Action PlanAction Plan

ImplementationImplementation

PBL in rest of the departmentsPBL in rest of the departments

By:

Associated Prof. Maqsoud Stanikzai MD

Department of Pathology, KMU

Dean of Curative Faculty

December 2006

BackgroundBackground• 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.

AimsAims

• 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

WeaknessesWeaknesses

• Resources – Tutors, staffs– Rooms – Library, text books

• Low experience

GoalGoal

• Improvement of education system

ObjectivesObjectives• Standardization of teaching method• Structuring of lectures in practice• Increase motivation for learning• The developing of an effective reasoning process

MethodsMethods• 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

ScheduleSchedule

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

Implementation PlanImplementation 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

ResourcesResources

• Facilities– Rooms: laboratory rooms for paraclinic

• Scenarios– Dr. Stanikzai will write scenarios assisted by

Dr. Kamal

Arigato GozaimasuArigato Gozaimasu

Thank you Associated Prof. Stanikzai

CBL for all clinical departmentsCBL for all clinical departments

By:

Prof. Mohammad Salim Tawana MD

Head, Department of General Surgery

Maiwand Hospital

December 2006

BackgroundBackground

• 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.

Case-based Learning (CBL)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

ScheduleSchedule

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 Surgery

Other Surgery

Other Other Other Other Other Other Other Other

Current Clinical PracticalCurrent Clinical Practical

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

WeaknessesWeaknesses

• Need of resources – Tutor time– Library

• Transportation of students and lecturers between hospitals and KMU

• Low experience

GoalGoal• Implementation of CBL in education system

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

MethodsMethods

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

management

Implementation PlanImplementation Plan

• March 2007

• For 5th class students

• In thoracic surgery department

Arigato GozaimasuArigato Gozaimasu

Thank you Prof. Tawana

OSCE for house job (Internship)OSCE for house job (Internship)

By:

Assistant Prof. Abdul Majeed Hosham MD,DO

Eye surgeon, Department of Ophthalmology

University Eye Hospital

December 2006

BackgroundBackground

• 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

WeaknessesWeaknesses

• Resistance from old system

• Resources – Standardized patients

• Low experience

• Unreliable assessment

MethodsMethods

• 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

MethodsMethodsStream 1 Stream 2 Stream 3 Stream 4

Schedule Medical Interview

Head & neck,

Abdomen

Chest & vital signs

Neurology

9:00-9:10 1 2 3 49:11-9:21 4 1 2 39:22-9:32 3 4 1 29:33-9:43 2 3 4 1

9:50-10:00 5 6 7 810:01-10:11 8 5 6 7

Methods Methods (cont)(cont)

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

Time FrameTime 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

SettingsSettings

• 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 Suggestions

• Establishment of OSCE committee /EDC

• Establishment of OSCE stations

• Preparation of a OSCE guide manual

Thank you Hosham

Arigato GozaimasuArigato Gozaimasu

Expansion of EDC capacityExpansion of EDC capacity

By:

Prof. Hedayatllah Salihi MD

Head, Department of ENT

Maiwand Hospital

President ,EDC/KMU

December 2006

BackgroundBackground

• Established on 2002

• Supported by JICA from 2005

• Different divisions- Curriculum development department- Evaluation and feedback department- Postgraduate department- Clerical staff

Background Background (cont.)(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 Background (cont.)(cont.)

• EDC Outputs (independently)– Establishment of postgraduate training

program– Curriculum revision, development and

standardization.– evaluation of lecturers by students

Background Background (cont.)(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

VisionsVisions

• EDC will lead the best medical education in Afghanistan

• EDC will expand all the medical education systems within the limitation of current resources

ObjectivesObjectives

• 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 Objectives (cont.)(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

MethodsMethods

• 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

Suggestions for JICASuggestions for JICA

• Fund for:– Partitions for OSCE/PBL

Suggestions for KMUSuggestions 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.

Arigato GozaimasuArigato Gozaimasu

Thank you Prof. Salihi