MEPI CC TWG 2012

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  • Ibadan and Stellenbosch have community/rural training – not MEPI-funded; Zimbabwe has long-term goals to implement Community Based Training: ZAM, AAU, KCMC, BOT, KZN (satellite sites) Highlight: MAK (COBERS) published articles around CBE. Curriculum Development: ZAM, BOT, KZN Preceptor Training : AAU, MAK, KZN, UON Site Expansion: ZAM, AAU, MAK, KZN, UON
  • Literature points to CBE leading to lower attrition rates, greater confidence in ability to function in rural areas; increased student and community satisfaction; also notes that if it is done poorly, it can have the reverse effect. MEPI community has leaders already in this area: Makerere has done ground-breaking research on COBES in their Gates-funded Learning Collaborative articles; Stellenbosch has rural schools, Walter Sisulu has moved its final yr of med school to community sites; El Gezira is a model for CBE We still don’t have good evidence regarding the impact of CBE on retention
  • CBE programs are frequently linked to: National workforce development plans Education for service strategies Appropriate skill training for rural practice National physician distribution strategies Emphasis on primary care and the development of Family Medicine programs Programs in this area are particularly important to the capacity development and retention goals of MEPI
  • Purpose: To assist schools in; Developing courses or rotations to expand CBE training at the school Promoting student interest and skills in regard to national health problems Developing family and community medicine programs Enhancing faculty skills in areas such as family medicine, rural practice, and health systems research Augmenting health services research programs and opportunities Promoting student interest in health system strengthening Promote MMed programs based at regional and district hospitals
  • All schools are investing in research capacity building – in training, seed grants, twinning, support structures (GM, IRB) Research mentoring and exchanges: MAK ( implementing), AAU, KCMK, KZN, ZIM, UEM (developing) Infrastructure/Facility Enhancement: ZAM ( implementing), UEM, BOT, UON (development states) Research Support Center: ZAM, ZIM (implementing), MAK, BOT ( development stages). Highlight MAK - Plans in advanced stages for establishment of the Research Communication Structures at MakCHS and Mbarara (but planned for all 6 institutions). MESAU Institutions engaged in institutional research priority setting exercises -- The four areas of focus for the unit will be research dissemination, alumni relations, public relations and inter-college communication Grants Management: MAK, IBA (implementing), ZAM, KCMC, BOT (development stages), UON ( expert non MEPI funded) Seed Grants/Fellowships : KZN, IBA (implementing), ZAM, KCMC, UON, ZIM, KNUST (developing) IRB/eIRB: ZAM, AAU, MAK, KZN ( developing) , UON ( expert, non MEPI funded)
  • Consultations/TA : Consult with individual schools on implementation and program improvement where requested. Identifying experts to assist MEPI schools: Sustainability : Provide assistance to programs in regards to ensuring sustainability of their RSCs through advice on number of financing (fixed cost to the institution versus percentage of grants), personnel, IT, infrastructure and space needs. Leadership : Assist programs in developing a leadership structure which is suitable to their program needs (i.e.: Single PI/Vice Dean for Research model versus Oversight Committee of research faculty with administrative support model). Strategy : Consider assistance when it comes to development of an overarching research administration strategy for the institution Workshops/Webinars : Conduct workshops or plenaries at the MEPI Symposium (i.e. grant writing, eIRB, training sessions in research ethics and methodologies). Conduct a minimum of one webinar in Y2 on an issue related to RSCs.
