DEPARTMENT OF MEDICAL EDUCATION

Department of Medical Education (DME) at College of Physicians and Surgeons, Pakistan, was established in 1979. The basic objective of DME was to provide support to CPSP in the development of Postgraduate training programs and examination systems, as well as, to help in the training of teachers of Health Sciences. In the same year it was recognized by the Ministry of Health, Government of Pakistan, as the National Teacher Training Centre (NTTC).

The DME engages itself in an array of activities that include education and training of medical teachers and practitioners. It is also actively involved in updating the medical curricula as well as improving the standard of examinations. The track record of the DME is an ample testimony to its constant endeavors at improvement of health professions education. In cognizance with the active part played by the department in organizing courses/ workshops for continuous educational development of health professionals, it has been designated as a WHO collaborating centre for Research and Training in Educational Development for Health Personnel since March, 1996.

The Centre organizes various workshops on educational methodology. Through these workshops, teachers of health profession (physicians, nurses, and paramedical staff) are introduced to the principles and concepts of education and its application to their day to day working. The major focus of these workshops is to strengthen their teaching and communication skills; train them to develop curricula for courses, structured training programs, teaching/learning materials, suitable assessment methods; supervise and monitor postgraduate training Programs; and to enable them to actively engage in and supervise research projects. In addition, the centre also organizes mandatory workshops for the trainees of the postgraduate courses of CPSP. The department has close coordination with other centers of academic excellence such as Department of Medical Education, University of Illinois, Chicago and Center for Medical Education, University of Dundee for exchange of expertise on curricula and other educational issues. In addition both international and local experts are invited to facilitate educational activities in the form of courses, workshops etc.

[Go Top]

AIMS & OBJECTIVES

The mission of WHO Collaborating Centre is to improve the quality of medical education being imparted to the health providers in Pakistan in order to improve the health status of the people of the country. A main goal of the Centre is to assist, support and facilitate the mission of the CPSP to improve and maintain the quality of postgraduate doctors in the country.

Following are the main objectives of the Department at both national and international level:

• Assist in formulating policies for educational practices for government as well as institutions and organizations in public and private sector
• Provide technical expertise for capacity building of educators of health professionals
• Develop qualified personnel to manage medical education departments in institutions.
• Conduct research for practicing evidence-based medical education
• Build capacity of providers of CME and CPD programs

[Go Top]

UNITS

The activities of the Department are performed by its various units in close collaboration with each other. These units along with their main areas of activities are:

1. Health Professions Education (HPE) Unit: Undertakes all activities related with the capacity building of medical teachers; and running a Diploma course in Health Professions Education i.e DCPS-HPE course. It is also responsible for planning and execution of the activities as WHO Collaborating Centre.
   
2. Faculties Unit: Works in close liaison with the specialist faculties for all the issues pertaining to training of postgraduates, organizes faculty meetings and assists them in development and review of curricula, syllabi and tools for monitoring, assessment and evaluations.
   
3. Health Care Systems Management (HCSM) Unit: Mainly responsible for the planning, organization and conduct of post graduate diploma course in Health Care Systems Management i.e. DCPS-HCSM course and for ensuring Quality Management Systems throughout the College.
   
4. Workshop Management Unit: Responsible for looking after the administrative aspects of organization and scheduling of workshops for the Trainees and Trainers.
   
5. Special Project Unit: Responsible for the collaborative projects under Joint Program Review Mission (JPRM) of W.H.O and Ministry of Health (MoH), and the projects for other donor agencies. It has worked for several years on Reproductive Health Project of the World Bank and is presently working on Continuing Medical Education (CME) and Monitoring and Assessment of Postgraduate Training.
   

ACTIVITIES OF THE DEPARTMENT

GENERAL ACTIVITIES:

Teacher Training
The primary aim of teacher training activity has been to create awareness of educational concepts among the teachers of health sciences throough workshops. The centre has also been actively involved in creating and developing a pool of educators trained in educational methodologies and the art of facilitation. These educators are in turn responsible for developing a Medical Education Cell in their respective medical institutes.

Training of Examiners of Supervisors
The department has been instrumental in improving the postgraduate training and evaluation for the fellowship examination of CPSP. The training program of all specialties are new competence based and have well defined objectives Mandatory Workshops for Supervisors and examiners are to be attended  order to become a supervisors / examiner. The centre trains the examiners in the new techniques whenever a change is introduced in the system.

