Quality improvement in teaching medicine

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Quality improvement in teaching medicine

• Vladimir Bumbairevic

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Teaching Medicine
Society
Patients
Teachers
Students
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Teaching Medicine
Knowledge Skills Attitude
Practical Teaching
Formal Teaching
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Curriculum
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Thomas Huxley1825-1895

• "The burden we place on the medical student is
  far too heavy, and it takes some doing to keep
  from breaking his intellectual back. A system of
  medical education that is actually calculated to
  obstruct the acquisition of sound knowledge and
  to heavily favour the crammer and the grinder is
  a disgrace.
• 1876

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Organising the overload
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New curriculum models

• Outcome-based education
• Problem-based learning
• Task-based learning
• Core and student-selected components
• An integrated system-based approach
• A spiral curriculum

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Classical (Subject based) curriculum
Clinical sciences
Basic sciences
Revised curriculum
Clinical sciences
Basic sciences
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New Law on Higher Education

• Quality Assurance in Higher Education
• National Council and Commission for Accreditation
  and Quality Control
• Quality Assurance Procedures at Universities
  including self-evaluation

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Quality defined
For most people, quality is like beauty it
has a positive connotation but denotes nothing
measurable. ...For quality to be managed, it must
be defined in terms of specific measurable
attributes.
Kritchevsky Simmons, 1991, p. 1817.
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Quality

• An indicator of category or rank related to
  features or characteristics of the products
  intended for the same functional use (ISO 8402)

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Quality

• Composite of attributes that meet required
  specifications
• Functionality fitness-for-purpose
• Meeting customers implied needs, demands and
  expectations
• Stakeholders/Customers satisfaction
• Value for money

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Quality assurance or quality enhancement

• Enhancement - a process of augmentation or
  improvement
• In relation to higher education quality
  enhancement refers to
• the enhancement of individual learners the
  augmentation or improvement of learners
  attributes, knowledge, ability, skills and
  potential.
• improvement in the quality of an institution or
  programme of study.

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Enhancement
Where are we now?
How do we get there?
Where we want to be?
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ENQA European Network for Quality Assurance in
Higher Education

• Standards and Guidelines for Quality Assurance in
  the European Higher Education Area
• European standards and guidelines for internal
  quality assurance within higher education
  institutions
• European standards and guidelines for the
  external quality assurance of higher education
• European standards and guidelines for external
  quality assurance agencies

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WFME Intentions

• to stimulate medical schools to formulate their
  own plans for change and for quality improvement
  in accordance with international recommendations
• to establish a system of national and/or
  international evaluation and accreditation of
  medical schools to assure minimum quality
  standards for medical school programmes
• to safeguard practice in medicine and medical
  manpower utilisation, and its increasing
  internationalisation, by well-defined
  international standards of medical education.

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Basic standards are expressed by a must

• This means that the standard must be met by every
  medical school and fulfillment demonstrated
  during evaluation of the school.

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Standards for quality development are expressed
by a should

• This means that the standard is in accordance
  with international consensus about best practice
  for medical schools and basic medical education.
  Fulfillment of - or initiatives to fulfill - some
  or all of such standards should be documented by
  medical schools. Fulfillment of these standards
  will vary with the stage of development of the
  medical schools, their resources and educational
  policy. Even the most advanced schools might not
  comply with all standards.

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EDUCATIONAL OUTCOME

• Basic standard
• The medical school must define the competencies
  that students should exhibit on graduation in
  relation to their subsequent training and future
  roles in the health system.

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Quality Spiral
Strategy- Quality focused
Vision and Mission
Objectives strategic and operational
Customers/Stakeholders needs expectations
ACADEMIC, INSTITUTIONAL QUALITY ASSURANCE
PROCESSES
Policy Development
Quality Procedures forvarious functions, e.g..
TLAR
Monitoring, Auditing and Review
TLAR Teaching, Learning, Assessment and
Research
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Quality Improvements

• Plan Plan on what you want to do - (Benchmark)
• Do Implement your plan - e.g. Deliver service
• Check Check to see that what you put in place is
  working - monitor, audit
• Act Take corrective action to right things that
  are not right

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School of MedicineUniversity of Belgrade

• Curriculum reform
• Introduction of Quality assurance procedures
• Tempus Projects
• Open Society Project

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Objectives

• To restructure teaching in Serbian Medical
  Faculties
• Restructuring of the present curricula
• Development and implementation of an innovative,
  constructively aligned and fit-for-purpose
  teaching methods best suited to facilitating
  students learning
• Development and implementation of quality
  assurance and quality control systems

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Policy priorities (Curriculum)School of
Medicine, University of Belgrade

• Implementation and further development of the new
  curriculum (started 2004/2005)
• Innovative teaching methods
• E-learning classrooms
• VLE - Project (with Medical University of Graz)
• Reticulum online e-learning pilot course in
  Histology and Embryology (Moodle)
• LOMED

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E-Learning Moodle
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Policy priorities (QA)School of Medicine,
University of Belgrade

• Center for quality assurance and teaching and
  learning enhancement (established in March 2005)
• Commission for evaluation of curriculum
  implementation
• Commission for control of teaching
• Commission for knowledge assessment and test
  standardization
• Commission for validation of courses

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Quality assurance

• Validation of courses
• Training of teaching staff
• Peer observation scheme
• Students evaluation of teaching process
  (anonymous questionnaire)
• Analysis of new curriculum implementation
• Corrective actions taken

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Quality enhancement or improvement

• Focusing on the continuous search for permanent
  improvement, stressing the responsibility of the
  higher education institution to make the best use
  of its institutional autonomy and freedom.
  Achieving quality is central to the academic
  ethos and to the idea that academics themselves
  know best what quality is.