institutions confer only a general Masters in Public Health (MPH), and together produce 30 graduates per year. The objective of this assessment was to identify challenges in graduate public health education in Nepal, and explore ways to address these challenges. METHODS The assessment included in-person school visits and data collection through semi-structured in-depth interviews with primary stakeholders of Nepal's public health academic sector. The 72 participants included faculty, students, alumni, and leaders of institutions that offered MPH programs, and the leadership of one government-funded institution that is currently developing an MPH program. Data were analyzed through content analysis to identify major themes. RESULTS Six themes characterizing the challenges of expanding and improving graduate public health training were identified: 1) a shortage of trained public health faculty, with consequent reliance on the internet to compensate for inadequate teaching resources; 2) teaching/learning cultures and bureaucratic traditions that are not optimal for graduate education; 3) within-institution dominance of clinical medicine over public health; 4) a desire for practice-oriented, contextually relevant training opportunities; 5) a demand for degree options in public health specialties (for example, epidemiology); and 6) a strong interest in international academic collaboration. CONCLUSION Despite an enormous need for trained public health professionals, Nepal's educational institutions face barriers to developing effective graduate programs. Overcoming these barriers will require: 1) increasing the investment in public health education and 2) improving the academic environment of educational institutions. Long term, committed academic collaborations with international universities may be a realistic way to: 1) redress immediate inadequacies in resources, including teachers; 2) encourage learning environments that promote inquiry, creativity, problem-solving, and critical thinking; and 3) support development of the in-country capacity of local institutions to produce a cadre of competent, well-trained public health practitioners, researchers, teachers, and leaders.
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Affiliation(s)
- Agya Mahat
- Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Stephen A Bezruchka
- Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Virginia Gonzales
- Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Frederick A Connell
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
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Burdick WP, Friedman SR, Diserens D. Faculty development projects for international health professions educators: Vehicles for institutional change? MEDICAL TEACHER 2012; 34:38-44. [PMID: 22250674 DOI: 10.3109/0142159x.2011.558538] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Projects are an important tool in faculty development, and project emphasis may offer insights into perceived education priorities. Impact of projects has been focused on individuals, not institutions or health. AIM Education innovation projects of Fellows in an international faculty development program were examined to better understand perceived needs in health professions education and institutional impact of projects. METHOD Four hundred and thirty-five projects were analyzed to identify focus areas. Fellows were asked to identify changes in their schools and communities resulting from their projects. RESULTS New education methods and curriculum change were common project focus areas. Regional differences were evident with a higher percentage of education methods projects by Fellows residing in India (52%), compared with South Africa (25%) and Brazil (24%). Fifty-six percent of projects were incorporated into the curriculum and/or incorporated as institutional policy. One-third to two-thirds of respondents noted improved teaching quality, collaboration, education research interest, assessment, student performance, and curriculum alignment with community health needs. CONCLUSION National differences in project focus may offer insight into local conditions and needs. High rates of diffusion of projects and impact on faculty, students, and curriculum suggest that faculty development projects may be a strategy for institutional change in resource limited environments.
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Affiliation(s)
- William P Burdick
- Foundation for Advancement of International Medical Education and Research, Philadelphia, PA 19104, USA.
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Van Essen C, Cartledge P, Kyamanywa P, Manirakiza A. Is HINARI appropriate for medical students in the developing world? Trop Med Int Health 2011; 17:406-8. [DOI: 10.1111/j.1365-3156.2011.02938.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Greysen SR, Dovlo D, Olapade-Olaopa EO, Jacobs M, Sewankambo N, Mullan F. Medical education in sub-Saharan Africa: a literature review. MEDICAL EDUCATION 2011; 45:973-86. [PMID: 21916938 DOI: 10.1111/j.1365-2923.2011.04039.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES This review synthesises research published in the traditional and 'grey' literature to promote a broader understanding of the history and current status of medical education in sub-Saharan Africa (SSA). METHODS We performed an extensive review and analysis of existing literature on medical education in SSA. Relevant literature was identified through searches of five traditional medical databases and three non-traditional or grey literature databases featuring many African journals not indexed by the traditional databases. We focused our inquiry upon three themes of importance to educators and policymakers: innovation; capacity building, and workforce retention. RESULTS Despite the tremendous heterogeneity of languages and institutions in the region, the available literature is published predominantly in English in journals based in South Africa, the UK and the USA. In addition, first authors usually come from those countries. Several topics are thoroughly described in this literature: (i) human resources planning priorities; (ii) curricular innovations such as problem-based and community-based learning, and (iii) the 'brain drain' and internal drain. Other important topics are largely neglected, including: (i) solution implementation; (ii) programme outcomes, and (iii) the development of medical education as a specialised field of inquiry. CONCLUSIONS Medical education in SSA has undergone dramatic changes over the last 50 years, which are recorded within both the traditionally indexed literature and the non-traditional, grey literature. Greater diversity in perspectives and experiences in medical education, as well as focused inquiry into neglected topics, is needed to advance medical education in the region. Lessons learned from this review may be relevant to other regions afflicted by doctor shortages and inequities in health care resulting from inadequate capacity in medical education; the findings from this study might be used to inform specific efforts to address these issues.
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Affiliation(s)
- S Ryan Greysen
- Division of Hospital Medicine, School of Medicine, University of California, San Francisco, CA 94143, USA.
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Gibbs T, McLean M. Creating equal opportunities: the social accountability of medical education. MEDICAL TEACHER 2011; 33:620-625. [PMID: 21774647 DOI: 10.3109/0142159x.2011.558537] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
As new developments in medical education move inexorably forward, medical schools are being encouraged to revisit their curricula to ensure quality graduates and match their outcomes against defined standards. These standards may eventually be transferred into global accreditation standards, which allow 'safe passage' of graduates from one country to another [Educational Commission for Foreign Medical Graduates (ECFMG) 2010. Requiring medical school accreditation for ECFMG certification--moving accreditation forward. Available from: http://www.ecfmg.org/accreditation/rationale.pdf]. Gaining much attention is the important standard of social accountability--ensuring that graduates' competencies are shaped by the health and social needs of the local, national and even international communities in which they will serve. But, in today's 'global village', if medical schools address the needs of their immediate community, who should address the needs of the wider global community? Should medical educators and their associations be looking beyond national borders into a world of very unequal opportunities in terms of human and financial resources; a world in which distant countries and populations are very quickly affected by medical and social disasters; a world in which the global playing field of medical education is far from level? With medical schools striving to produce fit-for-purpose graduates who will hopefully address the health needs of their country, is it now time for the medical education fraternity to extend their roles of social accountability to level this unlevel playing field? We believe so: the time has come for the profession to embrace a global accountability model and those responsible for all aspects of healthcare professional development to recognise their place within the wider global community.
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Affiliation(s)
- Trevor Gibbs
- National Medical Academy of Postgraduate Education, Kiev 04112, Ukraine.
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Affiliation(s)
- Trevor Gibbs
- Gifu University School of Medicine, Gifu, Japan.
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