Health Professions Education Institutions Research Articles

Preparing for Artificial General Intelligence (AGI) in Health Professions Education: AMEE Guide No. 172

Generative Artificial Intelligence (GenAI) caught Health Professions Education (HPE) institutions off-guard, and they are currently adjusting to a changed educational environment. On the horizon, however, is Artificial General Intelligence (AGI) which promises to be an even greater leap and challenge. This Guide begins by explaining the context and nature of AGI, including its characteristics of multi-modality, generality, adaptability, autonomy, and learning ability. It then explores the implications of AGI on students (including personalised learning and electronic tutors) and HPE institutions, and considers some of the context provided by AGI in healthcare. It then raises the problems to address, including the impact on employment, social risks, student adaptability, costs, quality, and others. After considering a possible timeline, the Guide then ends by indicating some first steps that HPE institutions and educators can take to prepare for AGI.

Building stronger foundations: exploring a collaborative faculty mentoring workshop for in-depth growth

BackgroundMentorship training programs demand a paradigm shift from theory-driven to hands-on practical approach with prioritization of preparation of mentors and mentees for their roles through self-awareness and targeted professional development planning. There is a lack of evidence generated from the health professions education institutions of global south regarding effectiveness of workshops in fostering mentorship culture.MethodsThis mixed method study with convergent parallel design was conducted through a collaborative mentoring workshop; “Faculty Mentoring-Building stronger by digging deeper” by Aga khan University Medical College, Karachi and University of Lahore, Punjab, Pakistan. Objective of the research was to emphasize the importance of faculty mentoring program, roles and responsibilities of mentors and mentees and perception of the participants regarding the associated role of institutions. It aimed to educate faculty members to develop personal development plans for becoming effective mentors and mentees. The demographic data was collected before the workshop, during the workshop data was collected from SWOT analysis, followed by goal settings and the action plans made by participants at the end. Post workshop online feedback was acquired by a questionnaire to comprehend participants’ educational attainment. Association between quantitative findings was done through ANOVA, while the qualitative data was subjected to thematic analysis.ResultsTotal of 37 faculty members participated in the hands-on workshop. All faculty equally perceived the workshop as satisfactory and reported that hands-on practice led to positive experience of setting clear goals and action plans in developing oneself both as mentor and mentee. Themes identified were; Faculty Mentorship Program, Personal development Plan of Mentors and Mentees and Building Positive Mentor-Mentee Relationships. Voluntary structured program, choice of more than one faculty mentor and portfolio development based on personal SWOT was recommended by participants for the success of formal mentoring programs.ConclusionMedical Faculty of Pakistani Universities at all career levels is interested in development of formal mentoring programs in their universities. Formal training for the same is also recommended by the participants. Institutions should cultivate a culture of mentorship that supports the professional growth and success of academics for cultivating the minds that are in turn shaping our future generations.

Evaluation of an online interprofessional course on ethics and professionalism: experience of medical, dental, and pharmacy students

IntroductionEthics and professionalism in the health professions reflect how health professionals behave during practice, based on their professional values and attitudes. Health professions education institutions have implemented various strategies for teaching ethics and professionalism, including interprofessional education. The aim of the study was to evaluate the perception of undergraduate health professions students about the outcomes of an online interprofessional course in ethics and professionalism as well as their perception of interprofessional education and the importance of ethics and professionalism after taking the course.MethodsThis is a descriptive cross-sectional study that targeted medical, dentistry, and pharmacy students. A researcher-made 31-item questionnaire was used. The questionnaire was tested for face, content, and construct validity. Reliability of the questionnaire was estimated by Cronbach alpha test. Descriptive statistics were used. T-test was performed to compare the results of male and female students and ANOVA was performed to compare the results of medical, dentistry, and pharmacy students. Statistical significance was set at p < 0.05.ResultsFactor analysis of the questionnaire yielded three factors, namely course evaluation, perception of interprofessional education, and importance of ethics and professionalism in health professions education. The study participants expressed positive perceptions of all aspects of the course. They reported positive perceptions of interprofessional education, highlighting its benefits in enhancing understanding, teamwork skills, and respect for other healthcare professionals. The findings reveal some program-related differences in participants’ responses, where medical students showed higher ratings of all aspects of the course, interprofessional education and importance of ethics and professionalism.ConclusionStudents of the three programs showed positive perceptions of the online IPE course on ethics and professionalism as well as the benefits of IPE and the importance of ethics and professionalism. This highlights the effectiveness of the course in addressing such important aspects of health professions education.

