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OBE what and how to apply in Vietnamese FM training

Details: Category: English; Published on Tuesday, 03 January 2012 08:14; Written by Super User; Hits: 23

OBE what and how to apply in Vietnamese FM training

Pham Le An MD, Ph.D

Director of Center for Family physician training.

For a long time, in the curriculum of medical school we have to teach what our future with the limited of teaching and learning resources. This problem cans influent to the quality of health care services. So outcome base education was one of the choices in the way to renovate the medical curriculum in the 21^st century.

The shift toward outcome-based education is analogous to the total quality movement in business and manufacturing. It reflects a belief that the best way for individuals and organizations to get where they're going is first to determine where they are and physician has to practice. That means the more real teaching problem the more valuable health care provider will be. Curriculum renovation always becomes the trend that every educator have to follow, in 21^st century we have to deal with the impact of global change in the local need, the irony situation is that many of new content is conflictwhere they want to be--then plan backwards to determine they best way to get from here to there. Proponents of the outcomes approach in education assume there are many ways to arrive at the same results: the important thing is that states, districts, schools students do, in fact, achieve them. Opponents worry about who will decide on outcomes and how students, school and districts will be held accountable for achieving them. Much confusion about terminology and concepts arises when educators try to apply this concept into their curriculum renovation. [1]

Common Arguments in Favor of Outcome-Based Education	Common Arguments Against Outcome-Based Education
Promotes high expectations and greater learning for all students	Conflicts with admission requirements and practices of most colleges and universities, which rely on credit hours and standardized test scores
Prepares students for life and work in the 21st Century	Some outcomes focus too much on feelings, values, attitudes and beliefs, and not enough on the attainment of factual knowledge.
Fosters more authentic forms of assessment.	Relies on subjective evaluation, rather than objective tests and measurements
Encourages decision making regarding curriculum, teaching methods, school structure and management at each school or district level.	Undermines local control.

Source [1]

Outcome-based education (OBE) is a recurring education reform model. It is a student-centered learning philosophy that focuses on empirically measuring student’s performance, which is called outcomes.Under the OBE model, education agencies may specify any outcome (skills and knowledge), but not inputs (field trips, arrangement of the school day, teaching styles). OBE was a popular term in the United States during the 1980s and early 1990s. It is also called standards-based education reform, mastery education, performance-based education, and other names. Outcome-based methods have been adopted in significant ways in the United States, Australia, South Africa, Hong Kong, and other countries. (Wikipedia)

Outcome- based education include of curriculum framework that help to defining clear, high standards which will be achieved by all students and rubric assessment that is an attempt to delineate consistent assessment criteria. Medical educators also like to use criterion references test for the performance’s assessment.

Writing appropriate and measurable outcomes can be very difficult, and the choice of specific outcomes is often a source of local controversies. Besides, setting up the appropriate cut-off point of the criterion reference test is still a touch question for medical educators.

How to solve these problems:

1. Need a multidiscipline cooperation with the medical educator and use evidence based approach to build up the appropriate and measurable outcomes that will be triangulated with needs assessment and accuracy prediction in health care services. Try to use intermediate outcome than long term outcome. Video conferencing promise the good solution for good communication among educators and the other disciplines such as government sectors.

2. Mentorship and relationship center care should be good for outcome based education.

2. Besides Angoff’s and Brenant’s method, Items respond theory with Rash’s model promise the good method to point out accuracy the cut-off point of criterion references test for assessing performance.

In Vietnam, focus in Family medicine training we try to build up the core blue print and test blue prints for active teaching method, combine both formative and summative assessment. The curriculum renovation to OBE is a big challenge to our training program due to our time based curriculum.

Reference:

Education Commission of the States. (1995, January). "Outcome-based" education: An overview. Denver, CO: Author.
Stephen E. Weil, Outcome-based Evaluations In My Opinion Board Member, The periodical for members of the National Center for Non-profit Boards (posted 6/97)
OBE, Wikipedia.
Luu Ngoc Hoat, Nguyen Minh Son,E Pamela Wright; Perceptions of graduating students from eight medical schools in Vietnam on acquisition of key skills identified by teachers; BMC Med Educ. 2008; 8: 5.
Hoat LN, Yen NB, Wright EP. Participatory identification of learning objectives for medical students in eight medical schools in Vietnam. Medical Teacher. 2007;29:683–690.
Hoat LN, Dung DV, Wright EP. Practicing doctors' perceptions on new learning objectives for Vietnamese medical schools. BMC Med Educ. 2007;7:19
Christensen L, Karle H, Nystrup J; Process-outcome interrelationship and standard setting in medical education: the need for a comprehensive approach; Med Teach. 2007 Sep;29(7):672-7
Harden RM; Outcome-based education--the ostrich, the peacock and the beaver; Med Teach. 2007 Sep;29(7):666-71
Schwarz MR, Wojtczak A, Stern D The outcomes of global minimum essential requirements (GMER) pilot implementation in ChinaMed Teach. 2007 Sep;29(7):699-705
Stern DT, Friedman Ben-David M, Norcini J, Wojtczak A, Schwarz MR; Setting school-level outcome standards; Med Educ. 2006 Feb;40(2):166-72
Howley LD, Performance assessment in medical education: where we've been and where we're going. Eval Health Prof. 2004 Sep;27(3):285-303
Jonh P Keeves; Educational research methodology and measurement; Pergamont Press, 1988; p365-392.

