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MEPI Technical Working
       Groups
Community
               Based
             Education   Research
Graduate
                         Support
Tracking
                          Centers

       Technical Working
        Groups (TWGs)
                         Competency
eLearning                   Based
             Medical      Education
            Education
            Research
Technical Working Groups and the
            3 MEPI Themes
                          Community
                             Based
CAPACITY                   Education    Research
              Graduate
                                        Support
              Tracking
                                         Centers

RETENTION            Technical Working
                      Groups (TWGs)
                                       Competency
              eLearning                   Based
RESEARCH                   Medical      Education
                          Education
                          Research
Community Based
     Education
MEPI Community Based Education
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
CBE Links to Health System
            Strengthening

             National workforce development plans


             Education for service strategies

CBE          Appropriate skill training for rural
             practice

             National physician distribution
             strategies
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
Research Support
         Centers
MEPI Research Support Activities
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.
Graduate Tracking
Graduate Tracking

A fundamental purpose of MEPI is to produce doctors who
provide 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)
Country Level Physician Tracking
               Physician Tracking Benefits:
                                              Ministries of Health,
    Medical Schools
                                            Education & Stakeholders
Evaluate the outcomes of                     Provide clear data on the
programs to increase                         current workforce
capacity & rural retention
                                             Inform workforce policies
Locate alumni for alumni
giving 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)
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
eLearning
eLearning TWG Goals

Case 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
Why focus on eLearning?


                                Potentially
               Increased
 Common                       High impact for
               relevance
  activity                      supporting:
             within Medical    • Distance/ remote
among MEPI                       education
               Education
  schools                      • Continuing medical
                globally         education
                               • Teaching training
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
Medical Education
         Research
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
Potential Areas of Medical Education
              Research Collaboration
MEPI Activity                                               MEPI Schools
Models for Post-graduate training initiatives to recruit    MAK, UEM, BOT, IBA, UoN, ZAM, ZIM, KNUST
and retain faculty
Use of skills labs to address learning needs in resource-   ZAM, UoN, MAK, AAU, KCMC
constrained settings
Effect of providing teaching training to students           ZAM, UoN, MAK, AAU, KCMC

Effect of providing mobile devices such as Xooms,           UEM, KCMC
iPads on learning
Training in the Community: UME, PGME,                       UoN, KZN, MAK, AAU, KCMC, BOT
interdisciplinary, multiple exposure, one short-term
exposure, duration
Training in the Community: A short term description of      KCMC, MAK
efforts and a long term analysis of outcomes

Effects of Community Based Education on student             ZAM, AAU, KCMC, MAK, BOT, KZN, UON
career choices
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
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
Competency Based
       Education
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
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
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)
Competency Based Education
           TWG Activities

• Literature search and review
• Case studies
• Dissemination of findings through site visits,
  workshops, webinars, conferences,
  publications etc.
Model of a Technical Working Group

Coordinating
   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)
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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MEPI CC TWG 2012

  • 2. Community Based Education Research Graduate Support Tracking Centers Technical Working Groups (TWGs) Competency eLearning Based Medical Education Education Research
  • 3. Technical Working Groups and the 3 MEPI Themes Community Based CAPACITY Education Research Graduate Support Tracking Centers RETENTION Technical Working Groups (TWGs) Competency eLearning Based RESEARCH Medical Education Education Research
  • 4. Community Based Education
  • 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. CBE Links to Health System Strengthening National workforce development plans Education for service strategies CBE Appropriate skill training for rural practice National physician distribution strategies
  • 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
  • 10. MEPI Research Support Activities
  • 11.
  • 12. 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.
  • 14. Graduate Tracking A fundamental purpose of MEPI is to produce doctors who provide 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)
  • 15. Country Level Physician Tracking Physician Tracking Benefits: Ministries of Health, Medical Schools Education & Stakeholders Evaluate the outcomes of Provide clear data on the programs to increase current workforce capacity & rural retention Inform workforce policies Locate alumni for alumni giving 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)
  • 16. 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
  • 18. eLearning TWG Goals Case 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
  • 19. Why focus on eLearning? Potentially Increased Common High impact for relevance activity supporting: within Medical • Distance/ remote among MEPI education Education schools • Continuing medical globally education • Teaching training
  • 20. 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
  • 21. Medical Education Research
  • 22. 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
  • 23. Potential Areas of Medical Education Research Collaboration MEPI Activity MEPI Schools Models for Post-graduate training initiatives to recruit MAK, UEM, BOT, IBA, UoN, ZAM, ZIM, KNUST and retain faculty Use of skills labs to address learning needs in resource- ZAM, UoN, MAK, AAU, KCMC constrained settings Effect of providing teaching training to students ZAM, UoN, MAK, AAU, KCMC Effect of providing mobile devices such as Xooms, UEM, KCMC iPads on learning Training in the Community: UME, PGME, UoN, KZN, MAK, AAU, KCMC, BOT interdisciplinary, multiple exposure, one short-term exposure, duration Training in the Community: A short term description of KCMC, MAK efforts and a long term analysis of outcomes Effects of Community Based Education on student ZAM, AAU, KCMC, MAK, BOT, KZN, UON career choices
  • 24. 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
  • 25. 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
  • 26. Competency Based Education
  • 27. 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
  • 28. 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
  • 29. 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)
  • 30. Competency Based Education TWG Activities • Literature search and review • Case studies • Dissemination of findings through site visits, workshops, webinars, conferences, publications etc.
  • 31. Model of a Technical Working Group Coordinating 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)
  • 32. 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

Editor's Notes

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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)
  6. 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.
  7. 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
  8. 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.
  9. 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
  10. 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
  11. 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
  12. 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.
  13. 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  
  14. 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