Social accountability

Symposium on Social Accountability in Healthcare

THE NETWORK: TUFH invites you to join us for this Expert Symposium on Social Accountability in Healthcare. Listen, learn, and participate in a thought leadership conversation about the latest Social Accountability Accreditation and Standards.  Learn about the current thinking regarding academic training, professional development, and interprofessional education exchanges to encourage Health Care Professionals to go where they are needed.   REGISTER: LIMITED SPACES

SYMPOSIUM DESCRIPTION Social accountability is the capacity to respond to society's priority health needs and health system challenges to meet such needs. It emphasizes the potential of medical schools to partner with key stakeholders in the health sector and organize medical education in a way that it has the greatest chances to yield most relevant outcomes and highest impact on people's health. Interprofessional education (also known as inter-professional education or “IPE”) refers to occasions when students from two or more professions in health and social care learn together during all or part of their professional training with the object of cultivating collaborative practice for providing client- or patient-centered health care.  PANELISTS Dr. David Bor (Invited) is the Chief Academic Officer of Cambridge Health Alliance affiliated with Harvard Medical School. Robert Woollard is an Associate Director at the University of British Columbia – Rural Coordination Centre of BC (RCCbc). Charles Boelen is a medical doctor (Belgium, 1966 ), specialized in public health  Nighat Huda (Invited): Professor of Health Professions Education at the Liaquat National Hospital and Medical College. PANEL QUESTIONS 1. How can Accreditation Criteria and Standards be used to advance Social Accountability Practices and be utilized as a lever for change? 2. How do we encourage Health Care Professionals and Graduates to go where needed (e.g. rural and underserved regions)? For example through Academic Training, Continuing Professional Development, and/or Interprofessional Education exchanges.   3. How do we ensure Health Care professionals are advocates promoting Social Accountability?

FAIMER programs

FAIMER fellowship programs: An international, project-centered approach to improving health through health professions education

Published online: 2 January, TAPS 2019, 4(1), 1-3
DOI: https://doi.org/10.29060/TAPS.2019-4-1/GP1072

Julie Drendall & John J. Norcini
Foundation for Advancement of International Medical Education and Research, United States

I. INTRODUCTION

The Foundation for Advancement of International Medical Education and Research (FAIMER^®) is a non-profit foundation committed to improving the health of communities by enhancing the quality of health professions education. This article highlights several of FAIMER’s international efforts, with particular emphasis on the fellowship programs developed in partnership with institutions in the Asia-Pacific region.

II. PERSONAL VIEW

FAIMER’s work has historically been concentrated in lower-income regions of Asia, Africa, and Latin America, and has focused on three specific strategies: faculty development, targeted research that informs health workforce policy and practice, and development of data that advances educational quality improvement decisions. FAIMER’s fellowship programs, in particular, enable us to build partnerships with local experts aimed at creating meaningful and sustained improvements in the systems that produce health care providers. These programs provide health professions educators with opportunities to learn new methodologies in teaching and assessment, develop leadership and management skills, exchange educational expertise, and pursue advanced degrees in health professions education (Burdick, 2014). Participants apply this knowledge to improve teaching and learning at their home institutions, with the ultimate goal of improving health outcomes.

The FAIMER Institute is a two-year, part-time fellowship program for international health professions faculty who have demonstrated the potential to play key roles in improving education at their institutions and in their regions. Fellows receive training, tools, and support that enables them to become agents of change — creators of meaningful and sustainable advances in health professions education. The curriculum is organized around four overlapping themes: education methods, project management and evaluation, leadership and management, and education research. Practical application of the knowledge and skills acquired in these four areas is demonstrated through individual, locally relevant education projects, which are proposed during the application process, endorsed by the Fellows’ home institutions, and developed and implemented over the course of the two-year fellowship.

