Health Professions Education Institutions Research Articles

Postdoctoral Teaching of Geriatric Dentistry in U.S. Dental Schools.

The aim of this study was to determine the number and size of postdoctoral teaching programs in geriatric dentistry in U.S. dental schools and other health professions educational institutions and those programs with Health Resources and Services Administration (HRSA) funding. In 2015, all 67 U.S. dental schools were contacted via email with a questionnaire to ask if they had a postdoctoral program in geriatric dentistry; if they did, they were asked to report the length and size of the program. Directors of all 16 HRSA-funded geriatric fellowships were also invited to participate in the survey. Fifty-six of the 67 (83.6%) dental schools and 15 of the 16 (93.8%) HRSA-funded programs completed the questionnaire. Postdoctoral geriatric dentistry programs were reported in 12 dental schools and six medical institutions, although only six programs were currently accepting fellows. The length of the programs was 12-36 months. The maximum number of residents in any program was ten. The oldest program was in Minnesota; it began in 1981. The newest program was beginning in 2017 at Boston University as a revised version of its previous HRSA-funded program. The loss of HRSA funding has had a major negative impact on the number of training programs. Future research is needed to determine how the loss of HRSA-funded programs has affected the availability of educators in geriatric dentistry for dental schools and the services provided to the geriatric community.

Standard setting and quality of assessment: A conceptual approach

The debate with regard to standard setting continues among scholars, but the perfect method remains elusive. Nonetheless, resolute demands for accountability by means of defensible, valid and reliable practices, including pass or fail decisions, provide an opportune vehicle for scholars to consider the quality of assessments and ramifications on standard setting. This conceptual review considers how standard setting can be placed strategically in the quality dialogue space to address concerns about credibility and defensibility in the literature. Quality performance standards and the effect of assessment outcomes are important in the educational milieu, as assessment remains the representative measure of achievement of the prescribed performance standard but also includes the quality of health professions education (HPE). The author suggests that standard setting can be a pivotal focus for technical and psychometric sufficiency of assessments and accountability of HPE institutions towards stakeholders. Standard setting should not be seen as a methodological process of setting pass/fail cut-off points only, but as a powerful catalyst for quality improvements in HPE by promoting excellence in assessments.

Gaps and gains from engaging districts stakeholders for community-based health professions education in Uganda: a qualitative study.

Community-based education research and service (COBERS) is a brand of community-based education that has been adopted by the Medical Education and Service for All Ugandans consortium. The COBERS programme is aimed at equipping students in health professional education with the knowledge, attitudes and skills required to provide appropriate health care services. For sustainability purposes, the health professional training institutions have made efforts to involve various stakeholders in the implementation of the programme. However, the actual engagement process and outcome of such efforts have not been documented. This paper documents gaps and gains made in engaging district stakeholders for community-based education. Key informant interviews, focus group discussions and document review were used to collect data. Atlas.ti, computer software for qualitative data was used to aid analysis. The analysis revealed that the adopted engagement model has registered some gains including increased awareness among district leaders about potential opportunities offered by COBERS such as boosting of human resources at health facilities, opportunities for professional development for health care workers at health facilities, and establishment of linkages between prospective employees and employers. However, the engagement model left some gaps in terms of knowledge, awareness and ownership of the programme among some sections of stakeholders. The apparent information gap about the programme among district stakeholders, especially the political leadership, may hinder concerted partnership. The findings highlight the need for health professional education institutions to broaden the scope of actively engaged stakeholders with the district level.

Health professional educational system in China from 1998 to 2012: a time-series analysis

BackgroundChina has a vast and complex system of health-professional education, which underwent fast changes beginning in 1998. Because of the notable shortage of international published work on quantitative characteristics of the system, we aimed to analyse the scale, distribution, and changes of this system. MethodsUsing previously unreleased datasets from China's Ministry of Education, we did a time-series analysis by studying the changes and tendency of health-professional education institutions, students, faculty members, and infrastructures from 1998 to 2012. Only routine statistics of education institutions were analysed, and no informed consent was necessary. FindingsIn 1998–2012, the number of health-professional education institutions increased from 189 to 590 in the field of regular higher education. 123 private institutions existed in 2012, compared with zero in 1998. In the same period, the number of health-professional students increased from 0·3 million to 2·1 million, with an average growth rate of 14·9% per year. By contrast, a much slower growth rate or a decreased rate was seen for faculty members (7·6%), campus area per student (–1·4%), classroom area per student (1·9%), number of library books per student (–5·6%), and number of computer per 100 students (5·7%). Furthermore, a widening gap was seen between western China and the other two parts of the country (eastern and central China) in terms of health-professional educational resources and output. InterpretationExpansion of health-professional education has a positive role in addressing the shortage of health workforce in China. Nevertheless, the quality of education might be compromised because of the rapid increase in the number of students without commensurate strengthening of faculty and infrastructure. The widening gap in educational resources and output among different regions might worsen the unequal distribution of health professionals in the country. FundingChinese Academy of Engineering.

