ABSTRACT

Background

Investments in training physician specialists through postgraduate medical education (PGME) are critical for Sub-Saharan Africa, given the increasing burden of non-communicable diseases.

Objectives

The objectives of this scoping review were to (1) understand the breadth of publications on PGME from Sub-Saharan Africa, and (2) conduct a thematic analysis of lessons learned by specific training programs.

Methods

We conducted a literature search of 7 databases for PGME literature published between January 1991 and December 2016. Two reviewers independently reviewed titles and abstracts for inclusion. Full-text articles were then reviewed, and bibliometric data were extracted to create a profile of PGME-related publications. Two authors coded the manuscripts to identify articles written about specific PGME programs. These were analyzed for lessons learned.

Results

We identified 813 publications that reported on postgraduate medical education in Sub-Saharan Africa. Most articles were published between 2005 and 2016. Nations leading in publication were South Africa and Nigeria, followed by Ethiopia, Uganda, Kenya, Ghana, and Malawi. The largest number of articles related to general surgery training, followed by family medicine, emergency medicine, and anesthesiology. Thematic analysis revealed advantages of training programs for health facilities, challenges related to teaching, resourcing, and standardizing of training, and lessons learned related to international partnerships, faculty engagement, and research support for trainees.

Conclusions

PGME in Sub-Saharan Africa has evolved over the past 26 years. Future growth will require strategic support to scale programs, support new specialties, trainees, and teachers, and leverage best practice models to sustain PGME programs.

ABSTRACT

Background

With increasing physician mobility, there is interest in how medical schools and postgraduate medical education institutions across the world develop and maintain the competence of medical teachers. Published reviews of faculty development (FD) have predominantly included studies from the United States and Canada.

Objective

We synthesized the international FD literature (beyond the US and Canada), focusing on FD type, intended audience, study format, effectiveness, differences among countries, and potential unique features.

Methods

We identified English-language publications that addressed FD for medical faculty for teaching and related activities, excluding US and Canadian publications.

Results

A search of 4 databases identified 149 publications, including 83 intervention studies. There was significant growth in international FD publications for the most recent decade, and a sizable number of studies were from developing economies and/or resulted from international collaborations. Focal areas echo those in earlier published reviews, suggesting the international FD literature addresses similar faculty needs and organizational concerns.

Conclusions

The growth in publications in recent years and a higher proportion of reporting on participant reactions, coupled with less frequent reporting of results, transfer to practice, and impact on learners and the organization, suggest this is an evolving field. To enhance international FD, educators and researchers should focus on addressing common needs expressed by faculty, including curriculum design and evaluation, small group teaching, assessing professionalism and providing feedback. Future research should focus on approaches for developing comprehensive institutional FD programs that include communities of learning and practice and evaluating their impact.

ABSTRACT

Background

Adolescent medicine (AM) has been increasingly recognized as critically important to the health of individuals during their transition to adulthood. On a global scale, AM is often underprioritized and underfunded. In low- and middle-income countries (LMICs), education and AM training is developing, and AM physicians often are from general medicine backgrounds.

Objective

The objective of our scoping review was to identify existing training curricula and educational tools designed to teach AM skills to health care workers in LMICs.

Methods

We followed PRISMA guidelines for scoping reviews for article identification and inclusion. Online databases, including MEDLINE, Embase, CINAHL, and Scopus, were used to identify papers. We included studies that took place in a LMIC, were available in English, and described any of the following: published educational curricula in AM, education-based intervention for HCWs that focused on AM, or a training opportunity in AM located in a LMIC.

Results

Our review includes 14 publications: 5 published curricula and 9 articles describing educational interventions or training opportunities in AM in LMICs. Curricula were relatively consistent in the topics included, although they varied in implementation and teaching strategies. The scholarly articles described educational materials and identified a number of innovative strategies for training programs.

Conclusions

Our review found existing high-quality AM curricula designed for LMICs. However, there is limited published data on their implementation and utilization. There is a continued need for funding and implementation of education in AM in resource-constrained settings.

A National Process to Enhance the Validity of Entrustment Decisions for Dutch Pediatric Residents

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Rip Out Action Items

International collaborators can start now to:

Develop an idea and formulate an internationally relevant research focus.
Understand varied international institutional review board requirements.
Embrace technology to communicate, create, share, and store work.
Consider successful group dynamics for effective collaboration.

International collaborators, in the long term, should aim to:

Schedule team meetings at international medical education conferences to disseminate work and engage future collaborators.
View international collaboration as a unique opportunity to explore multinational funding opportunities, engage a diverse team, and enrich outcomes.
Pay it forward to find personal fulfillment.

The Challenge

Globalization of medical education has

Rip Out Action Items

Clinical competency committees (CCCs) should:

Select CCC members invested in learner growth and development through evidence-based assessments.
Create a shared mental model of competency framework and periodically recheck.
Map current assessment tools to the milestones and identify gaps.
Ensure that all residents are deliberately discussed during CCC meetings.
Provide milestone data to the Program Evaluation Committee to support a review of curriculum and teaching.

The Challenge

Assessment of learners using a multifaceted approach is an essential component of the graduate medical education (GME) system across the globe. Clinical competency committees (CCCs) are expected to