Integrate the issue of global health in FM curriculum: promising solution for improving the quality of Primary care in Hochiminh city, Vietnam

Details: Category: English; Published on Tuesday, 03 January 2012 08:12; Written by Super User; Hits: 66

Integrate the issue of global health in FM curriculum:

promising solution for improving the quality of Primary

care in Hochiminh city, Vietnam

Pham Le An MD, Ph.D

Associate Professor Pediatrics

Director of Center for Family physician training

University of Medicine and pharmacy Ho Chi Minh city Vietnam

The need to improve the quality of care in health care in developing countries to match with the standard of care in developed countries is truth, primary care is the strategy to reach that aims. How to balance the gap between the help from developed countries and the need of health care in developing countries in the context of limited resources? In the world, Primary health care now change to primary care for reach the aims the health to all in reality, so global health will be the promise solution to exchange the experiences in research, teaching, consulting from developed countries to developing countries due to their core common problems like non chronic care (focus on non communicable diseases), neonatal care, traumatism care, disaster care…

Now in the global health care system, the concept of “International health” is changed to “Global health”. What and Why?

1. Global health is a field at the intersection of several disciplines--epidemiology, economics, demography and sociology--that is concerned with international health issues. The term global health, as opposed to International Health, implies consideration of the health needs of the people of the whole planet above the concerns of particular nations (Wikipedia). That means global health have wide scope and reach to equity that the term of international health.

Let take a look at the global situation that have been aware of the concept “global health” in Family Medicine:

v Increase the gap between the poor and the rich globally.

v Both rich and poor population have to deal with the same risk of health due to the phenomena of traveling and immigration

v The process of the urbanization/globalization

v Increase of the population in the world

v Decrease of the resources for health care

v Global warming phenomena

v Vaccination Era

v Apply Evidence Based Medicine in daily practice

v Increase the bad behavior such as fast food, tobacco, stress, use alcohol…

v Primary health care change to Primary care concept

2. The need of Primary care in Ho Chi Minh city is prominent now due to:

Ø The gap between urban care and rural care in the health care network.

Ø The competition among specialties: lack of cooperation in chronic care => increase the cost of management.

Ø The overloading phenomena of patients at central health care level

Ø Barrier in teaching ambulatory care and doing the out-patient’s research in our university.

The solution is to prepare the manpower focus in primary care such as Family physician training system. That means Family physicians can cooperate with another specialties as Pediatrics, Obs-Gyns to provide primary care services.

3. How to deal with the new issue “Global health” in FM’s training curiculum?

InVietnamwe established our health care network more than 40 years and the new specialty: Family medicine (2003). Family physician play the important role in primary care so we have to include the topic “Global health” into Medical Doctor and Family Physician’s training curriculum for being sure about the quality of “primary care”. Such as:

Clerkship:

v Subject (Global health Awareness) => Knowledge (- Burden global disease in the world : TB, malaria , Preventive care: vaccination), Skills ( Clinical making decision, Communication), Attitudes (Accept to build up the relationship center care among different specialties)

Orientation:

v Subject (Global health Awareness) => Knowledge ( Burden global disease in the world: new emerging infectious disease like SARS, hand foot mouth disease; non communicable diseases, traumatism care, HIV/AIDS), Skills ( Clinical making decision, Communication), Attitudes (Accept to build up the relationship center care among different specialties)

Residents

v Subject (Global health) => Knowledge (Burden global disease in the world: prenatal care, neonatal care, Preventive care: vaccination for family; Chronic care, mental health care, adolescent care, Emergency care in disaster), Skills ( Do research and practice Emergency care in disaster, Behavioral care after disaster, , Kangoroo’s program, IMCI program, NCD program, Obs-Gyn care program), Attitudes (Accept to build up the relationship center care with WIN- WIN theory for both developed and developing countries => increase of cooperation = Team work)

In addition, We need to build up the cooperation among the expert in medical field at local and international level for teaching, managing, doing research with the win-win strategy that help to promote the concept “relationship center care”. How to teach this in our Center? In our curriculum, we try to develop the module to teach the concept “Relationship center care” in the process of chronic care, end of life care, neonatal care, palliative care, disaster care…through our activities such as Continue Medical Education, the patient’s club. That means we building the bridge or integrate the teaching contents in Family Medicine with the other specialties like Pediatrics (IMCI program, Kangoroo ‘ s program for taking care of low birth weight neonate ), Traditional Medicine ( Oriental nutrition, Shiatsu), Cancerology/ Traditional Medicine (Palliative care), Multidiscipline (Disaster care, Evidence based Medicine, End of Life care, Chronic care). The activities of panel expert from different specialties that leading by Family physician like to give the advice or consultant to help patient maintain their health. The residents can learn more about the skill of Communication and Negotiation or the attitude of “Accept to build up the relationship centered care among specialties” when they join in this kind of activities in the CME and patient club.