Healthcare practitioners’ attitudes toward patient safety in hospital settings in Jeddah, Kingdom of Saudi Arabia

PurposePatient safety focuses on minimizing risks that might occur to patients during provision of healthcare. The purpose of this study was to explore healthcare practitioners’ attitudes towards patient safety inside different hospital settings in Jeddah, Kingdom of Saudi Arabia.Design/methodology/approachA descriptive, cross-sectional study was conducted on a sample of healthcare practitioners in main hospitals in Jeddah. Two main hospitals (one governmental and one private) were selected from each region of Jeddah (east, west, north and south), with a total number of eight out of thirty hospitals. Data were collected through the Attitudes to Patient Safety Questionnaire III that was distributed online. The questionnaire used a 5-point scale. Descriptive statistics were used. Comparisons were made by independent t-test and ANOVA. The statistical significance level was set at p < 0.05.FindingsThe study included 341 healthcare practitioners of different sexes and specialties in eight major governmental and private hospitals in Jeddah. “Working hours as error cause” subscale had the highest mean score (4.03 ± 0.89), while “Professional incompetence as error cause” had the lowest mean score (3.49 ± 0.97). The total questionnaire had a moderate average score (3.74 ± 0.63). Weak correlations between the average score of the questionnaire and sex, occupation and workplace were found (−0.119, −0.018 and −0.088, respectively).Practical implicationsHospitals need to develop targeted interventions, including continuing professional development programs, to enhance patient safety culture and practices. Moreover, patient safety training is required at the undergraduate education level, which necessitates health professions education institutions to give more attention to patient safety education in their curricula.Originality/valueThe study contributed to the existing literature on patient safety culture in hospital settings in Jeddah, Saudi Arabia. The insights generated by the study can inform targeted interventions to enhance patient safety culture in hospitals and improve patient outcomes.

Health practitioner regulation and national health goals.

The role of health practitioner regulation in ensuring patient safety is well recognized. Less recognized is the role of regulation in addressing broader health system priorities. These goals include managing the costs, capacities and distribution of health professional education institutions; ensuring the competence and equitable distribution of health workers; informing workforce planning and mobilization; enabling the use of digital technologies; and addressing challenges related to the international mobility of health workers. Even where health practitioner regulation is designed to advance these goals, important gaps exist between the potential of regulatory systems and their performance. The response to the coronavirus disease 2019 (COVID-19) pandemic led many countries to introduce regulatory changes to allow more flexibility and innovations in the mobilization of health practitioners. Building on this experience, we need to critically re-examine health practitioner regulatory systems to ensure that these systems support rather than impede progress towards national health goals. We discuss the role of health practitioner regulation in contemporary health systems, highlighting recent regulatory reforms in selected countries, including during the COVID-19 pandemic. We identify the importance of dynamic, effective and flexible health practitioner regulatory systems in progress towards universal health coverage and health security.