Training of Post Graduates
The postgraduate trainees of the college are made to attend the workshops during their training periods with the aim to train the candidates in difference aspects to help them improve their skills and to facilitate in research.

Curriculum Development
The Department is involved in providing guidance and advice to the members of the CPSP specialist faculties in reviewing the objectives and duration of training. The curricula are being reviewed and revised to make them more structured, standardized and up to date with international trends.

Student Assessment
The faculty of the centre is actively involved in improving the quality of certifying the examinations administered by the college.

Monitoring
The Centre assists the Research Training and Monitoring Cell of the CPSP in maintaining record of the fellowship trainees in various specialties. The WHO Collaborating Centre has developed accreditation criteria and forms for monitoring the fellowship training programs. The forms that have been developed include assessment of trainees by the trainer and assessment of training by the trainees. 

Research and Development

Continuing Medical Education
CME is vital for maintaining and improving the quality of work done by health personnel. The Department is currently involved in developing a system of continuing medical education for implementation nationally.The department in this context conducted a 3-day workshop each in Karachi and Lahore to develop National CME Policy and strategic guidelines in the month of July ,2003

Development of Teaching / Learning Maternal
The Department has been very active from the beginning in the development of various teaching / learning material required in the context of workshops. This includes flow sheets, handouts, charts, slides, videos etc.

Faculty Development
Since its inception DME has been sending faculty member of undergraduate and postgraduate medical institution on WHO fellowships. This setup has been taken in an effort to develop faculty trained in the science of education. These faculty members were sent to educational centers atat Bahrain , Egypt and Sudan in the Emro region and at Dundee (Scotland) and Chicago (USA) outside the region.

Technical Support
The department is extending help in developing Educational Development Cells (EDCs) in different Medical Colleges / Institutions within the country the department provides these EDCs with technical support in the form of facilitators and teaching learning materials.

Publications
Perspective, a quarterly newsletter for educator of health science since 1992.It covers the activities of DME as well as all the activities taking place under WHO's various programmes.It is as 8-12 page News letter brought out under the guidance of WHO coordinator and the Director DME.

Bulletin
The centre provides reports of all the activities conducted at the various CPSP offices to the Bulletin, which is the official monthly magazine of the CPSP.

SPECIFIC ACTIVITIES

Overview of activities conducted by the Centre 1996 - 2003

The WHO Collaborating Centre has succeeded in establishing its credibility as an educational resource. It has been actively involved in developing postgraduate curricula, designing a system of monitoring for ensuring quality of the training programs, providing technical guidance to the specialist faculties in developing standards and processes for accrediting training institutions.  It has played a major role in instituting quality assurance procedures in the postgraduate examinations. Major changes have taken place in the assessment methods utilized by the postgraduate exams.  In the part I examinations true false questions with negative marking have been replaced by one best questions and negative marking has been abolished. In final fellowship examinations the long essays have been replaced by  short essay questions and the staff of the centre conducted special training sessions for the item developers/assessors of the CPSP written and clinical examinations. 

Along with improving PGME the staff of the centre worked to sensitize the teachers of undergraduate medical and nursing education about the new tends in educational practices.  It also conducted training programs to equip the teachers with the requisite knowledge and skills for improving existing programs and developing innovative curricula. By these efforts it has created a large group of teachers aware not only of the need for change but also equipped to bring about the change when institutionalized. 

In the next few years the Centre plans to adopt a more active role in bringing and sustaining changes in education of health professionals.At the international front the Centre has assisted in improving educational practices by conducting faculty development programs. These have been held inSaudi Arabia, Nepal and Bangladesh. It is planned to take the activities further and increase the number of activities as well as offer technical expertise to the EMR countries in the areas of assessment and monitoring of training.

Details of activities    

For Postgraduate programs

1. Developing competence-based curricula for the educational programs at postgraduate level.

2. Creating awareness amongst the supervisors/trainers of PGprograms about the new trends in PG ME.

3. Increasing the capacity of the medical teachers to act as supervisors of PGME.

4. Instituting procedures for gauging the achievements of educational objectives during training.

5. Developing monitoring tools for keeping track of training activities and progress of candidates as per requirement.6. Developing standards and
    criteria for accrediting training institutes for PG training.