Structured Abstracts: Best Practices in Writing and Reviewing Abstracts for Publication and Presentation

Abstract Medical, nursing, and other allied health professional education institutions are expected by national accrediting bodies and associations to emphasize not only basic science and clinical ...

Redefining the measure of medical education: harnessing the transformative potential of MEPI.

The massive shortage of skilled health professionals in many parts of the world is a critical constraint to achieving the goal of universal health coverage. This shortfall reflects a generalized failure of leadership: a chronic misalignment between the direction of health professional education and the health goals of society. The Medical Education Partnership Initiative (MEPI) and Nurse Education Partnership Initiative (NEPI) are outliers in this regard through their deliberate efforts to revitalize education to address the pressing health needs of Sub-Saharan Africa. Inspired by this example, the World Bank Group sees health professional education institutions (HPEIs) as an insufficiently tapped source of knowledge and know-how for accelerating health achievement. The challenge ahead is to articulate clearer expectations for HPEI performance, marshal more and smarter investments across the public and private sectors, prioritize accountability, incentivize innovation, and strengthen global learning and evaluation. It is time to build on the positive legacy of MEPI/NEPI and ensure that the conditions are made available for a new generation of health workers with the competencies to meet the health and development challenges of today and tomorrow.

The Nursing Education Partnership Initiative (NEPI): innovations in nursing and midwifery education.

The nursing and midwifery workforce is key to improving the performance of the health system overall. Health workforce shortages are significantly influenced by the productive capacity of health professions education institutions. Long-standing underinvestment in preservice nursing and midwifery education severely limits the capacity of institutions to educate nurses and midwives in sufficient numbers, and with the necessary clinical skills, for current and anticipated population health needs. The Nursing Education Partnership Initiative (NEPI) was established in 2011 by the U.S. President's Emergency Plan for AIDS Relief in response to key capacity-building challenges facing preservice nursing and midwifery education in Sub-Saharan Africa. NEPI has formed partnerships with governments and key stakeholders in Ethiopia, Democratic Republic of Congo, Lesotho, Malawi, and Zambia and supports 19 nursing and midwifery education institutions and 1 nursing council. NEPI has been informed by activities that strengthen education systems, institutions, and organizations as well as faculty capacity building. Ministry of health-led advisory groups were established to provide strategic direction and oversight for the work, fostering intersectoral dialogue and ensuring country ownership and sustainability. Three illustrative examples of innovations at the system, institution, and workforce levels describe approaches for country ownership, for addressing the shortage of highly qualified faculty, and for remedying the inadequate teaching and learning infrastructure.

New curriculum in dentistry for Tanzania: Competency-based education for patient and population health (2008–2011)

From 2008 to 2011, the School of Dentistry at Muhimbili University of Health and Allied Sciences in Tanzania revised and then initiated implementation of a curriculum to improve the educational process for, and competence of, its graduates. As an increasing body of research demonstrates the detrimental effects of oral diseases on health and the interrelationships between oral and systemic diseases (including HIV and diabetes), the importance of dentistry education grows. We describe the population oral health problems in Tanzania, the need to enhance the dental workforce, and the process of curricular reform to meet these needs. This reform included transition to a competency-based curriculum featuring teaching methods that will enhance the effectiveness of the education and performance of graduates in traditional and new roles. We conclude with lessons for Tanzania and for health professions educational institutions elsewhere, as well as for public health-care planners concerned about linking health professions education to improving population health in resource-poor countries.

Using DREEM to compare graduating students′ perceptions of learning environments at medical schools adopting contrasting educational strategies

Background: In response to growing concerns about conventional modes of teaching and learning in medicine, some medical schools in Saudi Arabia have converted to hybrid problem-based learning (PBL) curricula while others continue to implement traditional discipline-based curricula. Understanding students’ perceptions of traditional versus PBL learning environments can be helpful for evaluating program strengths and weaknesses and should promote curriculum development.Aim: The purpose of this study was therefore to evaluate the educational environments of two medical schools in Riyadh, Saudi Arabia from perspectives of graduating medical students using the Dundee Ready Education Environment Measure (DREEM) inventory.Results: Compared to medical school implementing a hybrid PBL curriculum, the overall score on the inventory for the conventional school was statistically significantly less (p < 0.001). In addition, students experiencing the hybrid-PBL curriculum held significantly higher perceptions in the learning, academic self-perception and atmosphere sub-domains of the inventory (p < 0.001). Overall, our results align with previous studies pertaining to DREEM scores of other regional conventional and international PBL medical schools.Conclusion: We conclude that applying DREEM as a diagnostic tool provides important insights and understanding of learning environments where different educational strategies are adopted and which may be in need of development and change. Implications for curriculum development and improvement of learning environments in health professions education institutions are discussed.