  • Key Points: Graduate tracking is essential to: Show the success of medical schools in meeting health care needs of countries, and Evaluate the outcomes of funded educational interventions (like MEPI) to increase the number of physicians practicing in countries and in high need areas – this is critical for current and future grants Schools are interested in graduate tracking but few are doing it Many schools are looking to collaborate with country level physician tracking systems to meet their graduate tracking needs – this reflects real limitations at the medical school level to track graduates after they leave medical school National HRH Observatories are part of the African Health Workforce Observatory. Meant to be national level collaborations (between government, academia, professional associations, NGOs, others) to produce, share and utilize health workforce information and evidence to support HRH policy
  • Country level physician tracking is mutually beneficial. To medical schools for the reasons for the reasons already discussed and to locate alumni. To governments to allow for informed workforce planning and investment. A robust physician tracking system is also a starting point for other health professional tracking systems. For governments seeking external funding for HRH development, robust HRH tracking systems will support funding requests and allow for evaluation of outcomes Work has already been done in the area of HRH tracking: WHO Handbook on Monitoring and Evaluation of HRH provides a broad framework Africa Health Workforce Observatory: cooperative network among countries and different partners in the Region to promote, develop and sustain a solid knowledge base for HRH information – supports National Health Workforce Observatories, conducts research iHRIS is open source software that provides a database for collection of basic health professional data. 6/13 MEPI countries are currently using iHRIS for physician tracking – lessons can be learned from this implementation, even for countries currently implementing.
  • Our goals are to: Develop a minimum set of physician data points - such as specialty, practice location, public/private practice – that countries can adopt or adapt as needed Develop a framework for implementation, including organizations (example Medical Councils) that implement tracking systems, regulatory policies such as registration or licensing requirements to ensure physician compliance, and resource needs (such as personnel, software, etc.). This will provide a menu of options for countries seeking to implement physician tracking systems. Partner with interested MEPI schools to advocate for implementation of new or improved physician tracking systems at the country level
  • Key Points: Case studies at MEPI schools Perform in-depth reviews of eLearning efforts identified within the MEPI schools network Toolbox Create and maintain a toolbox of eLearning resources usable by the MEPI network Host “e-learning in medical education in resource constrained settings” mini-conference in summer 2012 Develop academic paper Defining, classifying and discussing the current state of eLearning in medical education globally with emphasis on Sub-Saharan Africa
  • What the CC plans to provide: Searchable repository of resources on www.mepinetwork.org GW full syllabus for a series of fully online workshops on eTeaching Core Practical Roadmap List of MEPI eLearning activities
  • MEPI is the first large-scale investment in medical education as a means to strengthen the health workforce. Therefore, there is a need to document how this investment is used, including successes, failures, challenges, and lessons learned among the MEPI schools. In addition, the schools and the coordinating center have a responsibility to demonstrate how educational investments will strengthen the health system, including but not limited to how they will increase the numbers of the health workers.
  • CBE is framework for designing and implementing education that focuses on the desired performance characteristics of health care professionals (1). The focus is on the skills, knowledge and attitudes that students are able to demonstrate when they complete their course. This has been the goal of medical education through the ages but was not sufficiently documented and systematized. Many medical schools around the world and Africa are increasingly adopting this approach of documentation and systematization of curricular. The objective is to produce graduates who are fit for purpose in diverse work environments being accountable and contributing to improved population health outcomes.   The main goals include   To engage the schools in a discussion on the process of identifying desired locally relevant competencies, developing and implementing curricular and pedagogical approaches for achieving the desired performance characteristics. To popularize Competency-Based Education among schools and to create a community of practice for CBE among the MEPI schools   Methods: Literature search and review Case studies Dissemination through, site visits, workshops, webinars, conferences, publications etc.   Outcomes: Increased awareness of competencies as core goal of medical education Increased number of schools reviewing curricula to address competencies An active community of practice among MEPI Schools and beyond Relevant publications   Impact:   Relevant accountable and competent graduates Improved retention Better population health  
