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Network of Community-Oriented Educational Institutions for Health Sciences
Number 8 / December 1987
Editorial
No doubt this issue of the Newsletter will provide much information oi
interest to our readers! You will find announcements of forthcoming
workshops, reports of meetings, reviews of books of interest to anyone
involved in the renewal of professional health education, and many other
topics.
To our deep regret Dr. Ramon Villarreal, one of the Network’ founding
fathers and a very dear friend, has died. We remember with respect and
gratitude his many contributions in the early years. An obituary written by
Dr. Mora Carrasco can be found in this Newsletter.
A major event this year was the Fifth General Network Meeting of mem
ber institutions in Pattaya, Thailand. Some of the important decisions
taken include, the formation of a new Executive Committee, the
establishment of an African Chapter of the Network and the awarding of
honorary memberships. A concrete plan of action for the next two years,
resulting from lengthy discussions in Pattaya, will be announced in the
Newsletter’s next issue, due in June 1988.
The Secretariat has undertaken two new activities:
the establishment of a new scientific periodical, "Annals of CommunityOriented Education", and the strengthening of its clearinghouse role.
To serve our readers on a more regular basis, the Executive Committee
has decided to publish two Newsletters annually; in December and June.
Those who would like to share information with our readers should submit
their contributions before April 30 and October 31.
A happy new year to you all.
Editor. Mrs Ine Kuppen
Co-editor: Prof.dr. Henk Schmidt
Published by the Network Secretarial
Rijksuniversiteit Limburg
P.O. Box 616
6200 MD Maastricht
The Netherlands
Tel. 043-888303/309
Telex: 56726
Telefax: 43-219 552
Inside
Editorial
Chairman’s Column
Activities planned in the Secretariat
Recent events
News from Network
Member Institutions
Forthcoming Events
Network Institutions
New Network Members
News from Network Students
The Network and other Organizations
Book Reviews
Have you read this?
Articles/Reports/Newsletters
Advertisement
Agenda 1988
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Ine Kuppen and Henk Schmidt
Chairman’s Column
The fifth biennial meeting of the Network has come and
gone. I am sure that those of you who attended will
agree that it was a most worthwile gathering. My sincere
thanks to all of you who worked so hard and participa
ted so actively to make it a success. A summary report
has been prepared by the Secretariat which will be sent
to all participants and members. Extra copies are
available, on application to the Secretariat. In this
column I want to highlight two points. First, a summary
of the ome "next steps" following the review al Pattaya oi
the discussion document "The Network in 1987 ....and
beyond". Second, 1 would like to introduce the new
Network Executive Committee team.
At the Thailand meetings, the representative ol member
institutions and other participants accepted the proposal
that three important strategics should characterize the
Network in the next few years. They arc:
1 Relevance -Education for Health Professionals
in Response to Cdmmtfiuiy
2 Adaption to change
3 Links with Health Services
The Network Executive Committee and the Secretarial
arc now putting together a "plan of action" document
which will specify the activities for the next two years to
be carried out by the various participants in the Net
work ; task forces; and special project groups. This plan
will be finalized at the Executive Committee meeting
scheduled for May 12-14, ’88 in Geneva. We have asked
leaders from member institutions to submit an outline ol
planned activities related lo the three Network themes.
We have an almost totally new Executive Committee
team. Let me introduce them to you :
Prof.Dr. Pablo Carlevaro is the dean of the Faculty ol
Medicine at the University of Montevideo in Uruguay.
He is a widely recognized and active leader in Latin
American medical education.
Dr. Arthur Kaufman of the University oi New Mexico.
Albuquerque, U.S.A., is the Director of the Primary
Care Curriculum, and the
/.
Dr. Foye Ogun bode is the Dean of the Faculty ol
Medicine, at the University of llorin, Nigeria. He has
Mp'150
COMMUNITY
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been a leading force in establishing an African chapter
of the Network.
Prof.Dr. Ferd Sturmans is the Dean of the Faculty of
Medicine of the University of Limburg. He is an
epidemiologist with strong interests in links with health
services.Prof.Dr. Charas Suwanweia is the Dean of the
Faculty of Medicine at Chulalongkorn University in
Bangkok, Thailand. He is a leader in medical education
in Thailand, and is working with his colleagues in
implementing a major curriculum change in his
institution.
Supporting the Network will be a strenghtened Secreta
riat. Co Creep will continue till the end of his 4-year
term which is June, 1988. He will be succeeded by
Dr. Zohair Nooman of Suez Canal University, who is a
living example of profound and visionary leadership in
health professions education. The Secretariat will remain
at Maastricht, and 1 am delighted that Henk Schmidt
has accepted the position of Associate SecretaryGeneral. Mrs. Ine Kuppen will continue as the co
ordinating secretary of the Secretariat and the Executive
Committee. These are exciting times for the Network
with a renewed and re-focussed vision on the countries
involved, a strengthened and a capable leadership tdam,
and in particular much active participation in an in
creasing number of institutions who share our goals and
are demonstrating these goals in specific activities.
Dr. Vic Neufeld, chairman.
Activities planned in the secretariat
The Network Secretariat will intensify its role as a com
munications center among member institutions and
between the Executive Committee and the members.
In addition, its function as a clearinghouse for
information useful to member institutions will be streng
thened. The following action will be undertaken.