However, the lack of up to date information in this field and sharing the experiences of the expert from developed countries on time will be the barrier for teaching “ global health” in HCM city. So the ADSL with video conferences and Electronic medical Family medicine record promise the good solution for solving:

• The gap in the information among developed and developing countries

•In time/ good reaction to new accidents.

•Long distance learning for developing residents

• National and International training course/team research on Medical issues.

•Cost effectiveness and good quality of teaching.

Videoconferencing and EMR based on web are useful technologies for practice & teaching Family Medicine in the 21^st century at global level.

4. Conclusion:

Global health, the new issue will be added in the medical curriculum with the support of videoconferences and EMR on web that make Family physicians more focus in relationship center care. That will be a promising solution and will improve the quality of Primary care with good cost effectiveness.

References:

Carol P. Tresolini, Report of the pew-fetzer task force on advancing psychosocial health education, health professions education and relationship-centered care, 1994.
Margaret Chan & coll, The World Health report 2007, a safer future global public health security in the 21^st century.
Luu Ngoc Hoat, Nguyen Minh Son,E Pamela Wright; Perceptions of graduating students from eight medical schools in Vietnam on acquisition of key skills identified by teachers; BMC Med Educ. 2008; 8: 5.
Hoat LN, Yen NB, Wright EP. Participatory identification of learning objectives for medical students in eight medical schools in Vietnam. Medical Teacher. 2007;29:683–690.
Hoat LN, Dung DV, Wright EP. Practicing doctors' perceptions on new learning objectives for Vietnamese medical schools. BMC Med Educ. 2007;7:19
Jonh P Keeves; Educational research methodology and measurement; Pergamont Press, 1988; p365-392.
Alain J. Montegut, Primary Care Is Important for Africa, The Journal of the American Board of Family Medicine 21 (2): 170- (2008)
Alain J. Montegut, The Power of Primary Care for the Future of health care: Is Family Medicine the Answer?1st International PHC Conference Doha, Qatar 1 - 4 November 2008
Pham le An, Introducion FM concept: global healh, texbook of Family medicine, Vietnamese version, Medicine Publisher, 2009.
Pham Le An, Global health perspective in Vietnam, A “Train the Trainer’s Workshop” WONCA ASIAN PACIFIC Vietnam Ho Chi minh city 2008
Pham Le An, Building the bridge of global demands and local needs: its effect on education and health human resources in Vietnamese Family physician training. WONCA ASIAN PACIFIC Hongkong 2009

Développement de la médecine familiale au Vietnam

Details: Category: English; Published on Wednesday, 21 December 2011 05:04; Written by Super User; Hits: 34

Développement de la médecine familiale au Vietnam
http://fr.vietnamplus.vn/Home/Developpement-de-la-medecine-familiale-au-Vietnam/201010/11978.vnplus Développement de la médecine familiale au Vietnam 26/10/2010 | 20:56:35

Building the bridge of global demands and local needs: its effect on education and health human resources in Vietnamese Family physician training

Details: Category: English; Published on Tuesday, 03 January 2012 08:10; Written by Super User; Hits: 65

Building the bridge of global demands and local needs: its effect on education and health human resources in Vietnamese Family physician training

Pham Le An MD, Ph.D

Associate professor Pediatrics

Director of Center for Family physician training

UniversityofMedicineand pharmacy HCM Vietnam

Now in the global health care system, the concept of “International health” is changed to “Global health”. What and Why?

Let take a look at the situation that have been aware of the concept “global health”:

*Situation*	*Problems*	*Events*	*Results*
*Society*	Increase the gap between the poor and the rich globally. Both rich and poor population have to deal with the same risk of health due to the phenomena of traveling and imigration	In developing countries: Child health care: high neonatal mortality. Energy --malnutrition Infectious disease - Emerging new disease such as H5N1, hand foot mouth disease.. - Bacteria resistant of antibiotic: TB, SRSA... - outbreak of cholera, H5N1	Threats to global public health security [2] Need to collaborating at global level. Need to share experiences and information as soon as posible at global health
	Urbanization/globalization	Problem of developed countries : Chronic disease care like HTA, Diabetes type II, Cancer	Increase the economical burden.
	Increase of the population Decrease of the resources for health care	Problem of cost effectiveness Overload at central health care level	Need to improve the quality of care in provincial and district level
*Environment*	Global warming phenomena	Change the climate => increase of disaster	Increase the need of emergency rescues in disasters Increase the outbreak of tropical disease: DHF, cholera Increase the trouble of psychology after –disaster
*Scientific*	Vaccination Era Evidence Based Medicine	More new vaccine then new antibiotic every year Vaccines prevent cancer such as Hepatitis B, HPV…. To master the medical information and apply them daily to health care.	Strategy expanded vaccination to all the member in the family Increase the cost effectiveness and improve the quality of health care services
*Behavioral science*	Bad behavior => fast food, tobacco, stress	Outbreak of: Metabolic diseases, COPD/asthma Depression	Need to changing bad behavior
Health care philosophy	Primary health care change to Primary care	Family physician network help to improve the quality of health than specialties network	Relationship center care

2. Impact of Global health to the local health care’s needs in HCM city:

Ø The gap between urban care and rural care in the health care network.

Ø Competition among specialties: lack of cooperation in chronic care => increase the cost of management.

Ø Overloading at central health care level

Ø Barrier in teaching ambulatory care and doing the out-patient’s research.

Global health

Family Medicine concept

Old approach

Multi-tasks approaches in one places: mother care, children care, dental care, chronic care..

Match to this totally in the health care network

New approach

Multidiscipline approaches

Need to change to relationship centered care

Solution: need to prepare the manpower follow the trend of primary care such as Family physician training system.

2.1 Build up the cooperation among the expert in medical field at international level: teaching, managing, does research with the win-win strategy => promote “relationship center care”

2.2 Teaching “Relationship center care” through the patient club in the chronic care:

Building the bridge/ intergration

Pediatrics

Traditional Medicine

Multidiscipline

Cancerology

Traditional Medicine

Family Medicine

IMCI program

Kangoroo ‘ s program

take care of low birth weight neonate

Oriental nutrition

Shiatsu

Disaster care

Evidence based Medicine

End of Life care

Chronic care

Palliative care

Activities

Content of knowledge

Skill

Attitude

Patient club and Panel expert from different specialties that leading by Family physician

Give the advice or consultant to help patient maintain their health

Communication

Negotiation

Accept to build up the relationship centered care among specialties

3. How to deal with the new issue “Global health” in FM’s training curiculum?

Trainees

Subject

Knowledge

Skills

Attitudes

Clerkship

Global health

Awareness

- Burden disease in the world : TB, malaria

- Preventive care: vaccination

- Clinical making decision

- Communication

Accept to build up the relationship center care among diferent specialties

Residents

Global health

- Burden disease in the world : TB, malaria, bacteria resistance

- Preventive care: vaccination for family

- Emergency care in disaster

Do research

Emergency care in disaster

Behavioral care after disaster

Team work

Kangoroo’s program

IMCI program

Accept to build up the relationship center care with WIN- WIN theory for both developed and developing countries => increase of cooperation

• The gap in the information among developed and developing countries

•In time/ good reaction to new accidents.

•Long distance learning for developing residents

• National and International training course/team research on Medical issues.

•Cost effectiveness and good quality of teaching.

Videoconferencing is a very useful technology for practice & teaching Family Medicine in the 21^st century at global level.

4. Conclusion:

Global health, the new issue will be added in the medical curriculum with the support of videoconferences that make Family physicians more focus in relationship center care. That will be a promising solution and will improve the quality of Primary care with good cost effectiveness.

References:

Carol P. Tresolini, Report of the pew-fetzer task force on advancing psychosocial health education, health professions education and relationship-centered care, 1994.
Margaret Chan & coll, The World Health report 2007, a safer future global public health security in the 21^st century.
Luu Ngoc Hoat, Nguyen Minh Son,E Pamela Wright; Perceptions of graduating students from eight medical schools in Vietnam on acquisition of key skills identified by teachers; BMC Med Educ. 2008; 8: 5.
Hoat LN, Yen NB, Wright EP. Participatory identification of learning objectives for medical students in eight medical schools in Vietnam. Medical Teacher. 2007;29:683–690.
Hoat LN, Dung DV, Wright EP. Practicing doctors' perceptions on new learning objectives for Vietnamese medical schools. BMC Med Educ. 2007;7:19
Jonh P Keeves; Educational research methodology and measurement; Pergamont Press, 1988; p365-392.

International Conference on Education in the Health Sciences

Details: Category: English; Published on Wednesday, 21 December 2011 03:32; Written by Super User; Hits: 31

International Conference on Education in the Health Sciences
(ICEHS) slated on October 1-3, 2008
Written by Louise Ian de los Reyes
Friday, 19 September 2008 01:01 - Last Updated Monday, 29 September 2008 16:50