  • CBE is framework for designing and implementing education that focuses on the desired performance characteristics of health care professionals (1). The focus is on the skills, knowledge and attitudes that students are able to demonstrate when they complete their course. This has been the goal of medical education through the ages but was not sufficiently documented and systematized. Many medical schools around the world and Africa are increasingly adopting this approach of documentation and systematization of curricular. The objective is to produce graduates who are fit for purpose in diverse work environments being accountable and contributing to improved population health outcomes.   The main goals include   To engage the schools in a discussion on the process of identifying desired locally relevant competencies, developing and implementing curricular and pedagogical approaches for achieving the desired performance characteristics. To popularize Competency-Based Education among schools and to create a community of practice for CBE among the MEPI schools   Methods: Literature search and review Case studies Dissemination through, site visits, workshops, webinars, conferences, publications etc.   Outcomes: Increased awareness of competencies as core goal of medical education Increased number of schools reviewing curricula to address competencies An active community of practice among MEPI Schools and beyond Relevant publications   Impact:   Relevant accountable and competent graduates Improved retention Better population health  
  • MEPI CC TWG 2012

    1. 1. MEPI Technical Working Groups
    2. 2. Community Based Education ResearchGraduate SupportTracking Centers Technical Working Groups (TWGs) CompetencyeLearning Based Medical Education Education Research
    3. 3. Technical Working Groups and the 3 MEPI Themes Community BasedCAPACITY Education Research Graduate Support Tracking CentersRETENTION Technical Working Groups (TWGs) Competency eLearning BasedRESEARCH Medical Education Education Research
    4. 4. Community Based Education
    5. 5. MEPI Community Based Education
    6. 6. Why focus on Community Based Education? High impact potential on distribution/ rural retention Common area of activity among MEPI schools and global priority Strong leadership in MEPI community
    7. 7. CBE Links to Health System Strengthening National workforce development plans Education for service strategiesCBE Appropriate skill training for rural practice National physician distribution strategies
    8. 8. Potential Outcomes for the CBE TWG• Enhanced CBE training in UGME and sharing of successful strategies among MEPI schools• Strengthen PGME program in the community through use of district hospitals and focus on Family Medicine• Promote student interest and skills in regard to national health problems and health system strengthening• Enhanced faculty skills in family medicine, rural practice, and health systems research• Establish strategies for long-term improvements in national physician distribution
    9. 9. Research Support Centers
    10. 10. MEPI Research Support Activities
    11. 11. Research Support Center TWG Activities• Consult on implementation & program improvement• Provide advice on financial concerns• Assist in developing a leadership structure• Help develop an overarching research administration strategy for the institution• Conduct workshops or plenary at Symposium• Conduct one webinar in Y2 on a RSC topic.
    12. 12. Graduate Tracking
    13. 13. Graduate TrackingA fundamental purpose of MEPI is to produce doctors whoprovide health care in their country and local communities. Graduate tracking is necessary to demonstrate the success of medical schools in achieving this goal.Proposed Methods of Tracking at MEPI Medical Schools: • Collaboration with National HRH Observatories • Collaboration with Medical Councils • Establishing Alumni Associations • Using Social Media (e.g. Facebook, LinkedIn) • Customized tools (e.g. mobile phones application, online tracking)
    14. 14. Country Level Physician Tracking Physician Tracking Benefits: Ministries of Health, Medical Schools Education & StakeholdersEvaluate the outcomes of Provide clear data on theprograms to increase current workforcecapacity & rural retention Inform workforce policiesLocate alumni for alumnigiving and CME Support HRH funding and evaluate outcomes Existing Resources: • WHO: Handbook on Monitoring and Evaluation of HRH • Africa Health Workforce Observatory • iHRIS (free open source HRH software)
