Action Plan

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Action Plan

• Implementation

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PBL in rest of the departments

• By
• Associated Prof. Maqsoud Stanikzai MD
• Department of Pathology, KMU
• Dean of Curative Faculty
• December 2006

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Background

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

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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

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Weaknesses

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

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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

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Methods

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

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Schedule
Day Group
Saturday 1-3
Sunday 4-6
Monday 7-9
Tuesday 10-12
Wednesday 13-15

• 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

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Implementation Plan

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

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Resources

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

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Arigato Gozaimasu

• Thank you
• Associated Prof. Stanikzai

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CBL for all clinical departments

• By
• Prof. Mohammad Salim Tawana MD
• Head, Department of General Surgery
• Maiwand Hospital
• December 2006

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Background

• Clinical subjects are taught in 3rd, 4th, 5th,
  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.

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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
• 5th class students have already learned clinical
  examination skills in 3rd and 4th 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

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Schedule
Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon
AM CBL for thyroid CBL for Breast cancer CBL for Hemopneumothorax CBL for Esophageal mass CBL for LungHydatid cyst CBL for Varicose vein of legs Holiday CBL for Pleural empyema CBL for Rib fracture Evaluation
PM(lecture) Surgery Other Surgery Other Other Free Holiday Surgery Other Surgery
PM(lecture) Other Other Other Other Other Free Holiday Other Other Other
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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

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Weaknesses

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

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Goal

• Implementation of CBL in education system

Objectives

• Standardization of teaching method
• Integrating lectures into practice
• Increasing motivation for learning

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Methods

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

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Implementation Plan

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

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Arigato Gozaimasu

• Thank you
• Prof. Tawana

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OSCE for house job (Internship)

• By
• Assistant Prof. Abdul Majeed Hosham MD,DO
• Eye surgeon, Department of Ophthalmology
• University Eye Hospital
• December 2006

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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

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Weaknesses

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

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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

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Methods
Stream 1 Stream 2 Stream 3 Stream 4
Schedule Medical Interview Head neck, Abdomen Chest vital signs Neurology
900-910 1 2 3 4
911-921 4 1 2 3
922-932 3 4 1 2
933-943 2 3 4 1
950-1000 5 6 7 8
1001-1011 8 5 6 7
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Methods (cont)

• Time40 minutes/ day, 10 days/year
• Interview 10 minutes
• Neurological examination 10 minutes
• Head, Neck, and Abdomen 10 minutes
• Chest, Vital signs 10 minutes

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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

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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.

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Suggestions

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

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• Thank you
• Hosham

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Arigato Gozaimasu
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Expansion of EDC capacity

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

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Background

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

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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

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Background (cont.)

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

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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

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Visions

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

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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

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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

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Methods

• Workshops for EDC personnel
• Negotiation with KMU, MoHE
• 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

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Suggestions for JICA

• Fund for
• Partitions for OSCE/PBL

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Suggestions for KMU

• To submit responsibility of implementation of PBL
  to all Paraclinic departments.
• PBL committee should have as a supervisory role.
• 1st and 2nd 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.

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Arigato Gozaimasu

• Thank you
• Prof. Salihi