The FAIMER Institute is designed to foster professional support and collaboration with other educators as each Fellow becomes a member of a global health professions education community of practice (Burdick et al., 2010). The program consists of two brief residential sessions in the United States, each followed by a one-year distance learning session. The residential sessions are scheduled so that incoming Fellows overlap with returning Fellows, which means that over the course of the two-year fellowship, each Fellow has the opportunity to work closely with nearly 50 other health professions educators. During the distance learning sessions, Fellows participate in a series of web-based discussions with other Fellows and Institute faculty while implementing their projects at their home institutions. Fellows also interact regularly with each other via a listserv and receive individual coaching and mentoring throughout the program from international experts.

FAIMER’s Regional Institute fellowship programs are modelled after the FAIMER Institute, adapting the curriculum and content to meet the needs of specific regions. To date, FAIMER has established 11 Regional Institutes, located in India, Brazil, Sub-Saharan Africa, China, Chile, Egypt, and Indonesia. Generally hosted by local medical schools, these regional programs draw their participants from the area. This regional concentration facilitates the development of a strong local professional community for collaboration and peer support (Burdick, 2014). Like the FAIMER Institute, the Regional Institute programs include both residential and distance learning sessions, and participants are required to propose and implement education innovation projects that are supported by their home institutions.

To date, we have more than 1,500 FAIMER Fellows, representing more than 50 countries. Slightly more than half of them are from the Asia-Pacific region. The largest concentrations of FAIMER Fellows in the Asia-Pacific region are in India and China, where six of FAIMER’s existing Regional Institutes are located: four in India, developed in partnership with Seth G.S. Medical College (Mumbai), Christian Medical College (Ludhiana), PSG Institute of Medical Sciences and Research (Coimbatore), and Manipal University (Manipal); and two in China, developed in partnership with China Medical University (Shenyang) and Southern Medical University (Guangzhou). The FAIMER Regional Institute of Indonesia for Educational Development and Leadership will welcome its first class of Fellows in Yogyakarta in February 2019, and current Asia-Pacific FAIMER Fellows also hail from Malaysia, Indonesia, Nepal, Pakistan, Sri Lanka, the Philippines, Vietnam, Mongolia, and Fiji.

This international, project-centered approach and emphasis on bringing together a mix of health professions educators from different disciplines make FAIMER’s fellowship programs relatively unique. One of our newer Regional Institutes, the Manipal University-FAIMER International Institute for Leadership in Interprofessional Education, has gone even a step further by inviting participation not just from health professions educators, but from all of the professions (e.g., engineers, urban designers) that contribute to the health of communities. Participants in this program design interprofessional projects, which foster interaction and collaboration among faculty of diverse professional backgrounds.

Central to FAIMER’s fellowship model, the Fellows’ education innovation projects serve as excellent learning experiences, but are also intended to address specific educational needs at participants’ home institutions. Projects with the potential to improve the health of the applicant’s community, country, or region, and which have full institutional support, are given higher priority in the fellowship selection process. For example, a project designed by FAIMER Institute Fellow Rukhsana Ayub Aslam utilized high school and medical students to supplement the care provided by public health workers through service learning projects in four different communities of Pakistan. Its primary focus was to raise awareness about the causes, effects, and prevention of iron deficiency anaemia, a common condition among women of reproductive age in Pakistan. The initial project was supported by local institutions and NGOs but within a few years, it had attracted international partners including Flinders University in Australia and Global Health through Education, Training and Service (GHETS), a U.S.-based NGO, which enabled it to add point-of-care testing and treatment components that have yielded measurable positive health outcomes (Aslam, 2015).

Individual project topics vary widely, but some of the most common areas of focus are teaching methods, curriculum change, program evaluation, alignment with health system/context, and student assessment (FAIMER Brief Reports, n.d.). In the Asia-Pacific region, specifically, the most common areas of concentration have been teaching methods, curriculum change, assessment, clinical skills, and faculty development; other popular areas of focus include problem-based learning, computer-based learning, student affairs, and community-based education.