1. The Newsletter, the most visible part of the Network
to the outside world and the medium for internal com
munication, will be issued twice a year in the future.
2. A Network scientific periodical. The field of health
professions education is marked by many interesting new
developments. Here, an assessment instrument for stu
dent performance during community postings is being
created; there, alternatives to the traditional clinical
clerkships are being pursued. The educators involved
however, often do not take the time —or lack the
experience- to write about their endeavors.
Consequently, few references to aspects of communityoriented or community-based instruction are to be found
in literature. The Network’s Executive Committee hab
decided therefore to support the publication of a
scientific periodical: "Annals of Community-Oriented
Education". This journal will provide a forum for those
actively involved in innovation in health professions
education, an opportunity to exchange experiences,
publish results of relevant research or just share good
ideas. A small international Editorial Board will
maintain a liberal policy with respect to topics to be
addressed in the Annals. However, in^addition fo if<
forum function, the new journafwill have an educational
purpose. The editorial team will not judge, accept or
reject in the first place, but try to help authors impro
ving on their manuscripts. The final product of these
collaborative efforts may be the publication in the
Annals or in another journal. The editorial staff at the
Secretarial will consist of Henk Schmidt and Pauline
Schoenmakcrs. The first issue of the Annals will be
published in April or May 1988 and will contain some of
the contributions from the Pattaya conicrencc.
Additional contributions are still welcome. This first
volume will also contain further details on editorial
board and publication policy.
3. Clearing House. The Secretarial will systematize its
collection of reports, articles, papers and other
information of interest to member institutions. In addi
tion, Tonja Mol, a former coordinator of Maastricht’s
primary care attachments program, has expressed her
willingness to support our organization by building up an
even more extensive collection. An attempt will be made
to make this "data bank" available to the members as
soon as possible. One of the media to be utilized will be
a floppy disk, usable on IBM compatible computers, and
updated once a year. This disk may contain extended
bibliographies compiled by the Secretariat, the Task
Forces, or by individuals. In addition, an inventory of
experts in various domains, available for consultation to
member institutions, will be prepared and made acces
sible to all institutions.
Recent Events
•5th General Network Meeting: a successful
and happy family reunion
September 28-29, 1987 PATTAYA, THAILAND
The meeting was attended by 150 partiepants, repre
senting the full, associate and corresponding members.
The only full member unable to send a representative
was the Faculty of Health Sciences, Kumasi, Ghana.
The World Health Organization was represented by Drs.
Tamas Fulop, Jean Jacques Guilbert, Harmen Tiddens
and Dr.Bisht; the World Federation for Medical
Education by its President, Dr. Henry Walton and the
Canadian International Development Agency by Dr.
Kerry Kennedy. Participants had received the discussion
paper on "The Network in 1987 .... and beyond" before
hand. This paper contained ideas, proposals and plans
and suggestions for new avenues to pursue. The main
objective of the general meeting was - to use this
discussion document - to review the priorities lor the
future activities of the Network. In addition to plenary
business sessions, members and observers were divided
into small groups. These groups were to answer concrete
questions and to respond to a number of suggestions
included in the discussion paper. Group opinions and
recommendations were reported to the General
Meeting. One can say that the atmosphere during the
meeting was superb. A real highlight was the poster
session, coinciding with the Network dinner. It was a
pleasure seeing every institution
lum : problem-community based or oriented, conven
tional or innovative. The summary report ol the meeting
will be distributed in January, ’88. Readers interested in
obtaining a copy please write to the Central Secretariat.
The Executive Committee is now working on a specific
plan of action for the next two years.
The venue of the next General Meeting will be Maas
tricht, The Netherlands. This site has beep chosen on
the occasion of the tenth anniversary of the Network.
Dr. Harmen Tiddens
Prof, of Health Care Organization
Chairman National Board for Continuing Medical
Education, The Netherlands.
and posthumously to
Dr. Ramon Villarreal
Former Dean, Faculty of Health Sciences
Universidad Aulonoma Metropolitana Xochimilco,
Mexico City, Mexico
► Enthusiastic approval of African Network
Chapter
At the General Meeting, Dr. Toye Ogunbode from the
Faculty of Health Sciences, Ilorin, Kawarc State,
Nigeria, launched the proposal to form a functional
group of African Network schools.
The objectives are :
1 To create linkages with Network schools in Africa
2 To slrenghten existing links and create awareness of
the Network objectives in medical schools where the
programs have not been established.
3 To facilitate establishment of programs in new
schools. The proposal met with great enthusiasm and
was accepted unanimously.
As a first step towards the realization or achievement of
the linkage objectives, Dr. Ogunbode is collecting the
required information about periods of community based
or other established components of innovative educatio
nal programs from each member school in Africa.
The information received will then be disseminated
among member schools to assist in devising an
appropriate fellowship plan.
More information can be obtained from:
Dr. Toye Ogunbode
Coordinator African Group of Network Faculty of Health
Sciences, Univesity of Ilorin, Ilorin Kwara State, Nigeria
Their nominations were approved unanimously.
►Obituary
Dr. Ramon Villarreal
Ramon Villarreal passed away on September 12, 1987.
If the disappearance of any distinguished public person
usually causes a sense of loss among those who worked
with or were influenced by him, the departure of Ramon
Villarreal has generated a deeper sadness. Perhaps it
was because his main attributes were related to a capa
city for openness and fairness making him the sometimes
unnoticed center of teams of intellectual workers who
frequently held strongly conflicting views.