Response to the impact of COVID-19 by health professions education institutions in Africa: a case study on preparedness for remote learning and teaching

BackgroundAfrica, like other parts of the world, continuously strives to deliver quality health professions education. These efforts are influenced to a larger extent by the socio-economic and cultural context of the region, but also by what happens globally. The global disruption caused by the COVID-19 pandemic in 2020 necessitated the implementation of emergency remote teaching to continue delivering on the mandate of educating future health professionals. The purpose of this research was to describe the response of selected health professions education institutions in Southern Africa to the impact of COVID-19 and their preparedness for remote learning and teaching.MethodsA case study design was applied using an adapted ADKAR model as a conceptual framework for data interpretation. The purposively selected study population consisted of educators, students, and administrators in undergraduate medical and nursing programmes from six institutions in five countries.ResultsA total of 1307 respondents provided data for the study. Many of the institutions were caught off-guard when most educators and almost all students were required to leave their universities and go home. Stakeholders immediately became aware of the need to adopt online approaches as an emergency measure. In all programmes, educators, students, and administrators agreed that change was desired, and students realised that they had to take charge of their own learning independently. Overall educators reported confidence in the ability to use of standard Microsoft software, while knowledge of learning management systems proved more challenging for both educators and students. Many stakeholders, especially students and administrators, reported uncertainty about their ability to function in the new reality. Conducive family dynamics, a quiet space to study, good connectivity, a reliable electricity supply and appropriate devices were reported to reinforce learning and teaching.ConclusionsThe findings highlight the need for higher education institutions to prepare for alternative modes to face-to-face learning and teaching approaches with the ultimate aim of transitioning to full online learning more expeditiously. This requires scaling up educational infrastructure, prioritising strategic directives driving continuous professional development of educators and fostering co-constructivist approaches towards student centered education.

How different is the Learning Environment of Public and Private Sector Medical Colleges in Lahore, Pakistan?

Regular assessment of the Learning Environment (LE) of health professions education institutions is important for their continuous improvement and to keep the students motivated. Pakistan Medical & Dental Council (PM&DC) applies uniform standards of quality in all public and private sector medical colleges of the country. However, the learning environment of these colleges might be different due to differences in their geographic location, structure, utilization of resources, and modus operandi. This study was conducted to measure the learning environment in selected public and private sector medical colleges in the city of Lahore, Pakistan, using a pre validated instrument (Jhon Hopkins Learning Environment Scale). This cross-sectional descriptive study was conducted on 3,400 medical students from six public and private sector medical colleges of Lahore, during November and December 2020. Data was collected through Google forms. Two stage cluster random sampling technique was used to draw the study sample. John Hopkins Learning Environment Scale (JHLES) was used for data collection. Overall JHLES mean score was 81.75 ±13.5. Public sector colleges had a significantly higher mean JHLES score (82.1) than private-sector colleges (81.1), with small effect size (0.083). Male students rated LE slightly higher than females (82.0 and 81.6 respectively). JHLES a relatively simpler tool (28 items) than DREEM, can be used effectively in the context of Pakistani environment to measure the LE in medical colleges. Both, public and private sector colleges had high overall JHLES mean scores, with public sector colleges having a significantly higher score than private-sector colleges.

Exploring the availability of specialist health workforce education in East and Southern Africa: a document analysis

BackgroundSpecialist health professionals improve health outcomes. Most low-income and middle-income countries do not have the capacity to educate and retain all types of specialists across various health professions. This study...

Distributed Autonomous Organization of Learning: Future Structure for Health Professions Education Institutions.

Current health professions education (HPE) institutions are based on an assembly-line hierarchical structure. The last decade has witnessed the advent of sophisticated networks allowing the exchange of information and educational assets. Blockchain provides an ideal data management framework that can support high-order applications such as learning systems and credentialing in an open and a distributed fashion. These system management characteristics enable the creation of a distributed autonomous organization of learning (DAOL). This new type of organization allows for the creation of decentralized adaptive competency curricula, simplification of credentialing and certification, leveling of information asymmetry among educational market stakeholders, assuring alignment with societal priorities, and supporting equity and transparency.

Assessment of Preparedness for Remote Teaching and Learning to Transform Health Professions Education in Sub-Saharan Africa in Response to the COVID-19 Pandemic: Protocol for a Mixed Methods Study With a Case Study Approach.

