TY - JOUR
T1 - Lessons learnt from comprehensive evaluation of community-based education in Uganda
T2 - A proposal for an ideal model community-based education for health professional training institutions
AU - Kaye, Dan K.
AU - Muhwezi, Wilson W.
AU - Kasozi, Ann N.
AU - Kijjambu, Steven
AU - Mbalinda, Scovia N.
AU - Okullo, Isaac
AU - Nabirye, Rose C.
AU - Oria, Hussein
AU - Atuyambe, Lynn
AU - Groves, Sarah
AU - Burnham, Gilbert
AU - Mwanika, Andrew
N1 - Funding Information:
The authors extend their gratitude to the leadership and all staff of the health training institutions as well as the health facilities where community-based education is conducted, the community members and alumni of the training institutions who participated in the evaluation. This assessment was part of activities to evaluate the service, learning and research contribution of Makerere to the community. This project: Partnership for building the capacity of Makerere University to improve priority health outcomes in Uganda is funded by the Makerere University Johns Hopkins University Learning Grant from Bill Gates Foundation.
PY - 2011
Y1 - 2011
N2 - Background: Community-based education (CBE) can provide contextual learning that addresses manpower scarcity by enabling trainees acquire requisite experiences, competence, confidence and values. In Uganda, many health professional training institutions conduct some form of community-based education (CBE). However, there is scanty information on the nature of the training: whether a curriculum exists (objectives, intended outcomes, content, implementation strategy), administration and constraints faced. The objective was to make a comprehensive assessment of CBE as implemented by Ugandan health professional training institutions to document the nature of CBE conducted and propose an ideal model with minimum requirements for health professional training institutions in Uganda. Methods. We employed several methods: documentary review of curricula of 22 institutions, so as to assess the nature, purpose, outcomes, and methods of instruction and assessment; site visits to these institutions and their CBE sites, to assess the learning environment (infrastructure and resources); in-depth interviews with key people involved in running CBE at the institutions and community, to evaluate CBE implementation, challenges experienced and perceived solutions. Results: CBE was perceived differently ranging from a subject, a course, a program or a project. Despite having similar curricula, institutions differ in the administration, implementation and assessment of CBE. Objectives of CBE, the curricula content and implementation strategies differ in similar institutions. On collaborative and social learning, most trainees do not reside in the community, though they work on group projects and write group reports. Lectures and skills demonstrations were the main instruction methods. Assessment involved mainly continuous assessment, oral or written reports and summative examination. Conclusion: This assessment identified deficiencies in the design and implementation of CBE at several health professional training institutions, with major flaws identified in curriculum content, supervision of trainees, inappropriate assessment, trainee welfare, and underutilization of opportunities for contextual and collaborative learning. Since CBE showed potential to benefit the trainees, community and institutions, we propose a model that delivers a minimum package of CBE and overcomes the wide variation in the concept, conduct and implementation of CBE.
AB - Background: Community-based education (CBE) can provide contextual learning that addresses manpower scarcity by enabling trainees acquire requisite experiences, competence, confidence and values. In Uganda, many health professional training institutions conduct some form of community-based education (CBE). However, there is scanty information on the nature of the training: whether a curriculum exists (objectives, intended outcomes, content, implementation strategy), administration and constraints faced. The objective was to make a comprehensive assessment of CBE as implemented by Ugandan health professional training institutions to document the nature of CBE conducted and propose an ideal model with minimum requirements for health professional training institutions in Uganda. Methods. We employed several methods: documentary review of curricula of 22 institutions, so as to assess the nature, purpose, outcomes, and methods of instruction and assessment; site visits to these institutions and their CBE sites, to assess the learning environment (infrastructure and resources); in-depth interviews with key people involved in running CBE at the institutions and community, to evaluate CBE implementation, challenges experienced and perceived solutions. Results: CBE was perceived differently ranging from a subject, a course, a program or a project. Despite having similar curricula, institutions differ in the administration, implementation and assessment of CBE. Objectives of CBE, the curricula content and implementation strategies differ in similar institutions. On collaborative and social learning, most trainees do not reside in the community, though they work on group projects and write group reports. Lectures and skills demonstrations were the main instruction methods. Assessment involved mainly continuous assessment, oral or written reports and summative examination. Conclusion: This assessment identified deficiencies in the design and implementation of CBE at several health professional training institutions, with major flaws identified in curriculum content, supervision of trainees, inappropriate assessment, trainee welfare, and underutilization of opportunities for contextual and collaborative learning. Since CBE showed potential to benefit the trainees, community and institutions, we propose a model that delivers a minimum package of CBE and overcomes the wide variation in the concept, conduct and implementation of CBE.
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U2 - 10.1186/1472-6920-11-7
DO - 10.1186/1472-6920-11-7
M3 - Article
C2 - 21362181
AN - SCOPUS:79952094730
SN - 1472-6920
VL - 11
JO - BMC medical education
JF - BMC medical education
IS - 1
M1 - 7
ER -