Professionalism and Emerging needs and demands in Medical Education and Health Care

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Professionalism and Emerging needs and demands in
Medical Education and Health Care

• Mexico City, Feb 29th 2008
• Pablo A. Pulido M.

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Health Policies

• Different approaches,
• Just considering health care to a basic
  Population
• HFA Year 2000, still pending
• Millenium Goals, not completed
• Endemic attention and problem solving
• National Health Care Systems
• Health as a basic building block for Social
  Development
• Others

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Health Policies

• Population and Patient Satisfaction
• Efficient Health Services Delivery
• Financing in place alternatives
• Access and Coverage universal
• Human Resources Planning and Education
• Professional and Stakeholders Satisfaction

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Challenges

• Understanding the Diversity of Contexts of
  Social Health care in Latin America
• 2. Quality and Professionalism in
• Medical Education
• 3. Non clinical Needs and Demands.
• 4. Remembering Edward Demming

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Role of Medical Education

• There are about 2000 medical schools worldwide.
• In the American Continent there are more than
  581 medical schools.
• More than 344 are in Latin America and the
  Caribbean
• Not all of them are accredited Institutions
• Are they providing the needed manpower to make
  the necessary changes to happen?

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Accreditation for Quality Assurance
Global Standards WFME (Copenhagen) IIME (White
Plains, NY), GMER WHO / PAHO ( Geneva
Washington) Hemispheric Standards PAFAMS
PAHO Regional and National Standards National
Associations of Medical Schools NAFTA, Mercosur,
Andean Region, Caricom CAAM-HP, others PAFAMS
INTERNATIONAL PROJECT
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Profesionalismo,

• Algunas Reflexiones

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Profesionalismo en Educación Médica implica

• Conocimiento de la Ciencia Médica
• Básica y Clínica
• Razonamiento clínico, identificación y solución
  de problemas
• Comunicación efectiva con pacientes y con
  fuentes de información veraz.
• Buen juicio, criterio ético e integración de
  datos para la toma de decisiones

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Profesionalismo

• Se demuestra a través de
• experticia en el desempeño clínico,
  comunicacional y compromiso ético
• lo cual se construye con la aplicación sabia
  de principios de excelencia, humanismo,
  corresponsabilidad y altruismo.
• Cumplir el contrato social médico

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Que es un profesional?

• Domina conocimientos y destrezas
• Tiene derechos y deberes específicos
  generalmente no presentes o adjudicados en el
  público.
• Tiene responsabilidades y deberes que no se
  esperan del público en general, son específicos.

Cruess and Cruess 2000 David Stern
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Como se enseña?

• El profesionalismo se transmite en el
  curriculum subyacente , lecturas y
  escritos..repitiéndolos..?
• Esto no quiere decir que es la mejor manera de
  enseñarlo
• Aprendizaje y seguimiento de normas, reglamentos
  y rutinasbien establecidas..permanentemente
  revisadas
• El profesionalismo se transmite a través de
  conflictos, ejemplos de conducta, Ortega y Gasset
  y parábolas, evangelio..
• Es la mejor manera de enseñarlo?
• Cómo medirlo?

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Profesionalismo Autoridad y Liderazgo

• Conocimientos, destrezas, humanismo,
  corresponsabilidad y actitudes éticas
• Toma de decisiones con pleno conocimiento de
  causa, sin improvisaciones
• Hacer que las decisiones se cumplan
• Todo ello implica Autoridad y Liderazgo, como
  productos en Educación Médica.