His perception of what was relevant at a given time
made him an important figure in health education in
Latin America. First at his post at the Pan American
Health Organization as head of human resources devel
opment (1972-1974), then as the first Rector of the
Metropolitan Autonomous University at Xochimilco
(1974-1978). But it would be wrong to assume that the
quality of his leadership was based only on personality
characteristics. Underneath was a scientist and a
physician, an author of more than 30 scientific articles.
As a physician he graduated from the National Univer
sity of Mexico in 1944, and did postgraduate work in
physiology and clinical research at Illinois and Harvard.
Later he developed an interest in social issues, obtain
ing an M.Ph. at John Hopkins University.
As a promotor of the development of new ideas he
served as Dean of the Medical Faculty at San Luis
Potosi University (Mexico), then at the Regional Office
of the World Health Organization in Washington, USA
(1959-1972), first as Rector and Founder of the
Metropolitan Autonomous University at Xochimilco
(1974-1978), and then Executive Secretary of the
Mexican Foundation for Health, until his untimely death.
Especially relevant to us, Ramon Villarreal was among
the "founding fathers" of the Network (1979), he was a
member of its Executive Committee in the early years,
and retained his interest in the Network to the end.
Already ill, he attended the Havana June 1986 meeting,
where many of us saw him for the last time.
►Honorary Membership
At the General Meeting it was decided to award hono
rary membership to a number of colleagues who have
made outstanding contributions to the Network and its
objectives:
The nominees were :
Dr. Tamas Fiilop
Director, Division of Health Manpower Development
World Health Organization, Geneva, Switzerland.
Dr. Jean-Jacques Guilbert
Chief Medical Officer for Educational Planning,
Methodology and Evaluation
Division of Health Manpower Development
World Health Organization, Geneva, Switzerland.
Dr. Cosme Ordonez
Representative, Ministry of Public Health
Higher Institute of Medical Sciences, Havana. Cuba.
Dr. Fernando Mora-Carrasco
Division Director
Faculty of Health Sciences
Mexico D.F., Mexico
Dr. Moshe Prywes
Chairman, Center for Medical Education Faculty oi
Health Sciences
Ben-Gurion UrttVCrSily^TthT^Ncgev, Israel.
a
Progress and Challenges in Health
Sciences Education
►the Pattaya Conference: an impression
September 30-October 2,1987
Report by Irma Kokx*
In Pattaya, Thailand, the conference "Progress and
Challenges in Health Sciences Education: an Interna
tional Perspective" was held (Sept.30-Oct.2.1987),
organized by the Network in collaboration with Chula
longkorn University’s Medical Faculty, in Bangkok.
224 participants from all over the world came together
to exchange some of their research findings and to dis
cuss innovation in educational programs at their schools.
People came from Nigeria and Australia, from the USA
and the Philippines, from Egypt and the Netherlands,
from Chile, Cuba and Zimbabwe and of course from the
host country Thailand.
The conference was organized around a limited number
of formal presentations, several workshops and a poster
session. A field trip was organized for early arriving
conference participants and Network members to get an
impression of the rural training sites of medical students
of Chulalongkorn University’s Medical Faculty. This
field trip started with an orientation on the Thai Health
Service System and Community-Based Education at the
conference site. The slides of rural health centres alter
nated with tourist views of Pattaya in an amusing way.
After a study tour at Banglamung Community Hospital,
a health centre in the rural community was visited.
Here the participants got the opportunity to talk with
students about MESRAP (Medical Education for
Students in Rural Areas Project), and their experiences
in a rural health centre.
The students were sometimes asked very difficult ques
tions about their motives for becoming physicians and
their reasons for eventually returning to a rural health
centre when their education was completed. Some of the
participants seemed to doubt the honesty of the rather
idealistic replies. But let’s be frank: what would our
students answer to such questions in such a situation.
The real start of the conference was made by a presenta
tion and discussion of Medical Education in Thailand:
an overview of the development and present state of the
medical education.
On the second day of the conference, the morning
session consisted of formal presentations around two
themes: "How to change a conventional curriculum" and
"Is problem-based learning a necessary condition for the
implementation of community-oriented education, or
can the latter do without the former?".
In the first thematic session three schools reported about
their attempts to change their existing curricula: their
experience was useful for other schools with conventio
nal curricula. For example: the experience of the Kebangsaan Malaysia University taught how important it
was to involve all the staff concerned right from the
start.
The panel discussion after the presentations around the
sccoodAhymCr^bowcd that a discussion about problem
based learning as a necessary condition for the imple-
mentation of community-oriented education still
exercises many minds.
In addition to the concurrent workshops one can say
that the contacts and discussions in between the presen
tations and in the breaks seemed more interesting than
the papers themselves. The poster session also promoted ■
an exchange of information and experience. New cop
tacts were made, old ones renewed. All through the
conference there was an atmosphere of friendliness.
Two causes for this can be mentioned: perfect organiza
tion with a very helpful secretariat and comfortable
accomodation.
The Pattaya conference will probably be remembered as
very useful, very agreeable and well run.
*Irma Kokx is educational psychologist
Dept, of Educational Development and Research
University of Limburg
Maastricht, The Netherlands.