BackgroundThe current COVID-19 pandemic is affecting all aspects of society worldwide. To combat the pandemic, measures such as face mask–wearing, hand-washing and -sanitizing, movement restrictions, and social distancing have been introduced. These measures have significantly disrupted education, particularly health professions education, which depends on student-patient contact for the development of clinical competence. The wide-ranging consequences of the pandemic are immense, and health professions education institutions in sub-Saharan Africa have not been spared.ObjectiveThis paper describes a protocol for assessing the preparedness of selected health professions education institutions in sub-Saharan Africa for remote teaching and learning during the COVID-19 pandemic.MethodsA mixed-methods design with a case study approach will be used. The awareness, desire, knowledge, ability, and reinforcement model of change was selected as the conceptual framework to guide the study. Eight higher education institutions in 6 sub-Saharan countries have participated in this study. Data will be collected through electronic surveys from among whole populations of academic staff, students, and administrators in undergraduate medicine and nursing programs. Qualitative and quantitative data from each institution will be analyzed as a case study, which will yield an inventory of similar cases grouped for comparison. Quantitative data will be analyzed for each institution and then compared to determine associations among variables and differences among programs, institutions, or countries.ResultsOur findings will provide information to higher education institutions, particularly those offering health professions education programs, in Africa regarding the preparedness for remote teaching and learning to influence efforts related to web-based teaching and learning, which is envisaged to become the new normal in the future.ConclusionsThis study has not received any funding, and any costs involved were borne by individual consortium members at the various institutions. Ethics approval from the institutional review board was obtained at various times across the participating sites, which were free to commence data collection as soon as approval was obtained. Data collection was scheduled to begin on October 1, 2020, and end on February 28, 2021. As of this submission, data collection has been completed, and a total of 1099 participants have been enrolled. Data analysis has not yet commenced.International Registered Report Identifier (IRRID)DERR1-10.2196/28905

Informing the increasing production of the health workforce in Bangladesh: evidence from a mapping exercise of health professional education institutions

This study aimed to evaluate the trend of production (2007-2016) and associated factors of seven health professionals i.e. physicians, dentists, diploma nurses, bachelor nurses, midwives, medical assistants and medical technologists in Bangladesh. The study team adopted a mapping approach to geographically locate all the health professional education institutions recognized by the Ministry of Health and Family Welfare (MOHFW). This was supported by a mixed-method design combining qualitative (e.g. group discussions and key informant interviews) and quantitative (questionnaire survey) methods. From 2007 to 2016, a total of 107,406 students graduated from all seven professional categories. Out of the total, about 40% belonged to the MBBS physician, 6% dentists, 15% medical assistants, 18% medical technologists, 21% nurses, and only 1% to the midwives. So, a skill-mix imbalance exists at the production level. Though the production had been on rising last 10 years, the production of the physicians was higher than any other professional categories. Feminization of the workforce is prominent as there was an average 14% increase of the female doctors than the male. The increasing production of health professionals needs to be supported by proper planning and policy interventions in order to avoid distortion of skill mix. Growing feminization of the workforce is also another area that requires special attention on the development of gender-sensitive employment conditions.
 Bangladesh Journal of Medical Education Vol.12(2) July 2021: 30-46

Organizational Readiness for Change: A Case Study on Change Drivers and Inhibitors from Oman’s Health Professions Education Institutions