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Global EduHealth Initiative Concept Overview

• PABLO PULIDO, Honorio Silva, Thomas Thomson
• SEMINAR ON PROFESSIONALISM IN MEDICINE
• Mexico City, February 29 2008

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Mission
To provide leaders in  academic medicine and
medical organizations worldwide with a range of
resources for improving skills in leadership,
advocacy, health policy and other non-clinical
subjects based on emerging health care and
medical education needs and demands, resulting in
enhanced professional satisfaction and measurable
improvements in population health
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Key elements for Continued Professional
Development

• Organizational focus
• Team building
• Leadership
• Medical Professional Organizations must play
  important role
• Registration
• Documentation of CPD activities

• Enhanced classical roles and competencies
• Clinical skills
• Theoretical knowledge
• Non-classical roles and competencies such as
• Communication
• Medical ethics
• Teaching
• Research Drug development
• Managerial Skills Administration

WFME Global Standards for Quality Improvement in
Continuous Professional Development (2003)

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Transitions and roles of physicians in a life
long journey

• Undergraduate
• Internship
• Residency
• Graduate Programs/ Fellowships
• CME/CPD
• Change in Practice Behaviors
• Patient outcome improvement

• Legal Expert
• Health Advocate
• Communicator
• Team Worker/Partner
• Administrator
• Researcher
• Social Leader
• Manager
• Educator
• Author
• Negotiator
• Policy Maker

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Who are we?

• A new NGO incorporated in the USA (CT, NY)
• Sponsored by
• - PAFAMS
• - Project GLOBE Consortium
  for CPD
• - PMHI
• A Partnership with Academia, Professional
  Associations
• the Public Sector aiming to
• Catalyze new thinking and perspectives on
  complex issues in medicine, medical education and
  medical practice and
• Develop educational seminars, workshops and
  continuing professional development (CPD)
  programs

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GEHI Impact Benefits

• Improved systems/programs in medicine, medical
  education, medical practice
• CPD designed to change physician practice
  behaviors
• More physicians with optimal professional skills
• Optimization of patient care and satisfaction
• Improved health care and patient outcomes

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Tasks2007 2008

• Define the non-clinical subjects about which
  physicians need more education
• Identify the factors currently impacting (/-)
  physicians attitudes toward the practice of
  medicine and their own career development
• Raise awareness of the importance of non-clinical
  knowledge and skills within the medical education
  community
• Develop an action plan, in collaboration with
  partner organizations, to close the most pressing
  gaps in physician non-clinical education
• Secure stable funding for GEHIs program

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Progress to Date

• Preliminary study of underemphasized subjects
• Study of factors impacting physicians attitudes
  toward the practice of medicine and their
  careers.
• Series of awareness raising meetings for medical
  education leaders
• Funding strategy

Completed 2006
UnderwayCompleted Fall 2007 Jan 2008
Scheduled for 2008, beginning today and 2009
In progress of further Development
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Longer-term Vision

• Build on the success of start-up activities and
  continue to conduct and sponsor research, conduct
  professional meetings, publish findings and
  develop solutions
• Develop a model of the non-clinical competencies
  required for physician excellence in various
  practice settings across a medical career

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Longer-term Vision

• Use that model to enhance medical education
  curricula and continuing professional development
  in partnership with academia, professional
  associations and other medical educators
• Establish a mechanism to continually refresh the
  initial model and improve medical education Data
  Base of experiences

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Longer-term Vision

• Build on the success of start-up activities and
  continue to conduct and sponsor research, conduct
  professional meetings, publish findings and
  develop solutions
• Develop a model of the non-clinical competencies
  required for physician excellence in various
  practice settings across a medical career.
• Use that model to enhance medical education
  curricula and continuing professional development
  in partnership with academia, professional
  associations and other medical educators
• Establish a mechanism to continually refresh the
  initial model.

Each cell in this matrix represents a potentially
unique set of non-clinical skills related to
success as a physician in that cell
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Prospective Services
Degree Programs
Content Information

• Cost
• Value
• Scope
• reach

Medical Institutions Network
Mid-Career Certifications
Think Tank papers and documents
Publications
Seminars/Symposia
Programs
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Medical Education and behavioral Changes ?

• Medical Education can achieve its promising and
  deserved future only by addressing the current
  gaps between societal expectations and perceived
  reality
• Transformations and changes are needed

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Every system is perfectly designed to obtain
the results. it gets

• Edward Demming