News from Network Member
Institutions
►The llorin faculty of Health Sciences Collaboring
Centre of the world Health Organization
On September 24,1987, The llorin Faculty of Health
Sciences was designated as a W.H.O. Collaborating
Centre in Research an Manpower Development in Com
munity-Based Educational Programs. The Faculty, a full
member of the Network, is regarded as the leading
centre of the Network in Africa. It has played a leader
ship role in the encouragement of functional linkages
between the Network Group of Schools. It has also assis
ted two new medical schools, Bayero University, Kano,
and Zimbabwe University in Harare, in the development
and implementation of their medical curricula.
The overall program of llorin was invited many favour
able comments from all over the world. With the innova
tive approach, which is relevant to the health care needs
of a vast number of Nigerians, the structure of the
community-based program, the total commitment ol
faculty staff, and long term plans for priority health
research activities and manpower development princi
pally at the community level, its membership of the
Network, llorin will continue to make important contri
butions to the development of health care delivery in this
country in particular and in the world at large.
The Faculty of Health Sciences, University of llorin was
established in 1977/78 session as an Innovative Medical
School in response to the Federal Government order
that New Medical Schools should train doctors and
other health personnel sensitive to community needs and
well able to deliver primary health care. Since its incep
tion the faculty has been the foremost institution
dedicated to the health needs of the population it serves
in Nigeria. The faculty has maintained the precious
legacy and historic educational philosophy based on four
innovative components of the medical curriculum; inte
grated teachujg,jirpfelem-tiased learning, studentcentred learning which deemphasi/cs didactic lectures
while encouraging independent learning and community
based experience and services. The students arc intro
duced to the community after 8 weeks of entry into the
Medical School. Almost 23 weeks, appr. 10% of the
medical training period, is spent in the community.
In this respect the faculty perhaps has the highest com
munity-based programs in Nigeria. One other outstan
ding feature of the faculty is'the structure of the commu
nity-based programs. This is faculty based and run by a
COBES Unit which has a coordina- tor who can emerge
from any department of faculty. During the COBES
posting the tutors are drawn form various departments
and in rotation to allow all the teachers to be actively
engaged in the programs. It has been found that these
arrangements encourage faculty commitment and permit
the system to endure. Today the faculty offers the Com
munity Health Officers (CHO) program and engages in
a number of collaborative service oriented research
programs with the Teaching Hospital as well as the State
Ministry of Health who arc primarily service providers.
Also established are joint international research
programs with such bodies as John Hopkins University,
UNICEF and Columbia University in the USA.
The Secretariat also received from Dr. Moshe Prywes*
copies of:
1. A special booklet called "The Beer Sheva Experiment:
An Interim Assessment". It has been edited by Shimon
Glick, Lechaim Naggan and Moshe Prywes and appea
red as a special issue of the Scientific Israel Journal of
Medical Sciences (Vol.23, Nos. 9-10, Sept.-Oct. 1987).
It is intended as a presentation of concrete issues that in
Beer Sheva has been defined as highly germane to medi
cal education and health service delivery.
The volume is divided in two parts: Educational Issues
and Health Services. In part I consideration is given to a
variety of educational problems that are intermediate
between the overall ideology and its application to speci
fic substantive matters. Part II is devoted to a considera
tion of what has happened in these 13 years to the health
services in the Negev and how the changes are linked to
the Ben Gurion Medical School.
2 A brochure by Dr. Shimon Glick, describing the
history, goals and accomplishments of the Faculty of
Health Sciences of the Ben Gurion University, Beer
Sheva, Israel.
* Dr. Moshe Prywes is Founding Dean, Prof, of Medical
Education and Chairman, Center for Medical
Education, University Center for Health Sciences and
Services, Ben Gurion University, Israel.
► 13th Anniversary of the Ben Gurion Medical School
November 21-26, 1987, Beer Sheva, Israel
Report by Dr. Shimon Glick*
The Faculty of Health Sciences of the Ben Gurion Uni
versity began its 13th year (Bar Mitzvah-coming of age
in the Jewish tradition) by a reunion of 60 former visiting
professors from abroad. These distinguished leaders of
world medicine who had spent 4-6 weeks each at the
Ben Gurion University as Dozor professors (in honor
of the donor Mr. Harry Dozor), during the preceding
decade, returned to see the changes and renew old ties
with the Faculty. In four days full of activities, they heard
about the history of the school and its impact on health
in the community (in a visit to the Health facility in the
Bedouin urban settlement of Rabat). They met with
students and faculty and participated actively in small
workshops on various aspects of the program. Graduates
of the school presented papers in community projects as
well as on clinical and basic research. Symposia were
held in most major clinical subjects and on current areas
of interest in medical education. Three major talks were
given by guests: Professor Sheps, Professor of Social
Medicine, University of North Carolina, spoke on "The
Future of Medical Practice and Community Health
Problems: Problems and Prospects"; Professor Donald
Seldin, Chairman of the Dept, of Medicine. Texas
Southwestern Medical School on "Conflicting Social and
Academic Demands on the Medical School" and Profes
sor Albert Solnit, Professor of Pedia- tries and Psychia
try, Yale University spoke on "Behavioral Sciences in the
Year 2000". The visit culminated in a gala Thanksgiving
dinner which ended with a sound and light show about
the Faculty. The visiting Faculty organized itself into a
working organization to continue supporting the
activities of the Faculty.