Background: A study in 2014 on systems and processes needed to enhance the quality of health professions education during a period of transition at the Ministry of Health Educational Institutes; now known as Oman College for Health Sciences and the Higher Institute for Health Specialties, revealed positive expectations of staff towards the upgrade to a four-year college. However, staffs were uncertain about how they would manage the change, resulting in adverse psychological impact. The purpose of this study was to evaluate the overall readiness for change at Oman College of Health Sciences (OCHS) and the Higher Institute for Health Specialties (HIHS) during its second phase of transition.Aim of the study: to evaluate the overall readiness for change at Oman College of Health Sciences (OCHS) and the Higher Institute for Health Specialties (HIHS) during its second phase of transition.Methodology: a mixed method case study approach was conducted during the period of August 2017 to March 2019. For the quantitative part of the study, the authors used the Organizational Change Readiness Assessment OCRA tool to explore the barriers and drivers regarding change implementation experienced by employees at (OCHS) during a period of transition. This was followed by semi-structured interviews with five participants in leadership position of OCHS and the HIHS.Results: of 381 questionnaires distributed, 128 were completed; a response rate of 33.6%. The quantitative findings identified inhibitors that had the highest impact towards successful change implementation to be information processes, organizational structure and task processes, and human resources system, while the qualitative analysis resulted in two main themes, organizational readiness for change, and individuals’ readiness for change.Conclusion: Based on the results, it was apparent that the existing change and transition management strategies require further planning. Study findings indicated that readiness for change was influenced by organizational and behavioral factors. Both aspects were accompanied by challenges and possible opportunities regarding change implementation.Recommendations: This study recommended that other future studies should be conducted within the scope of this study to include students and external stakeholders.

Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income Countries (LMICs): How Do Drivers and Enablers of Rural Practice Intention Differ Between Learners From LMICs and High Income Countries?

Equity in health outcomes for rural and remote populations in low- and middle-income countries (LMICs) is limited by a range of socio-economic, cultural and environmental determinants of health. Health professional education that is sensitive to local population needs and that attends to all elements of the rural pathway is vital to increase the proportion of the health workforce that practices in underserved rural and remote areas. The Training for Health Equity Network (THEnet) is a community-of-practice of 13 health professional education institutions with a focus on delivering socially accountable education to produce a fit-for-purpose health workforce. The THEnet Graduate Outcome Study is an international prospective cohort study with more than 6,000 learners from nine health professional schools in seven countries (including four LMICs; the Philippines, Sudan, South Africa and Nepal). Surveys of learners are administered at entry to and exit from medical school, and at years 1, 4, 7, and 10 thereafter. The association of learners' intention to practice in rural and other underserved areas, and a range of individual and institutional level variables at two time points—entry to and exit from the medical program, are examined and compared between country income settings. These findings are then triangulated with a sociocultural exploration of the structural relationships between educational and health service delivery ministries in each setting, status of postgraduate training for primary care, and current policy settings. This analysis confirmed the association of rural background with intention to practice in rural areas at both entry and exit. Intention to work abroad was greater for learners at entry, with a significant shift to an intention to work in-country for learners with entry and exit data. Learners at exit were more likely to intend a career in generalist disciplines than those at entry however lack of health policy and unclear career pathways limits the effectiveness of educational strategies in LMICs. This multi-national study of learners from medical schools with a social accountability mandate confirms that it is possible to produce a health workforce with a strong intent to practice in rural areas through attention to all aspects of the rural pathway.

How Should Allopathic Physicians Respond to Native American Patients Hesitant About Allopathic Medicine?

American Indian (AI) and Indigenous peoples utilize traditional medicine/healing (TM/H) for health and well-being. Allopathic health care practitioners (HCPs) receive minimal training and education on TM/H and its application and integration into health care settings. Lack of knowledge and practice guidelines on how to navigate these 2 health care perspectives (allopathic and traditional) creates uncertainties in the treatment of AI and Indigenous peoples. Such conflicts can undermine patient autonomy and result in culturally incongruent practice. This article presents a case study showcasing suggestions for how HCPs can direct clinical decision making when working with AI/Indigenous patients who utilize TM/H. The article argues that health professions education institutions and HCPs must dedicate effort to expanding awareness of and education about TM/H to enhance the delivery of evidence-based and integrated clinical treatment for AI/Indigenous patients.