Training students to learn in a problem-based learning programme

models constitute the major results of this collective work. They are designated: Blurry Mirror; Local Health Needs; Community Interest; Participatory Action Research, and Systematisation. These models provide a vehicle and a foundational framework for collaboration between community and health professions education institutions. Specifically, seven characteristics guide the development and implementation of a systematic model that embraces collective health. These identified characteristics are: approach to the community; engagement in and understanding the community; needs assessment; establishment of goals and objectives; development of a plan; intervention implementation, and evaluation and dissemination of results. This work has come to represent the foundation for the development of a systematic approach in our institution and can be generalised to other community-based education efforts.

Addressing inequities in access to primary health care: lessons for the training of health care professionals from a regional medical school

Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities.

A new opportunity for Egyptian health professions educators

Context and setting In Egypt, health professions education (HPE) is practised by health professionals who have no formal training in education. Faculty members are the cornerstone of the educational process. To enhance HPE, the Egyptian National Quality Assurance and Accreditation Agency and the Eastern Mediterranean Regional Office of the World Health Organization (EMRO-WHO) recommended that an urgent plan should be developed for training HPE faculty staff in medical education. Why the idea was necessary In order to access training in medical education, the only option for potential trainees was to leave their employment for expensive on-site educational programmes offered either regionally or abroad. To make an impact on HPE in Egypt, it was critical to develop more affordable and accessible opportunities for educating larger numbers of faculty in HPE. What was done The newly established Medical Education Department in the Faculty of Medicine, Suez Canal University, developed a distance learning diploma in HPE that covers all the medical education domains. This programme is sponsored by the WHO and targets a wide range of faculty staff in all HPE institutions in Egypt, including those in faculties of medicine, pharmacy, nursing, dentistry, physiotherapy and speech therapy. Faculty recruited to teach in this diploma programme are qualified and have substantial experience in medical education. Twenty, including three from other institutions in Egypt, have Masters degrees in medical education from a number of internationally recognised medical schools. The diploma is composed of seven modules, each taught in 6-week blocks. Topics include curriculum development, student assessment, teaching and learning skills, programme evaluation, and quality assurance in HPE. The programme also addresses and encourages interprofessional learning. The programme is run through a dedicated website that includes a Blackboard e-learning space. The diploma programme was announced through newspaper advertisements, mass e-mails, flyers and brochures. This resulted in a rush of applications from a number of medical, dental, pharmacy and nursing schools in Egypt. A total of 38 candidates from 15 different institutions were selected for the first cohort of entrants and other applications were postponed to subsequent years. Evaluation of results and impact When the planning of the seven modules had been completed, a number of regional, national and international experts in medical education validated the diploma curriculum. The Medical Sector of the Supreme Council of Universities has endorsed the diploma course and recognised its certificate as representative of the only formal course in medical education in Egypt that is taught through distance learning. The 5-year goal of the programme is to train 5% of HPE faculty across the country. The diploma curriculum is designed to ensure that the alumni of this programme will educate other educators in their institutions and make a real impact on HPE in Egypt.

World Federation for Medical Education Policy on International Recognition of Medical Schools’ Programme

The increasing globalisation of medicine, as manifested in the migration rate of medical doctors and in the growth of cross-border education providers, has inflicted a wave of quality assurance efforts in medical education, and underlined the need for definition of standards and for introduction of effective and transparent accreditation systems. In 2004, reflecting the importance of the interface between medical education and the healthcare delivery sector, a World Health Organization (WHO)/World Federation for Medical Education (WFME) Strategic Partnership to improve medical education was formed. In 2005, the partnership published Guidelines for Accreditation of Basic Medical Education. The WHO/WFME Guidelines recommend the establishment of proper accreditation systems that are effective, independent, transparent and based on medical education-specific criteria. An important prerequisite for this development was the WFME Global Standards programme, initiated in 1997 and widely endorsed. The standards are now being used in all 6 WHO/WFME regions as a basis for quality improvement of medical education throughout its continuum and as a template for national and regional accreditation standards. Promotion of national accreditation systems will have a pivotal influence on future international appraisal of medical education. Information about accreditation status - the agencies involved and the criteria and procedure used - will be an essential component of new Global Directories of Health Professions Educational Institutions. According to an agreement between the WHO and the University of Copenhagen (UC), these Directories (the Avicenna Directories) will be developed and published by the UC with the assistance of the WFME, starting with renewal of the WHO World Directory of Medical Schools, and sequentially expanding to cover educational institutions for other health professions. The Directories will be a foundation for international meta-recognition ("accrediting the accreditors") of educational institutions and their programmes.