* Dr. Shimon Glick is Dean of the Faculty of Health
Sci<>jiccs.of-tbe-. Ben Gurion University of the Negev.
^International Workshop On Community- based
Education Incorporating Problem- based Learning
December 12-17,1987, Faculty of Medicine
Suez Canal University, Ismailia, Egypt
The workshop was organized by the faculty development
group of the center of research and development in
medical education and health services at the Suez Canal
University. There were 18 participants from outside
Egypt, including 3 from Khartoum and 2 from Gezira,
Sudan, 2 from Bahrain and 1 from Karachi.
The workshop introduced participants to the principles
and practices of community-based education and
problem-based learning and problems of introducing
change in established schools. Each participants was
requested to present his plan for change in his institu
tion by the end of the workshop.
Forthcoming Events Network
Institutions
►Nigerian Network Schools of Health Sciences
First Educational Workshop
February 9-12, 1988, Ilorin, Nigeria
Objectives of the workshop :
At the end of the workshop each participant will be :
- introduced to a model community based medical
educational program, its advantages and constraints.
- informed on the value of introducing the student to
coniiiiuniiy vTfflV hr hrs 'training to diagnose and offer
5
June 27-July 1, 1988
Workshop 2: Learning Through Problems:
Opportunities and Limitations
In recent years, the design of problems, suitable for sti
mulating self-directed learning has become an important
issue. Until 1980, most new schools copied the
McMaster approach, almost exclusively presenting their
students with clinical problems. However, in particular
in schools admitting students right from secondary
school, experiments have been carried out with simpler
problems, because these students often seem to lack
prior knowledge to work on a complex clinical problem
in a fruitful way. In addition, relying solely on clinical
problems, it proved difficult to acquaint students with
knowledge of the wider epidemiologic, socio-economic
and psychological context, often defining the boun
daries of health and disease.
Participants will learn the techniques of how to construct
these problems, in a format emphasizing practical exer
cises, including testing self-made problems on students
in small-group tutorials. In addition, this workshop will
give much attention to the role of the tutor.
service.
- able to distinguish between learning and leaching and
understand problem based integrated student learning in
all disciplines.
- able to evaluate his achievement from the workshop ex
perience.
Participants :
The workshop is open to all participants in Nigeria and
overseas who have interest in community based student
centred, problem solving medical education with special
reference to African experience.
For more information please write to :
Dr. S.K. Odaibo, Frcs
Chairman, Organizing Committee
First Educational Workshop
Faculty of Health Sciences
University of Ilorin
Ilorin, Nigeria
► Ced Plans Short Course in Community Based Medical
Education
May 1988, Chicago, U.S.A.
- July 4-8, 1988
Workshop 3: New Methods in Student Assessment and
Skills Training. In recent years, a wealth of new
approaches to student assessment has been developed:
Progress testing, OSCE, the use of simulated patients in
assessment, SEMP, skills testing, and sophisticated
observational methods, to name a few. Participants will
have hands-on experiences with these methods. In addi
tion, the experience of the Maastricht Skills Laboratory
with the design of structured training programmes, both
for clinical and interpersonal skills will be shared with
the participants. As in the first two weeks, there will be
lots of opportunities to apply the newly acquired know
ledge and skills. The workshop will be given together
with staff of the Center for Educational Development ol
the University of Illinois at Chicago and the University
of Texas, Galveston. These Centers provide interna
tionally recognized expertise in these areas.
In summary: You may choose one of these workshops;
or pick two; or you may decide to join us here in Maas
tricht for three weeks. Make your choice!
CED faculty, in collaboration with seven international
consultant faculty, are preparing a short course for
health professionals on "preparing leaders for
community based medical education". Tentatively
scheduled for May, 1988, the program will be offered to
health personnel in faculty or administrative posts who
are interested in or responsible for leading community
based medical education programs.
The course will be problem based, using a case study
format. Participants will work through the problem ana
lysis, curriculum design, and leadership strategy of an
educational problem currently existent in an educational
government or health services delivery organization.
Primary mode of instruction will be small-group discus
sion along with faculty led seminars, independent study,
and ample resource reading.
For further information please contact:
Dr. Thomas Telder
Associate Director for Educational Programs
Center for Educational Development
808 S. Wood Street (m/c 581)
Chicago, IL 60653, U.SA. tel. (312) 996-3590
^■Introducing Problem-based Learning
The University of Limburg Educational Workshops for
the Health Sciences 1988
June 20-July 8, 1988, Maastricht, The Netherlands
For further information please phone, write of tax to
Miss Willie Schipper, Workshop Secretariat
Faculty of Medicine, University of Limburg
P.O.B. 616, 6200 MD Maastricht, The Netherlands
Tel. (43) 888242, Telex: 56726.
■►A Celebration
Ten Years of innovative Medical Education
August 30-September 16, 1988
Newcastle, Australia
Invitation:
The Faculty of Medicine at the University oi Newcastle
in New South Wales cordially invites everybody with an
interest in medical education and innovation to join it
in 1988 for some or all of its celebration of its first ten
- June 20-24, 1988
Introductory Workshop 1
This workshop provides an overview of the main features
of the problem-based approach to health professions
education, as elucidated in the folder.
i '•
6
years. The program of workshops and meetings has been
designed to offer something to everyone.