We routinely evaluate our work and have found that through their projects, Fellows have successfully introduced new educational approaches, faculty development initiatives, curriculum reform, and the creation and/or strengthening of medical education units and departments at their home institutions. Fellows report improvements in the quality of teaching and collaboration at their schools, as well as an increased interest in research and scholarship pertaining to health professions education (FAIMER Brief Reports, n.d.). Many of the projects that have been incorporated successfully at an institutional level are then expanded and replicated at other institutions in Fellows’ countries and regions—creating a ripple or multiplier effect. A significant number of these projects are also having a direct effect on health, through faculty and student-led patient education initiatives, health surveillance projects, and community-based interventions aimed at increasing access to care (Burdick, Amaral, Campos, & Norcini, 2011).

Aside from the projects, we have evidence of the personal and professional growth of our Fellows over the course of their fellowships and beyond. Our data suggest that the leadership training Fellows receive improves their confidence, which contributes to professional advancement and enables them to have increased impact and influence on health education practice and policy, institutionally, regionally, and internationally (FAIMER Brief Reports, n.d.). Many are appointed to key leadership roles at their institutions, and some go on to become members of specialized groups and committees, serve on regulatory bodies, and are appointed to national commissions and councils.

A number of our Fellows expressed the need for additional training with academic recognition, as have other educators around the world. Consequently, we created the FAIMER Distance Learning program in partnership with Keele University and the Centre for Medical Education in Context (CenMEDIC). It aims to empower health professions educators with the knowledge and skills to take educational standards and practice to a higher level— to develop their own practice, improve health professions education at their institutions and in their communities, and ultimately help bring about real and lasting advances in local health care. Participants are able to earn a Certificate, Diploma, or Master’s Degree in Health Professions Education with a focus on accreditation and assessment. The Certificate and Diploma programs are conducted entirely online, and the Master’s Degree is a blended learning program that includes a brief residential session and a dissertation. Our inaugural Masters class graduated in 2016, and it included six educators from the Asia-Pacific region.

The improvement of health professions education may not be the most obvious or immediate means of improving global health outcomes, but evidence from FAIMER’s 18 years indicates that it has a definite impact. We are privileged to be able to do this work, and we are extremely proud of the accomplishments of our Fellows.

Note on Contributors

Julie Drendall, MSS, MLSP, is the Administrative Manager for Communications of the Foundation for Advancement of International Medical Education and Research (FAIMER).

John J. Norcini, PhD, is the President and CEO of the Foundation for Advancement of International Medical Education and Research (FAIMER).

 

Funding

No funding is involved in this paper.

Declaration of Interest

Both authors report no competing interests.

References

Aslam, R. A. (2015, September). Service learning to develop students’ social responsibility and improve women’s health. Project presented at the Annual Conference of The Network: Towards Unity for Health, Gauteng Province, South Africa.

Burdick, W. P. (2014). Global faculty development: Lessons learned from the Foundation for Advancement of International Medical Education and Research (FAIMER) initiatives. Academic Medicine, 89(8), 1097-1099.

Burdick, W. P., Amaral, E., Campos, H., Norcini, J. (2011). A model for linkage between health professions education and health: FAIMER international faculty development initiatives. Medical Teacher, 33(8), 632-637.

Burdick, W. P., Diserens, D., Friedman, S. R., Morahan, P. S., Kalishman, S., Eklund, M. A., … Norcini, J. J. (2010). Measuring the effects of an international health professions faculty development fellowship: The FAIMER Institute. Medical Teacher, 32(5), 414-421.

FAIMER Brief Reports. Retrieved from http://www.faimer.org/education/program-evaluation.html.

*John Norcini
Email: jnorcini@faimer.org
Mailing address: 3624 Market Street,
3rd Floor, Philadelphia,
PA 19104-2685 USA

Med Schools recruitment

This doctor thinks medical schools should recruit more like Google and other tech companies

 

• Jefferson Health's Stephen Klasko says medical schools are designed to "suck the creativity" out of their students.
• Medical schools need to change their recruitment process and take a page from Google and other tech companies, he says.

