Students’ and junior doctors’ preparedness for the reality of practice in sub-Saharan Africa

Frambach, Janneke; Manuel, Beatriz; Fumo, A; Vleuten, Cees van der; Driessen, Erik

doi:10.3109/0142159x.2014.920490

Cited by 17 publications

(13 citation statements)

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“…Local and national health professions communities in these places, as well as the educational staff, have often raised doubts as to whether PBL will deliver competent graduates compared with traditional, lecture-based curricula. As a result, the field of PBL research was born: worldwide, countless studies have been conducted to investigate whether PBL delivers ‘superior’ graduates compared to lecture-based curricula, such as in the Netherlands (Prince et al 2005), Mozambique (Frambach et al 2015), and China (Yan et al 2017; Zhou et al 2016). Many of these studies ascribe a certain degree of superiority to PBL, particularly as a superior instructional approach for training competencies in the social and cognitive domains, which review studies echo (Koh et al 2008; Neville 2009).…”

Section: Problematics and Research Accompanying The Worldwide Spread mentioning

confidence: 99%

The case for plural PBL: an analysis of dominant and marginalized perspectives in the globalization of problem-based learning

Frambach

Wasenitz

Martimianakis

2019

Adv in Health Sci Educ

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The globalization of problem-based learning (PBL) in health professions education has been both celebrated and criticized. Using a critical narrative review approach, underpinned by our archive of global PBL literature and a targeted literature search, we analyze these dominant global discourses of PBL in health professions education. More precisely, we explore what is missed when the globalization of PBL is theorized either as a positive consequence of standardization, or a problematic spread of Western educational ideals and values around the world. We make visible how two dominant global discourses, a universalist and culturalist discourse, have emerged in the global proliferation of PBL. We also discuss the limitations of the two discourses by demonstrating how they either ignore contextual and cultural diversity or see it as problematic. We then turn to a perspective that has been marginalized in the PBL literature that emphasizes the global origins of PBL, transcending the dichotomy between West and non-West. We make a case for relating to PBL as a plural construct in order to learn from the cultural and situational nuances of educational activities labeled PBL around the world. We argue that PBL as a singular and universal concept has no global future, yet versions of PBL may continue to thrive locally. Finally, we propose avenues for future research that may help elucidate the global and local values that underpin our curricula, as well as the socio-political factors that perpetuate neocolonialist views and practices in the uptake and implementation of PBL approaches across the globe.

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Section: Problematics and Research Accompanying The Worldwide Spread mentioning

confidence: 99%

The case for plural PBL: an analysis of dominant and marginalized perspectives in the globalization of problem-based learning

Frambach

Wasenitz

Martimianakis

2019

Adv in Health Sci Educ

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“…Scale-up of doctors in LMICs requires initiatives to address both quantity and quality of the healthcare workforce. Frambach et al [19] describe how education programmes in sub-Saharan Africa should impart lifelong learning skills and equip learners with the motivation for self-directed development if the quality of healthcare professionals is to improve. We consider our online Master's programme as effectively encouraging students to engage in continuing professional development (CPD) through critical appraisal of the research literature, current clinical guidelines, opinions of peers and self-reflection to practise safe, evidence-based medicine.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of an online, distance-learning Master’s in Surgical Sciences programme in Malawi