Background:
The Faculty of Medicine at the University of Newcastle
was established in 1973, acquired its first staff in 1975,
accepted its first cohort of students in 1978 and produ
ced its first graduates in 1982. Students entered a
program planned ands developed by a small, innovative
and educationally dedicated foundation staff under the
visionary direction of the Foundation Dean , the late
David Maddison.
The faculty accepts appr. 70 students a year. The admis
sions policy is founded on the premise that academic
ability should not form the sole criterion for selection of
future medical practitioners. Students arc selected from
a wider than normal academic pool, based largely on
personal qualities assessments. From its inception, the
school has aimed to achieve a socially relevant approach
to medical education. The goal has been to create an
educational experience congruent with the complex
needs of contemporary society and the diverse roles
required of a doctor. The course uses on the problem
based approach, with an integrated curriculum in which
small group activities and independent study are the
predominant modes of student learning. The entire 5
year curriculum is organized around a sequence of clini
cal problems, and community issues are explored in
relation to these problems. The faculty has quickly
gained an international reputation. It is a founding mem
ber of the Network and is recognised as a centre of ex
cellence and a place to visit for those interested in fron
tier developments in medical education.
Over the past ten years, a wealth of experience has been
gained and many important lessons learned. These have
already led to a major revision of the entire curriculum.
The faculty is committed to continually evaluating and
improving its effectiveness.
For more information please write to :
Information Officer, Faculty of Medicine
University of Newcastle, New South Wales 2308
Australia, telex AA 28194 Telefax 61 49 67636)6.
Limited support funding may be available to assist those
who might be otherwise unable to attend.
^International Symposium on the Role of Student Health
Professionals in Community Health Education
October 9-13, 1988, Beer Sheva, Israel
The symposium will cover the following areas:
1 Methods of activating health education in schools by
medical and health professional students.
2 Methods of training students to carry out this task.
3 Methods of evaluating the student’s activities and the
project’s efficiency.
4 Collaboration with other schools and educational insti
tutions and their contribution to the project’s success.
For further information please contact:
Chaim Yosefy, Symposium organizer
Center for Medical Education, Faculty of Health Sciences,
Ben Gurion University of the Negev
P.O.B. 653, Beersheva 84105, Israel
Mcmaster Workshops in Health Sciences Education
Hamilton, Canada
Role of the Tutor in Small Group Learning Workshop
Dates offered:
May 17-20 and October 25-28,1988
The overall goals of these workshops are: to provide
participants with an orientation to the issues and skills in
problem-based, self-directed learning in a small group
setting.
These issues may include:
1 The definition and rationale of
- problem-based learning
- self-directed learning
2 Implications of this approach for
- teaching
- design of learning resources
- evaluation
- dynamics of the learning group.
Objectives:
1 To gain an understanding of the role of the tutor as an
educational facilitator and evaluator of learning.
2 To experience the role through participation.
3 To prepare for the eventual undertaking of tutor roles
in educaitonal programs.
Diary:
- August 30-Sept. 2
Problem-based Learning : Education for the
Professions
Four day inter-professional workshop
- Sept. 5-6
A Case Study in Innovation
Two day review of faculty and curriculum development
over the past 10 years
- Sept. 7
David Maddison Lecture
A commemorative lecture from a distinguished guest
- Sept. 8-9
Comparison of Goals and Strategies in Innovative
Medical Schools
Two day international seminar to compare innovative
programs
- Sept. 12-16
Priorities for the Future
Concurrent one to three day workshops and seminars on
key topics with implications for academic developments
and student learning, c.d. medical informatics, health
promotion education, sexuality, nutrition, palliative care
.'..valid aboriginal health.
Visitors’ Workshops
Dates offered:
June 6-9 and November 21-23, 1988
The Visitors’ Workshops provide an overview of the
approach to Health Sciences Education at McMaster
l^iversity.
7
Goals: To gain familiarity with the educational
approaches used in the Faculty of Health Sciences at
McMaster, especially problem-based learning, problem
solving, self-directed learning, and small group learning,
particularly as applied in our undergraduate medical
program.
Activities: Small Group Tutorials - Self-Directed
Learning - Elective Resource Sessions.
For further information and application forms contact:
Miss Annette Sciarra, Workshop Coordinator
Education Services, Room 3N51
Faculty of Health Sciences
McMaster University, 1200 Main Street West
Hamilton, Ontario, Canada L8N 3Z5
►First Jerusalem Health Exposition
October 10-13, 1988, Jerusalem, Israel
The Hebrew University - Hadassah School of Public
Health and Community Medicine and the Minister of
Health of Israel announce the first Jerusalem Health
Exposition to be held at the Hebrew University.
The program will deal with strategies for health
promotion within the framework of Health for All in the
Year 2000.
The goal is to gather health professionals manufacturers,
distributors and consumers to exchange information and
to develop effective programs for health promotion.
Internation participation is invited.
Workshops are being planned in women’s, health, nutri
tion, Aids education, health promotion policy in deve
loping and developed countries and other subjects de
pending upon interest.
For further information please write to Atzeret
zgb. Keren Hayesod Street
P.O.B. 3888, Jerusalem 91037, Israel
New Network Members
Full member institutions
Faculty of Medicine
University of Sherbrooke
Sherbrooke, Quebec, Canada
Associate member institutions
Faculty of Medicine
Office of Medical Education
Lund University
Lund, Sweden
Faculty of Medicine
Chiangmai University
Chiangmai, Thailand
Corresponding members
Dr. P.L. Petit, Consultant for Management of
Development Programmes BV (C.D.P.)