 

Christina Farr | @chrissyfarr

 

 

Jefferson Health

Jefferson Health's Steve Klasko walking through campus.

Dr. Stephen Klasko, the president of Thomas Jefferson University in Philadelphia and CEO of Jefferson Health, says that medical schools have the recruiting process all wrong.

In an age of advanced technology, they're still choosing students who can reel off organic chemistry compounds, rather than screening for qualities like critical thinking, entrepreneurship and empathy. Once students arrive, they're being asked to spend years on rote memorization.

It's a system designed to "suck the creativity out of physicians," Klasko said, while encouraging them to compete with each other, rather than collaborate.

Klasko is pushing Thomas Jefferson along a different path, one that's similarly being followed by Mount Sinai, Yale and Stanford. They're all seeking ways to find candidates that may not be obvious targets for medical school by using techniques that are well known to tech companies. Klasko's son once interviewed for a job at Google, and "they didn't want to see a transcript," he said. Recruiters asked him a series of questions to see whether he could come up with creative solutions on the fly.

Klasko has worked with a firm called Teleos Leaders, which has clients ranging from Cisco to IBM, to develop a program to select medical students on the basis of their emotional intelligence.

"We need to make medical students more human," Klasko said in an interview. "The way things are today is that you can be the most antisocial person in the room, but if we train you to pass a multiple choice test you can go and treat sick patients."

Jefferson is tapping humanities departments, design universities and drama schools to convince young graduates to consider a career in medicine. It has a partnership with Princeton University that allows about a dozen Princeton undergraduates each year to take the minimum number of science courses and study any other subjects they wish before attending medical school at Jefferson.

It also has a program that trains students in design thinking under Bon Ku, an emergency room physician who was described by a local publication as "one of the coolest docs in Philadelphia." Ku graduated with a degree in classics and was terrible at math.

FlexMed at New York's Mount Sinai allows college sophomores in any major to apply for early acceptance. Students in humanities have proven to be just as successful as those with a science background, and they're more likely to choose primary care or psychiatry as a specialty, which are both areas facing shortages. Other med schools like Yale and Stanford are offering art appreciation courses alongside traditional subjects like pathology and microbiology.

 

The role of AI in medicine

Ku predicts that as artificial intelligence become more prominent, memorization skills will become far less relevant.

"We still need the basic memorization of scientific knowledge, but no human can possibly keep up," Ku told CNBC. "Medical knowledge is doubling at this crazy rate. So instead there should be a greater emphasis on creative problem solving."

Klasko sees a future in which technology will be used to provide an immediate list of drugs for a particular case and offer clinical decision support tools to make a diagnosis. That will free doctors up to spend time listening to their patients, improving their surgical techniques or learning new skills.

Klasko has a real-life example. He said that in his career as an obstetrician and gynecologist, he's delivered thousands of babies. While most are fairly routine, occasionally an infant is born unexpectedly with a genetic disease like Down Syndrome. In such cases, parents will often ask him what it all means.

They don't want a detailed explanation of the chromosomal anomaly, but rather to understand how to deal with this new reality and how to be proper caregivers. Sometimes they just to talk to someone about their hopes and fears.

"At some point, the real bar should be whether or not you can actually listen to patients and talk to them," Klasko said.

Project-based learning

Effective PD for project-based learning

 

Kevin Armstrong and Cheryl Bautista

 

 

Pixabay

Project-based learning is one of the best ways to teach students 21^st century skills. It promotes deeper engagement in the content while also teaching skills such as communication, collaboration and teamwork. But a good PBL program only works if the school or district invests in targeted, sustained professional development.