    15. 15. Physician Tracking TWG• Develop a standardized set of physician data points• Develop a framework of organizational, regulatory, and stakeholder requirements for tracking systems• Partner with MEPI schools to advocate at the country level for implementation of physician tracking systems
    16. 16. eLearning
    17. 17. eLearning TWG GoalsCase studies Perform in-depth reviews of eLearning efforts at MEPI identified within the MEPI schools network schools Create & maintain a toolbox of eLearning resources usable by the MEPI network Toolbox Host a mini-conference :“eLearning in medical education in resource constrained settings” Global Define, classify, and discuss the current state of Literature eLearning in medical education globally with review emphasis on Sub-Saharan Africa
    18. 18. Why focus on eLearning? Potentially Increased Common High impact for relevance activity supporting: within Medical • Distance/ remoteamong MEPI education Education schools • Continuing medical globally education • Teaching training
    19. 19. eLearning TWG Collaboration• Coordinating Center roles: • Searchable repository of resources on www.mepinetwork.org • Practical Roadmap • List of MEPI eLearning activities• MEPI Grantee institutional role: • Recommend resources • Define eLearning needs • Connect with other MEPI Network members
    20. 20. Medical Education Research
    21. 21. Why Emphasize Medical Education Research?• Accountability • MEPI is a large investment, we must document how the investment is used• Document Outcomes • Demonstrate how educational investments strengthen the health system• Catalyze Collaboration • Many common areas of activity, stimulate collaborative research
    22. 22. Potential Areas of Medical Education Research CollaborationMEPI Activity MEPI SchoolsModels for Post-graduate training initiatives to recruit MAK, UEM, BOT, IBA, UoN, ZAM, ZIM, KNUSTand retain facultyUse of skills labs to address learning needs in resource- ZAM, UoN, MAK, AAU, KCMCconstrained settingsEffect of providing teaching training to students ZAM, UoN, MAK, AAU, KCMCEffect of providing mobile devices such as Xooms, UEM, KCMCiPads on learningTraining in the Community: UME, PGME, UoN, KZN, MAK, AAU, KCMC, BOTinterdisciplinary, multiple exposure, one short-termexposure, durationTraining in the Community: A short term description of KCMC, MAKefforts and a long term analysis of outcomesEffects of Community Based Education on student ZAM, AAU, KCMC, MAK, BOT, KZN, UONcareer choices
    23. 23. Medical Education Research TWG Activities Stimulate Stimulate school publications and catalyze Scholarship Plans collaborative research among MEPI schools Develop a Bring MEPI faculty together to share ideas,Community of Practice challenges, and provide mentorship Identify Opportunities to publish and present Resources & Training opportunities for faculty
    24. 24. Medical Education Research TWG Activities Provide Identify Supportive Consult External Community Literature Resources • Grantees can• On Medical consult experts Education in the MEPI • Example: • Listserv of Research network for FAIMER online faculty Methods guidance on modules about interested in• Examples of research Research education literature in projects Methods research MEPI common • Interactions • Workshop at • Peer-to-Peer areas can be MEPI annual support• Database of facilitated by symposium • Share literature in the resources to specific areas Coordinating publish and/ Center or present
    25. 25. Competency Based Education
    26. 26. What is Competency Based Education?• Education aimed at improving those underlying characteristics causally related to job performance• Encompasses knowledge, traits, skills, and abilities acquired over time
    27. 27. Competency Based Education in MEPI• 10 MEPI grants are reviewing and developing curricula• Competency Based Education aligns itself well to MEPI themes • Quality improvement requires graduates be competent • HCWs must be competent to carry out research• Competencies should address the needs of individuals, families, and the communities in which graduates will practice
    28. 28. Six Steps to developing a Competency Based Curriculum 1 Conduct needs assessment 2 Identify competencies 3 Write goals and objectives 4 Determine teaching methods 5 Determine assessment methods 6 Determine program improvement methods From: ACGME’s Developing a Competency-based Curriculum (B. Joyce)
    29. 29. Competency Based Education TWG Activities• Literature search and review• Case studies• Dissemination of findings through site visits, workshops, webinars, conferences, publications etc.
    30. 30. Model of a Technical Working GroupCoordinating Center Technical Working Group Support TWG MEPI Non-TWG TWG MEPI TWG MEPI School 3 participating School 1 School 2 School(s) Partner Partner Partner Partner School(s) School(s) School(s) School(s)
    31. 31. Technical Working Groups• Communities of practice—sharing of ideas, innovations, lessons learnt• Most valuable if they include input from both MEPI PIs and programmatic personnel If you would like to participate in a Technical Working Group, please email info@mepinetwork.org

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