Using the DREEM questionnaire to gather baseline information on an evolving medical school in Sri Lanka

The recent introduction of the Dundee Ready Education Environment Measure (DREEM) has fulfilled a long-felt need for a test instrument specifically meant to evaluate health professions education institutions. It was intended in this study to ascertain the overall DREEM score for the newly established Faculty of Medical Sciences of University of Sri Jayewardenepura (FMS/USJ), Sri Lanka and to compare the DREEM score of the students in the pre-, para- and clinical phases of the traditional curriculum practiced in this school. A total of 339 students belonging to the pre- (n = 147), para- (n = 116) and clinical (n = 76) phases of the medical course participated in this study. The DREEM questionnaire was administered face-to-face after one of their routine lectures to each group of students. The age of the students ranged from 20 to 28 years and the gender distribution was almost equal. The overall DREEM score was 108 (54%) for the pooled data for all three phases. There was no significant difference on the overall DREEM score obtained by each phase of students. The overall DREEM scores of pooled data and also for each domain indicated that the position of the FMS/USJ qualifies to be placed just on the third grade (one below the best) within the overall DREEM scale. However, on analysis of the responses for each domain, Students’ Perception of Teachers (SPT), Students’ Academic Self-Perceptions (SAP) and Students’ Social Self-Perceptions (SSP) showed significant difference between the pre-, para- and clinical phases. Similarly, 22 out of the 50 items showed significant differences between the pre- and clinical phases. Overall, the DREEM demonstrated compatibility of its scores along with the gradual development that took place at this medical school over the last 10 years. Thus, the DREEM could be utilized in a variety of situations.

Lessons learned from implementing multidisciplinary health professions educational models in community settings

This article addresses sustainability elements for multidisciplinary health professions education in communities. The results are based on a 5 year program involving multiple health professions education institutions in seven states within the USA. We offer observations and suggestions to others who plan and implement multidisciplinary programs for health professions educators. Our findings are based on the outcomes of the Community Partnerships in Health Professions Education (CPHPE) initiative funded by the W. K. Kellogg Foundation. Data sources included pre and post surveys of students and faculty, site visits, published evaluations and site reports, and a 2 year follow-up evaluation after the external funding phase. Elements of the partnership that facilitated the sustainability of the models were: leadership, complementary missions, curriculum that mirrors clinical community practice, change from outside in, partnership boards, and faculty development. Those elements that were barriers to sustaining the efforts were: professional identities and territorial boundaries, structural differences, costs, and unclear goals. The multidisciplinary components of the community partnership initiative were the most challenging. However, in most programs, they did succeed and are currently in place. By paying attention to the elements that enhance and detract from teaming, one can plan for more successful multidisciplinary education.

Medical education in People's Republic of China.

The three types of physicians being educated in the People's Republic of China--practitioners in traditional Chinese medicine, traditional Mongolian medicine, and western-type medicine--and the nation's medical schools are discussed. The country officially recognizes 117 health professions educational institutions--23 colleges of traditional Chinese medicine, 91 western-type medical schools, two schools of pharmacy, and one institution that trains pharmacy, medical, and hygienic inspectors. Eight of the 91 western-type schools, in addition to providing training in western-type medicine, also offer education in traditional Chinese medicine. Training in Mongolian medicine is offered by one of these eight western schools and by one other western school. No schools offer only Mongolian medicine education.

Health manpower legislation.

In response to the desires of Congress, medical schools dramatically enhanced their ability to perform biomedical research and to educate health professions personnel. Initially, Congress viewed health professionals as a national resource in terms of being willing to subsidize their education. Congress continues to view the health professions as a national resource, but the philosophy of Congress has become substantially modified: Congress is unwilling to subsidize the education of physicians, but perceives that it must regulate their specialty and geographic distribution. Medical students and medical schools have, in a major sense, been left "holding the bag." A cogent argument can be offered that the natural history of health-care evolution has been confused by excessive meddling with the system. Additional legislatively induced confusion should not be imposed, at least until the results of the previous meddling have been observed. Unfortunately, the foregoing presentation raises considerably more questions than it answers: Medical schools: What will be the source(s) of financial support? Medical students: What will be the impact of tuition indebtedness? Practicing physicians: What will be the result(s) of severe competition? Health professions educational institutions must address fundamental issues concerning their financial survival. That is, will they accept the carrot-and-stick philosophy and pursue federal funding? or will they seek financial independence toward the goal of assuming responsibility for their own destiny? The philosophy of federal funding "without strings attached" does not exist.