Our school, Katherine Smith Elementary School in California adopted a PBL program six years ago. It was a massive overhaul for us. The program focuses on six principles: Think, Learn, Work, Communicate, Collaborate and Contribute. We used the Buck Institute for Education’s PBL framework and partnered with them for our professional development. Their PD provided not only high intensity PBL training sessions for both administrators and teachers, it also provided us with an on-call Buck Institute PBL coach for two years to support our launch into this model. During the first year, we learned the basics of a PBL-focused curriculum such as determining the “driving questions” and the “entry event” for each project. During the second year we worked on improving implementation by focusing on reflection, authenticity and academic rigor.

Redesigning to a PBL model has changed teaching and learning here. PBL gives our students the engagement they have been craving. They are doing much more than just regurgitating thoughts. They are emotionally invested in their work, and in their learning.

This impact would not be possible without the PD program. If your school or district is considering switching to a PBL model, here are six ways to prepare your team:

1. Change is messy. It can be difficult to navigate new instructional practices while also trying to change the culture of the community. Make sure your PD program addresses the nuances of how to work through both of these issues.
2. Surround yourselves with good partners. You want partners who will be there for the long haul, not just at the onset of your program. The ongoing support from the Buck Institute has been invaluable. Our teachers were able to work with the PBL coach as they developed their projects and transitioned to the new model. These coaches continue to provide support, even as we move into year seven of implementation. We also partnered with New Tech Network for our system-level support. We work closely with an elementary cohort of three schools in the network to not only improve our own practice, but to help build the elementary model for NTN.
3. Don’t forget to train for technology. Often PBL projects include new uses of technology. Students (and teachers) may be using tablets and digital tools to create videos, complete a coding project or collaborate on a PowerPoint presentation. As part of our redesign, we added iPads and Smartboards to our classrooms for the first time so we had to make sure we included training on the new technology.
4. Set structures for team planning. For example, we meet as a staff every Wednesday for PD and leadership work, and Thursday afternoons are disciplined planning time. Our meetings provide dedicated time for our staff to debrief from the week, talk about any concerns and prepare for the next phase of our projects. We’ve found this to be instrumental in supporting our staff and understanding where they may need help.
5. Create leadership teams around topics. We let teachers pick what teams they wanted to lead based on their interests. For example, if a teacher was interested in technology, they could ask to lead the tech team where they got to make decisions about PD around new applications for the iPad or Smartboards. This autonomy is important because it gives them more ownership over the work done by that team. We also have a strategic leadership team that is in charge of revising and monitoring progress towards the school’s strategic goals every year.
6. Take time to reflect. A cornerstone of good PBL PD is to allow opportunities to sit back and think about what you are doing and to discuss your progress toward goals, for example: Is this engaging for students? How are we going to assess student learning at the end? Do we need to modify the project, and if so, how? Even into year seven of implementation, we continue to reflect and assess our work to inform future PD to help push our work further in designing projects to meet deeper learning outcomes.

A successfully shift to PBL starts with getting everyone on board first. PBL can be a game-changer, provided you plan carefully and make sure everyone receives the proper training.

Kevin Armstrong is the principal and Cheryl Bautista is the instructional coach at Katherine Smith Elementary School in the Evergreen Elementary School District in California. Kevin is also a Buck Institute for Education National Faculty member.

Exame de Ordem

CNS publica resolução
contra o Exame de Ordem

 

 

O Conselho Nacional de Saúde (CNS) publicou no dia 31 de dezembro, no Diário Oficial da União, a Resolução 586/2018, manifestando-se de forma contrária à realização do Exame Nacional de Proficiência (“exame de ordem”) como requisito obrigatório para o exercício legal das profissões da área da saúde de nível superior. O parecer do CNS baseou-se, entre outras fontes, no posicionamento da ABEM, que tem participado ativamente nas discussões sobre o tema, sendo mencionada no documento.