How Should Health Professions Schools Partner With AI/AN Communities?

Many health professions education institutions exist on land once inhabited by American Indians and Alaska Natives (AI/AN). Land acknowledgment by these academic organizations is helpful, but collaborative support of AI/AN health is also needed. Because tribal-university partnerships in education are fewer than in research but just as important, this article considers health professions schools' responsibilities to offer students clinical rotations on tribal lands and to recruit AI/AN students. Such investment expands student educational opportunity, diversifies clinical workforces, and helps tribes improve health infrastructure and sustainability. This article also offers an adaptable roadmap for building such partnerships.

The role of accreditation in 21st century health professions education: report of an International Consensus Group

BackgroundAccreditation is considered an essential ingredient for an effective system of health professions education (HPE) globally. While accreditation systems exist in various forms worldwide, there has been little written about the contemporary enterprise of accreditation and even less about its role in improving health care outcomes.We set out to 1) identify a global, contemporary definition of accreditation in the health professions, 2) describe the relationship of educational accreditation to health care outcomes, 3) identify important questions and recurring issues in twenty-first century HPE accreditation, and 4) propose a framework of essential ingredients in present-day HPE accreditation.MethodsWe identified health professions accreditation leaders via a literature search and a Google search of HPE institutions, as well as by accessing the networks of other leaders. These leaders were invited to join an international consensus consortium to advance the scholarship and thinking about HPE accreditation. We describe the consensus findings from the International Health Professions Accreditation Outcomes Consortium (IHPAOC).ResultsWe define accreditation as the process of formal evaluation of an educational program, institution, or system against defined standards by an external body for the purposes of quality assurance and enhancement. In the context of HPE, accreditation is distinct from other forms of program evaluation or research. Accreditation can enhance health care outcomes because of its ability to influence and standardize the quality of training programs, continuously enhance curriculum to align with population needs, and improve learning environments. We describe ten fundamental and recurring elements of accreditation systems commonly found in HPE and provide an overview of five emerging developments in accreditation in the health professions based on the consensus findings.ConclusionsAccreditation has taken on greater importance in contemporary HPE. These consensus findings provide frameworks of core elements of accreditation systems and both recurring and emerging design issues. HPE scholars, educators, and leaders can build on these frameworks to advance research, development, and operation of high-quality accreditation systems worldwide.

Development of an interprofessional curriculum to improve team-based HIV care in sub-Saharan Africa: a training programme for undergraduate and early career health professionals

BackgroundDespite evidence of the impact of interprofessional education (IPE) strategies to improve the efficiency and quality of training, few undergraduate health professions education programmes in sub-Saharan Africa have implemented such approaches. Furthermore, few pre-service health professions educational institutions have developed educational interventions that target trainees during the transition between pre-service training and professional practice. We developed HIV-specific, interprofessional, team-based resources to better support trainees during the transition period. MethodsBetween April 1 and July 31, 2019 ten faculty members representing nine medical and nursing schools in Uganda and South Africa developed a training package focused on core clinical, public health, IPE, and quality improvement (QI) domains related to HIV service delivery. Using small-group learning principles, they developed 17 case-based modules to address a diverse set of HIV-related topics, including, but not limited to, HIV prevention, diagnosis, linkage to care, treatment, and management of opportunistic infections. All modules were aimed at newly, or nearly, qualified health-care professionals, including nurses, doctors, pharmacists, and laboratory scientists and were intended to be taught in workshops that will complement existing institution-specific HIV curricula. FindingsTraining resources were launched in August, 2019; in the following 6 months, 66 nursing and medical schools and their affiliated training sites in 14 countries in sub-Saharan Africa used the training modules to support interprofessional training for health professionals in training. In the first 6 months of the project, 3500 learners participated in the training. InterpretationFurther evaluation of this project and its effects on pedagogical approaches, trainee competencies, as well as wider changes in the organisation and delivery of HIV care, are warranted. The collaborative, interinstitutional, interprofessional approach to curriculum development could provide a benchmark for how best-practice approaches to education can be rapidly disseminated and scaled up across training programmes in Africa. FundingHealth Resources and Services Administration, HRSA