Johannes Worpstraat 5 - Ill
1076 BC Amsterdam, The Netherlands.
News from Network Students
International Workshop on Innovative Undergraduate
Medical Curricula
June 1987, Harare, Zimbabwe
Report by Bill Bradley*
! From June 22-26, 1987 I had the opportunity to attend
the International Workshop on the Innovative Under
graduate Medical Curricula at Harare, Zimbabwe. I was
invited to represent the student perspective from
McMaster University Medical School in Hamilton,
Ontario, Canada, a program which is philosophically
supportive of community-based, community-oriented
medical educaiton. I participated in small groups and
discussions with faculty from Harare as well as faculty
from a few other Network programs. As well, I met a
number of 1st, 4th and 6th year students in the
Zimbabwe Medical School Program. Now I would like
to share with you sopme of my impressions of the week
long workshop. The three main themes of the workshop
I would like to comment on are (1) community-based,
community-oriented medical education, (2)
problem-based learning, and (3) evaluation.
Community-Based, Community-Oriented Medical
Education
Zimbabwe is a country where 70% of the population
lives in the rural regions, yet by far the majority of
doctors practise in urban centres. This is often a prob
lem even in (more) developed countries. As in these
countries, the medical program in Zimbabwe trains(ed)
their students in a tertiary care setting in the major city,
Harare. Because of this tertiary training it has been
found that graduates were not as well prepared as they
could before working in rural settings, nor were an
adequate number settling in these after their medical
education. In an attempt to address this, the medical
program has decided to change its curriculum to a more
community-based, community-oriented (CB/CO)
approach with the hopes that the new curriculum would
prepare grads at least as well as the past program for
working in tertiary care centres, while at the same time
ensuring that these new graduates will be much more
capable and better prepared to work in the rural
settings.
Often times during the workshop the idea was expressed
either overtly or implicitly that the new curriculum
would also address the issue of getting graduates to
settle in the rural areas. While they agreed that a change
in the curriculum would probably better prepare grads
to work in rural settings, the students pointed out that
curriculum change alone could not be expected to get
graduates to actually settle there. If a program is going
to train them and wants tehm to go to those settings, the
students felt that there must be some kind of incentive.
More importantly, the students frowned on the idea that
getting doctors into the community would make an im
pact on the health status, that this was in fact naive and
wildly expectant, just another example of the omnipotent
attitude medical doctors have about themselves. It was
the Zimbabwe students that stated The issue is far more
complex, embedded in a variety of socio-economic-
8
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i
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t
I
□
!
During the actual workshop sessions on problem-based
learning, the philosophy of using problems as a catalyst
and learning by systems seemed very foreign to most
participants. Initially a certain amount of scepticism was
verbalized, and understandably so. Further into the
sessions some people opened up to the ideas, but I sen
sed a larger degree of resistance and a return to
suggestions of lectures. I can only begin to appreciate
the origins of this resistance. Medical schools demand of
their faculty huge time committments for administrative
duties, researching and clinical.responsibilities. Beyond
that they are expected to teach, but most have no formal
training or practice in educating others than exposure to
the traditional system from which they graduated. This is
indeed a tail order, and a difficult one. Without the
faculty understanding the conditions and forces motiva
ting the change in curriculum, without them being invol
ved in planning for it, and without them being trained
(and given credit for this) in the delivery of that innova
tive curricula, their resistance is totally understandable.
Evaluation
This idea is inextricably tied to the third major theme of
the workshop - evaluation. Our small group session on
this topic was very similar to that on problem-based
learning-scepticism, with a few people receptive to new
ideas. I can’t profess to be the definitive judge on
anything, however, I did sense that what our group had
written down on paper to present to the other workshop
participants, while fairly progressive, did not have
behind it the hearts of most of the people in our group.
People seemed to go along with a couple of the more
verbal members of the group. Again .there was a large
degree of resistance, and as I mentioned above, it is
understandable.
Certainly one area in evaluation which met some resis
tance was student input into evaluation. The idea that
students can evaluate themselves, their peers, their
faculty and the program was often frowned upon at the
workshop. Suggestions given for such a reaction
included students not being capable or accurate. This
may or may not be true. I would suggest however that if
they are not accurate, it is in large part because they are
not given the opportunity, and I think people would be
most surprised at student’s initial ability, and then how
quickly they pick up the skills. One reason why their
opinions may not be sought may be because they can be
very incisive in their observations and comments, some
thing which faculty or administration may not wish to
hear. This, however, is probably the time they should
listen most.
The Zimbabwe, students who did speak were hesitant at
first, not only about what they should say, but whether
they should say anything at all. Too bad, because who
could be a better judge of the process than the product
itself, both during and after, especially if the product can
speak to the owners and operators of the factory.
Beyond this, by listening to student input and by inclu
ding them on every committee in the faculty it provides
them with early experiences that are necessary and will
prove very useful when at some point in the future they
arc faculty members and perhaps even heads of those
committees.
policital conditions, and what will really improve the
health status is improvement of the social and economic
conditions in the rural areas". So, while the students
believe the curriculum change was an important deve
lopment, it has to be seen in perspective.
Problem-based Learning
A number of year,one medical students from Zimbabwe
attended the first day of the workshop, the one devoted
to problem-based learning using an integrated curricula.
