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Talbert-Slagle K, Ajami I, Currey B, Galvao R, Hadush J, Li SS, Flowers JT, Ziah M, Amuh D, Rabb M, Ilesanmi OS, Allen N, Martin M, Miller M, Yaman A, Nuthulaganti T, Plyler C, Kumeh O, Sieka J, Ogbuagu O, Marsh R, Rastegar A, Sherman L, Adams Z, Benson A, Dahn B. Transforming medical education in Liberia through an international community of inquiry. PLOS Glob Public Health 2023; 3:e0001610. [PMID: 36963025 PMCID: PMC10021565 DOI: 10.1371/journal.pgph.0001610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/26/2023] [Indexed: 03/26/2023]
Abstract
A critical component of building capacity in Liberia's physician workforce involves strengthening the country's only medical school, A.M. Dogliotti School of Medicine. Beginning in 2015, senior health sector stakeholders in Liberia invited faculty and staff from U.S. academic institutions and non-governmental organizations to partner with them on improving undergraduate medical education in Liberia. Over the subsequent six years, the members of this partnership came together through an iterative, mutual-learning process and created what William Torbert et al describe as a "community of inquiry," in which practitioners and researchers pair action and inquiry toward evidence-informed practice and organizational transformation. Incorporating faculty, practitioners, and students from Liberia and the U.S., the community of inquiry consistently focused on following the vision, goals, and priorities of leadership in Liberia, irrespective of funding source or institutional affiliation. The work of the community of inquiry has incorporated multiple mixed methods assessments, stakeholder discussions, strategic planning, and collaborative self-reflection, resulting in transformation of medical education in Liberia. We suggest that the community of inquiry approach reported here can serve as a model for others seeking to form sustainable global health partnerships focused on organizational transformation.
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Affiliation(s)
| | - Ibrahim Ajami
- Republic of Liberia Ministry of Health, Monrovia, Liberia
| | - Braden Currey
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Rachel Galvao
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Jerusalem Hadush
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Serene Silin Li
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Javaughn T Flowers
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Moses Ziah
- Liberian College of Physicians and Surgeons, Monrovia, Liberia
| | - Desmond Amuh
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Mikaela Rabb
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | | | - Nikole Allen
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Marie Martin
- Department of Health Policy, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Mary Miller
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Attila Yaman
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | - Tej Nuthulaganti
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | - Chelsea Plyler
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | - Odell Kumeh
- University of Liberia College of Health Sciences, Monrovia, Liberia
| | - Joseph Sieka
- University of Liberia College of Health Sciences, Monrovia, Liberia
| | - Onyema Ogbuagu
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Regan Marsh
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Asghar Rastegar
- Department of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Lawrence Sherman
- University of Liberia College of Health Sciences, Monrovia, Liberia
- A.M. Dogliotti School of Medicine, University of Liberia College of Health Sciences, Monrovia, Liberia
| | - Z'Sherman Adams
- University of Liberia College of Health Sciences, Monrovia, Liberia
- A.M. Dogliotti School of Medicine, University of Liberia College of Health Sciences, Monrovia, Liberia
| | - Angela Benson
- University of Liberia College of Health Sciences, Monrovia, Liberia
| | - Bernice Dahn
- University of Liberia College of Health Sciences, Monrovia, Liberia
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Krishna R, Amuh D, Lowder CY, Gordon SM, Adal KA, Hall G. Should all patients with candidaemia have an ophthalmic examination to rule out ocular candidiasis? Eye (Lond) 2000; 14 ( Pt 1):30-4. [PMID: 10755096 DOI: 10.1038/eye.2000.7] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To determine the incidence of ocular candidiasis and length of ophthalmic follow-up required to rule out ocular candidiasis in candidemia patients. METHODS We prospectively studied patients with candidemia at our institution. Eligibility criteria included a dilated ophthalmological examination within 72 h of fungemia. Patients without ocular candidiasis on initial examination had follow-up dilated ophthalmoscopy performed at 1, 2, 4, 12 and 24 weeks. RESULTS Between May 1996 and March 1997 a total of 50 patients with fungemia were identified of whom 31 were included in the study; 15 excluded patients died before an initial examination was performed. The overall incidence of ocular candidiasis was 26% (8/31 patients), all manifested as chorioretinitis. Five patients (16%) had ocular candidiasis on their initial examination. One of 21 patients (5%) without ocular candidiasis on initial examination developed ocular candidiasis within 1 week. Two of 16 patients (13%) without ocular candidiasis on initial examination or at 1 week follow-up developed ocular candidiasis within 2 weeks. No evidence of ocular candidiasis occurred in the 12 patients with follow-up at 4 weeks, the 8 patients with follow-up at 12 weeks and the 4 patients with follow-up at 24 weeks. CONCLUSION The incidence of ocular candidiasis among hospitalized patients is clinically significant. We recommend ophthalmological follow-up for development of ocular candidiasis for at least 2 weeks after an initial negative eye examination.
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Affiliation(s)
- R Krishna
- Division of Ophthalmology, Cleveland Clinic Foundation, OH 44195, USA
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