Faculty development - needs, priorities and preferences in health professions education - questionnaire-based descriptive study

Introduction: Instructors in the health professions today must acquire knowledge and competencies. The domains necessary are teaching, assessment, curriculum support, organizational leadership, and mentoring. Most Health professions Educational Institutions support faculty development programs as a way of providing opportunities for professional and personal growth in knowledge, skills, motivation, attitude, and innovation. Method: This is a Questionnaire based study. Two sets of questions were prepared. Questions were validated and assessed for reliability. Total Number - 640, Administrators - 120, Faculty- 520 Result: Number of responses recorded - 423/640 (66.09%), Faculty - 349/520 (67.11%), Administrators -74/120 (61.66%). Faculty; It is clear that only roles of teacher and presumed benefits of FDP's were observed to be significant. Significance is noticed in items roles of teacher and Newer contents of FDP. The respondents who had attended MCI have opinionated that it is the role of the teacher to fulfil the FDP and there are some newer content areas that should be covered in FDP. Administrators; only significance is noticed with respect to the respondents who had attended NCI/DCI and they felt that it is better to organize FDP's. Clinical faculty felt that specialized FDP's are to be organized. Conclusion: The need for faculty development is universal and it is clear by the responses given by the faculty.

Exploring practising pharmacy graduates’ views on improving the effectiveness of pharmacy education at the University of the Western Cape, South Africa

Background. South African health professional education institutions have a mandate to produce graduates who are able to address priority needs of the healthcare system and larger society. However, evidence of the effective use of public resources by health education institutions is not routinely collected. Practising graduates are a target audience who could provide part of this evidence. Objectives. To explore the views of University of the Western Cape (UWC) pharmacy graduates on the effectiveness of pharmacy education in relation to their current and anticipated practice aspirations. Methods. A cross-sectional electronic survey was administered to UWC pharmacy graduates through the university’s alumni office network. Results. Twenty-five graduates responded, of whom 60% were male (average age 38.9 (standard deviation 9.52) years). One of the strongest themes that emerged was the need for exposing pharmacy students from early on in the curriculum to a broad range of pharmacy and healthcare sectors and addressing real issues in these changing and complex environments. Graduates stressed the importance of the development of generic skills, such as interpersonal skills, leadership, advocacy and innovative problem-solving, which are necessary to effect positive change through collaborative and equitable approaches. Conclusions. The findings are aligned with general trends in health education reform, such as embedding undergraduate training in the healthcare system and development of generic skills. Routine and reciprocal communication with graduates might be a valuable resource to monitor and evaluate educational outcomes to strengthen the healthcare system and benefit society.

Faculty development program evaluation: a need to embrace complexity.

Faculty development is essential for renewing and assisting faculty to maintain teaching effectiveness and adapt to innovations in Health Professions educational institutions. The evaluation of faculty development programs appears to be a significant step in maintaining its relevance and efficiency. Yet, little has been published on the specific case of faculty development program evaluation in spite of the availability of general program evaluation models. These models do not measure or capture the information educators want to know about outcomes and impacts of faculty development. We posit that two reasons account for this. The first is the evolving nature of faculty development programs as they adapt to current reforms and innovations. The second involves the limitations imposed by program evaluation models that fail to take into account the multiple and unpredictable outcomes and impacts of faculty development. It is generally accepted that the outcomes and impacts are situated at various levels, ranging from the individual to the institutional and cultural levels. This calls for evaluation models that better capture the complexity of the impacts of faculty development, in particular the reciprocal relationships between program components and outcomes. We suggest conceptual avenues, based on Structuration Theory, that could lead to identifying the multilevel impacts of faculty development.