Action Plan Implementation PBL in rest of

Action Plan Implementation

PBL in rest of the departments By: Associated Prof. Maqsoud Stanikzai MD Department of Pathology, KMU Dean of Curative Faculty December 2006

Background • Paraclinic subjects are taught in 1 st, 2 nd and 3 rd class completely, and beside that some subjects in classes 4 th and 5 th are also included. • PBL has been already implemented in 1 st class, and now we are going to implement it into the 2 nd class.

Aims • PBL is useful to facilitate self-directed learning • Students will integrate different aspects of medicine • PBL will motivate group processes • Expand capacity to produce long life learning

Weaknesses • Resources – Tutors, staffs – Rooms – Library, text books • Low experience

Goal • Improvement of education system Objectives • • Standardization of teaching method Structuring of lectures in practice Increase motivation for learning The developing of an effective reasoning process

Methods • Scenario writing in Dari language • In the 1 st session, case scenario is distributed, and discussion to determine learning issues • Self-directed learning for a week • In the 2 nd session presentation and further discussion • Tutors facilitate the discussion • 100 minutes /session • 6 cases (12 sessions) /semester

Schedule • 100 students will be divided into 15 groups • Each PBL case has 2 sessions (2 weeks) • 6 cases for each semester (12 weeks) • 3 rooms, 3 tutors will be needed Day Group Saturday 1 -3 Sunday 4 -6 Monday 7 -9 Tuesday 10 -12 Wednesday 13 -15

Implementation Plan • PBL will be started in August 2007 • In the 2 nd semester – August: Edema and congestion cases – September: Inflammation and tumor cases – October: Shock and infarction cases • Tutors from physiology, microbiology, biochemistry, and pathology

Resources • Facilities – Rooms: laboratory rooms for paraclinic • Scenarios – Dr. Stanikzai will write scenarios assisted by Dr. Kamal

Arigato Gozaimasu Thank you Associated Prof. Stanikzai

CBL for all clinical departments By: Prof. Mohammad Salim Tawana MD Head, Department of General Surgery Maiwand Hospital December 2006

Background • Clinical subjects are taught in 3 rd, 4 th, 5 th, and house job (internship) • Lectures 60% • Practical 40% • CBL is a proved teaching method • CBL had been already started in some departments, and now we are going to implement in the rest of the departments.

Case-based Learning (CBL) • 10 students come to the dept for 10 days • Students come to the teaching hospital in a. m. and go to KMU in p. m. every day • 5 th class students have already learned clinical examination skills in 3 rd and 4 th classes • 10 students will work with a case with a tutor to take history, examine patients, and present the findings to the tutor and other students

Schedule Sat AM CBL for thyroi d Sun Mon Tue Wed Thu Fri Sat Sun Mon CBL for Breas t cance r CBL for Hemo pneu moth orax CBL for Esop hage al mass CBL for Lung Hydat id cyst CBL for Varic ose vein of legs Holid ay CBL for Pleur al empy ema CBL for Rib fractu re Evalu ation Surge Other ry Other Free Surge Other ry Surge ry Other PM Surge Other (lec ry tur Other e) Other

Current Clinical Practical • Common cases for thoracic surgery – – – – Goiter Breast cancer Hemopneumothorax Esophageal mass Lung Hydatid cyst Varicose vein of legs Pleural empyema Rib fracture

Weaknesses • Need of resources – Tutor time – Library • Transportation of students and lecturers between hospitals and KMU • Low experience

Goal • Implementation of CBL in education system Objectives • Standardization of teaching method • Integrating lectures into practice • Increasing motivation for learning

Methods • • Patients (cases) Students small groups Clinical tutor Discussion on clinical reasoning and management

Implementation Plan • March 2007 • For 5 th class students • In thoracic surgery department

Arigato Gozaimasu Thank you Prof. Tawana

OSCE for house job (Internship) By: Assistant Prof. Abdul Majeed Hosham MD, DO Eye surgeon, Department of Ophthalmology University Eye Hospital December 2006