Em debate há alguns anos, o exame de ordem vem sendo discutido na tramitação do Projeto de Lei 165/2017, de autoria do senador Pedro Chagas (PSC/MS), que visa a instituir a realização da avaliação para o exercício da medicina no Brasil. Em novembro, a diretora executiva da ABEM, Hermila Guedes, participou de audiência pública no Senado defendendo a posição da entidade, que é contrária ao exame.

São vários os argumentos apresentados pela ABEM e pelo CNS para que não se adote o exame no modelo proposto. Para as entidades, a avaliação não deve ser fundamentada em um único exame para os estudantes, e sim abranger também as instituições de ensino, os docentes e a comunidade, pois a formação profissional em saúde engloba todos estes fatores. O projeto de lei não considera a responsabilidade do governo e das escolas de formar profissionais necessários e adequados para a população e para o Sistema Único de Saúde. Por outro lado, a proposta expõe os processos de avaliação a fragilidades, dando margem a corporativismo e proliferação de cursos preparatórios.

A ABEM defende um processo de avaliação seriada do estudante de medicina, ao longo de todo o curso, que se conclua antes da emissão do diploma, sem ônus financeiro para o discente – alinhado com as Diretrizes Curriculares Nacionais para os Cursos de Graduação de Medicina.

 

* Para ler a Resolução CNS 586/2018 na íntegra: http://conselho.saude.gov.br/resolucoes/2018/Reso586.pdf

* Para conhecer o posicionamento da ABEM sobre o tema: http://abem-educmed.org.br/posicionamento-da-abem-ao-projeto-de-lei-do-senado-no-165-2017-exame-nacional-de-proficiencia-em-medicina/

 

Agenda de Prioridades de Pesquisa do Ministério da Saúde (APPMS)

Ministério publica agenda com prioridades de pesquisa na saúde

 

 

O Departamento de Ciência e Tecnologia do Ministério da Saúde publicou a Agenda de Prioridades de Pesquisa do Ministério da Saúde (APPMS). A iniciativa tem o objetivo de alinhar as prioridades atuais de saúde com as atividades de pesquisa científica, tecnológica e inovação e direcionar os recursos disponíveis para investimento em temas de pesquisas estratégicos para o SUS.

A construção da agenda foi realizada em um processo participativo envolvendo todas as sete Secretarias do Ministério da Saúde em todas as etapas, que traz 172 linhas de pesquisa distribuídas em 14 eixos temáticos.

Durante a elaboração da APPMS, os problemas de saúde e de pesquisa foram identificados juntos às áreas técnicas e gestores do Ministério da Saúde. Esses problemas foram priorizados dentro das secretarias e, então, criadas linhas de pesquisa que refletem as necessidades de pesquisa do SUS. O trabalho iniciou em 2017, considerando o conceito amplo de saúde, seus determinantes e condicionantes, por meio da metodologia proposta pelo Global Forum for Health Research (2009) e adaptada para as nossas necessidades.

O documento APPMS não substituirá a Agenda Nacional de Prioridades de Pesquisa (ANPPS). Trata-se de um instrumento para subsidiar a destinação de recursos, o planejamento institucional e a tomada de decisão no Ministério da Saúde nos próximos dois anos.

Confira os 14 eixos temáticos: 

Eixo 1 – Ambiente, Trabalho e Saúde
Eixo 2 – Assistência Farmacêutica
Eixo 3 – Avaliação Pós-Incorporação
Eixo 4 – Desenvolvimento de Tecnologias e Inovação em Saúde
Eixo 5 – Doenças Crônicas Não Transmissíveis
Eixo 6 – Doenças Transmissíveis
Eixo 7 – Economia e Gestão em Saúde
Eixo 8 – Gestão do Trabalho e Educação em Saúde
Eixo 9 – Programas e Políticas em Saúde
Eixo 10 – Saúde da Mulher
Eixo 11 – Saúde da População Negra e das Comunidades Tradicionais
Eixo 12 – Saúde do Idoso
Eixo 13 – Saúde Indígena
Eixo 14 – Saúde Materno Infantil

Acesse a Agenda aqui.