Smith

Garden

Wigmore

et al. 2018

AJHPE

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Less than half of the world's population has access to safe, affordable and timely surgical care. [1,2] In 2010, 30% of all deaths (16.9 million) worldwide resulted from conditions requiring surgical care; this number surpassed that of HIV/AIDS, tuberculosis and malaria combined. [3] The Lancet Commission on Global Surgery identified that the unmet need is greatest in sub-Saharan Africa, where 90% of the population do not have access to basic surgical procedures. [2] The development of surgical care in these regions has halted or even regressed over the past two decades, often owing to the loss of young surgeons whose personal training needs are not met locally, resulting in ongoing migration to developed countries, the so-called brain drain. Major limiting factors in the development of surgical services are a lack of surgeons on the ground and of specialist surgical expertise and training in healthcare systems. [2] Malawi, a landlocked country in sub-Saharan Africa, has the lowest physician-to-patient ratio in the world, where 1 doctor is responsible for 50 000 patients. [4] This shortage is particularly acute in surgery; in 2007, it was reported that 15 surgeons served this country, which has a population of 12 million people, [5] and more recent data suggest that this alarming ratio remains unchanged. [6] The Malawi Ministry of Health acknowledges that medical training institutions are not producing adequate numbers of graduates to meet the country's healthcare needs, and aims to address the critical staff shortages by piloting cost-effective higher-qualification training methods, such as e-learning, distance learning, applied and parttime learning. [7] Our partner institutions have developed a pioneering approach to the delivery of vocational, academic training to the surgical profession in Malawi through an innovative, online Master's programme. The MSc in Surgical Sciences was established in 2007 by the University of Edinburgh and the Royal College of Surgeons of Edinburgh, and is designed to support trainees in the early years of surgical training. [8] This 3-year, part-time programme uses a bespoke e-learning platform, hosting virtual case scenarios based on the most common surgical condi tions, and a range of assessment activities, culminating in submission of a research dissertation (Fig. 1). All students enrolled on the MSc programme are in full-time employ as surgical trainees. Their parttime online learning activities are underpinned by in-the-workplace training, where they gain direct practical skills in surgery that, in turn, can be discussed and reflected upon in the virtual learning environment (VLE). Establishing what Garrison and Anderson [9] term a 'community of inquiry' , is central to the success of the students' educational experiences, and their model is shared with all of the e-tutors at the start of their teaching block. By delivering core academic content online, handson surgical training can be augmented without the need to remove trainees from their own country. Crucially, this transn...

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“…Onderzoek laat zien dat afgestudeerden van opleidingen die aandacht besteden aan zachte vaardigheden ook over meer van deze vaardigheden beschikken [32][33][34], zonder dat het ten koste gaat van de kennis [15,35,36]. Een recente studie vergeleek een vervolgopleiding waarin veel aandacht wordt besteed aan communicatie (huisartsopleiding) met een opleiding waar minder aandacht aan communicatie wordt besteed (chirurgie) [37].…”

Section: Conclusieunclassified

De toetsing van medische competentie

Vleuten

Merriënboer

2016

Tijdschr Urol

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Samenvatting Toetsing van medische competentie kent een rijke historie van ontwikkeling en onderzoek. In dit artikel wordt eerst een kort overzicht gegeven van een aantal door onderzoek verworven inzichten en hun praktische implicaties. Vervolgens wordt er ingegaan op het moderne competentiegerichte opleiden en de implicaties voor toetsing. Ook de koppeling van competenties aan beter te begrijpen kritische beroepstaken, de Entrustable Professional Activities (EPA's), komt aan bod. Tot slot wordt ingegaan op een meer systematische aanpak van toetsing, met aandacht voor meer feedback om het leren te bevorderen en het op basis daarvan nemen van zwaarwichtige beslissingen. Mits de toetsing zorgvuldig wordt geïmplementeerd en wordt geaccepteerd in de klinische praktijk, kan toetsing bijdragen aan het verkrijgen van betere dokters.

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Students’ and junior doctors’ preparedness for the reality of practice in sub-Saharan Africa

Abstract: An innovative problem- and community-based curriculum can improve sub-Saharan African doctors' motivation and preparedness to tackle the challenges of health care practice in this region.

Cited by 17 publications

References 31 publications

The case for plural PBL: an analysis of dominant and marginalized perspectives in the globalization of problem-based learning

The case for plural PBL: an analysis of dominant and marginalized perspectives in the globalization of problem-based learning

The effectiveness of an online, distance-learning Master’s in Surgical Sciences programme in Malawi

De toetsing van medische competentie

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