7. Developing procedures for carrying out an accreditation process. 

8. Improving the examination systems of the CPSP by introducing QA    procedures.

9. Training question developers into writing test items of a good standard for both theoretical and clinical examinations.

10. Developing a bank of new test items namely one best multiple choice questions and extended matching questions.

11. Performing post examination analysis and providing feedback to items writers for improvement.

The above-mentioned were achieved through a series of conferences, workshops and meetings of the specialists, supervisors, assessors, and heads of training institutions and trainees of the postgraduate educational programs.  The activities conducted included:

a) Conference on Issues involved in Postgraduate Medical Education in March 1999 .

b) Conference on Towards Quality Assurance in Medical Education in March 2000.

c) A series of meetings with supervisors and trainees of postgraduate  programs in various  disciplines for developing strategies for implementing
    the recommendations of the above mentioned in 1999 – 2003.      

d) Development and pilot testing of feedback / monitoring forms to the trainees and supervisors and its analysis.

e) Item development workshops for strengthening the item bank of the CPSP

f)  Meetings to discuss the Post-hoc analysis reports of the items after each examination

Through these activities the department was able to bring the following  outputs

i. Revision of all the curricula for training towards fellowship leading to an increase in duration  of training and increased structuring of the program

ii. Revision of logbook and introduction of annual summary sheets to keep record of trainees progress during training

iii. Abolition of negative marking in true false examination

iv. Replacement of true false MCQs with one-best MCQs and extended matching questions testing higher levels of cognition

v. Replacement of long essay questions with short essay questions

vi. Introduction of analytic scoring in written examinations

vii. Abolition of traditional table viva from the postgraduate final examination

viii. Introduction of structured test of clinical skills with structured viva 

One of the objectives of establishment of the Collaborating Center is research in the field of medical education. In July, 2003 a pre-testing of the world health survey was conducted in collaboration with the Ministry of Health and the Pakistan Medical and Research Council.

In continuation of the WHS work the Director of the Centre visited the Abidjan to participate in the inter-regional workshop in September 2002.  The Centre will participate in the detailed WHS.

           RoleOf the Department of Medical Education in assisting WHO in conducting training                          courses and workshops in the following areas.

Areas of Particular Strength  

a.         Curriculum Development

1. The staff of the centre provided technical expertise to the content specialists in    developing the following curricula:

-           Curricula for diploma, membership, fellowship and PhD in 54 disciplines 

-           RH curricula for undergraduate medical programs -  funded by the World Bank.

-           RH curriculum for family physicians and postgraduate trainees.- funded by the World
            Bank

-           Psychiatry curriculum using interactive case-based instructional methodology for a
            private sector medical college

-           Curricula for health workers at the primary care level (already  mentioned).

2. Capacity building of the educators to develop and implement innovative curricula. This was done by conducting workshops of 3-6 days by the Centre. 

b.         Instructional Design

Improving the instructional design is a main objective of the workshops titled "Educational Planning and Evaluation" and "Teaching Skills" in which the participants are made aware of teaching learning methodologies and principles of learning and how they can best be used in our local settings.

c.         Examination and Assessments

The Centre has been directly involved in bringing about changes in the examination and assessment by the introducing more reliable and objective methods, procedures and processes at the postgraduate level.  Prior to July 1999 both the papers comprised of multiple true false type of questions. However in the light of best evidence educational practice changes were suggested by the Centre to the CPSP Council and one-best type of MCQs and extended matching questions were introduced with the approval of the Council. A landmark change was the abolition of negative marking from the objective examination.  The next change was in theory papers where the centre proposed short essay questions instead of long essays and use of analytical scoring.  Both the proposals were accepted by the CPSP Council and the changes made.

As the third stage of improving examinations the Center proposed introduction of structured and objective examination in clinical exams.  The College introduced the proposed task-oriented assessment of clinical skills with structured viva replacing the traditional viva. 

The Centre has been instrumental in introducing QA procedures for standardization of the assessment of postgraduate qualification. The procedures include:

d.       Research in Medical Education

The Department of Medical Education provides a platform for research and brings together physicians, surgeons and other specialists periodically for scientific discussion. It assists the CPSP in holding national and international conferences, moots and periodical joint meetings with overseas sister institutions. These meetings and scientific discussions culminate in useful and beneficial gains for the medical professions of the countries involved. 

The Department of Medical Education has established a research unit in June 2003 headed by an expert in research in the unit.

 [Go Top]

[Go Top]