Background • House job period in KMU / 48 weeks • MD Diploma history: – Previously Governmental / National Examination (oral and written examinations) – Recently unorganized exam by each dept • OSCE is a new and proved method for clinical skill assessment

Weaknesses • Resistance from old system • Resources – Standardized patients • Low experience • Unreliable assessment

Methods • Time: – February 2008 – End of house job students • 500 House job students • Distribution and Collection: – Dr Hosham, Prof Azizi • Scoring of Questionnaire by EDC administration

Methods Stream 1 Stream 2 Stream 3 Stream 4 Schedule Medical Interview Head & neck, Abdomen Chest & vital signs Neurology 9: 00 -9: 10 1 4 3 2 5 8 2 1 4 3 6 5 3 2 1 4 7 6 4 3 2 1 8 7 9: 11 -9: 21 9: 22 -9: 32 9: 33 -9: 43 9: 50 -10: 00 10: 01 -10: 11

Methods (cont) • Time: 40 minutes/ day, 10 days/year – Interview – Neurological examination – Head, Neck, and Abdomen – Chest, Vital signs 10 minutes

Time Frame • If 13 streams of 4 stations are available, 52 students will finish OSCE in 50 minutes • In one day, 260 students will finish OSCE in 4 hours 10 minutes • KMU will need 2 days to complete all the OSCE

Settings • Broad space (being used for exams) will be separated by partitions into 52 areas • 52 examiners (1 for each station) and several admin staffs (time keeper, etc) • Two cases and manuals for each station will be needed for two-day OSCE • 30 standardized patients will be needed for medical interview. Junior students will do SP for physical examination stations.

Suggestions • Establishment of OSCE committee /EDC • Establishment of OSCE stations • Preparation of a OSCE guide manual

Thank you Hosham

Arigato Gozaimasu

Expansion of EDC capacity By: Prof. Hedayatllah Salihi MD Head, Department of ENT Maiwand Hospital President , EDC/KMU December 2006

Background • • • Established on 2002 Supported by JICA from 2005 Different divisions - Curriculum development department Evaluation and feedback department Postgraduate department Clerical staff

Background (cont. ) • Goals of Establishment of EDC – Better arrangement of academic affairs – Arrangement and observation of teaching methods – Development of education system in KMU – Establishment of relationship between KMU and other universities – Establishment of workshops and seminars for improvement of education system in KMU

Background (cont. ) • EDC Outputs (independently) – Establishment of postgraduate training program – Curriculum revision, development and standardization. – evaluation of lecturers by students

Background (cont. ) • EDC Outputs (with cooperation of JICA) – Establishment of workshops. – Introduction and implementation of new teaching methods in KMU (PBL, CBL and EE) – Implementation of OSCE

Visions • EDC will lead the best medical education in Afghanistan • EDC will expand all the medical education systems within the limitation of current resources

Objectives • Proposal for expansion • Negotiation with Ministry of Higher Education • EDC staff capacity building • Providing needed material (JICA) • Establishment of OSCE committee • Proposal for implementation of OSCE as a new exam method to KMU

Objectives (cont. ) • • Conduct a workshop for OSCE Establishment of OSCE stations Increasing students’ motivation by CBL Publicity for OSCE as a new examination method • Sending more KMU lecturers for Medical education to Japan

Methods • Workshops for EDC personnel • Negotiation with KMU, Mo. HE • Conduction of workshops by EDC and JICA, for lecturers and house job students • Establishment of OSCE station (KMU) • Continuation of JICA project for medical education

Suggestions for JICA • Fund for: – Partitions for OSCE/PBL

Suggestions for KMU • To submit responsibility of implementation of PBL to all Paraclinic departments. • PBL committee should have as a supervisory role. • 1 st and 2 nd grade students should cooperate and participate in clinical practice for creation and motivation of learning (during winter vacation) as Early Exposure. • Having long term expert of Medical Education in KMU.

Arigato Gozaimasu Thank you Prof. Salihi