They were very curious about the McMaster system and
my experiences there. As they learned more about it,
many of them found it understandably difficult to
conceive how such a system could work. We learn in
small groups of 5 or 6 students with a tutor acting as a
facilitator, not an information sourse. There are few, if
any, lectures and these are completely optional. We use
patient problems as a catalyst for learning and material
(anatomy, biochemistry, physiology, histology, etc.) is
integrated focussing on systems (e.g. cardiology of gast
rointestinal) rather than segregate into courses.
When I surveyed the students as to what they thought of
lectures, most (including 4lh and 6th year students)
answered with: "A useful way to learn how to make up
believable excuses for not attending", "I used to try to
take notes but the lecturer talked so quickly and in so
much detail I couldn’t keep up or decide what was im
portant. Now, I sit and listen (sometimes)" or, "usually
it’s some old fart that does research and comes in and
tells us everything there is to know in his one area in
incredibly useless detail (to us as student clinicians)".
Not to belabor the point, or to single out the
Zimbabwe school, but by far the majority of students
there and at other lecture-based schools strongly dislike
the lecture type system. Suggesting an alternative to
lectures was very difficult for them.
That afternoon they had the opportunity to participate
in a problem-solving exercise in front of the rest of the
workshop delegates. Nervous though they were, 1
personally thought they did very well. Unfortunately, I
think some people in the ’audience’ left feeling the stu
dents didn’t know or learn much during the exercise.
Being only 3 months in medical school at that point they
indeed didn’t know much physiology, biochemistry, etc.
As well, in a problem-based system, the student may
spend only 4-6 hours per week in the group, with the
remainder of their time spent seeking information how
to explain the problem (physiology, biochemistry, etc.).
I think one of the flaws in the workshop program was
that the students should have been given a second group
meeting 3 days later, and the time between used to do
their information gathering. Had they done so, I think
they would have surprised many people with their
quality of understanding of the problem in only 3 days.
Later while talking with the students about the expe
rience they were unanimously positive, said they could
understand better how a problem-solving approach
worked, and said they felt as though they were "thinking
during the exercise rather than feeling like a trash can
that people keep dumping things into". So, while the
’audience’ may have been neutral or negative about the
experience, it was interesting that the students were
positive about it.
*
9
- participating in the Network task-forces;
- recruiting students as active participants in the
Network;
- carrying out information on innovative education in the
health sciences for students of traditional and innova
ting schools by the organization of workshops, site visits,
students exchanges, etc.;
- promoting student exchange and electives at Network
schools;
- promoting the "village concept'' in cooperation with the
IFMSA;
- stimulating, coordinating and publishing research
relevant to students on issues concerning education and
health sciences;
- cooperating with the Network in the realization of a
computer network.
3. Communication between Network students.
One contact person at each member institution will be
recruited. This local contact person will coordinate all
local Network activities and communicate with the
regional contact person and the central Network stu
dents secretariat.
A regional contact person will act as an intermediate
between local and central levels. There will be one
contact person for each of the following regions:
1. America, 2. Africa and the Middle East, 3. Asia and
the West Pacific, 4. Europe.
The nomination of all contact persons and the
determination of the central secretariat’s location will be
fixed every two years during the General Meeting of the
Network.
4. Plan of action for the following two years.
A. Central Network students secretariat.
For the following two years Maastricht has been chosen
as the location of the central Network secretariat. It will
be concerned with the following activities:
. collecting names and addresses of local and regional
contact persons;
. sending information on the structure, implementation
and (financial) consequences of their students
participating within the Network to the staff of all mem
ber institutions;
. editing a handbook, which will contain information on
names, addresses, educational programs, electives,
student exchange, research, participation in task-forces,
etc. for all schools; assiting as much as possible in the
realization of the IFMSA "village concept";
. preparing a budget for the next General Meeting.
B. Regional contact persons.
Recruitment of local contact persons in their region.
C. Local contact person.
. contacting deans or other responsible staff members
involved in Network activities in order to improve
cooperation;
. promoting Network objectives among students and
student organizations involved in planning, implemen
tation and evaluation of education;
. stimulating student participation in the task-force
allocated to their institution;
. distributing the Newsletter among students;
. taking care of entries for the Newsletter;
. finding a staff member who can act as a major link
To close, I would like to thank the funding bodies of the
workshop, the World Health Organization and Deutsche
Stiftung Fur Internazionale Entwicklung - as well as the
organizing committee and attendees of the workshop. It
was a most interesting week, and I sincerely appreciate
the graciousness with which I was treated. Thank you.
* Bill Bradley is student
McMaster University Medical School
Hamilton, Ontario, Canada.
► Workshop of Medical Students
Sth General Meeting
September 1987, Pattaya, Thailand
During the 5th General Meeting of the Network in
Thailand, September 1987, a student workshop has been
organized. The aim of this workshop was to discuss ways
of achieving more fully-integrated student participation
in the Network and to formulate a two year plan of
action for this. Twenty-five students from the following
countries participated: Thailand, Indonesia, India,
Canada, Sudan, Israel and The Netherlands. In addition
to this, we, and the other students represented, partici
pated in the General Meeting and the Symposium
"Progress and Challenges in Health Sciences Education".
Among other things, we presented a student point of
view on dr. Neufeld’s report "The Network in 1987... and
beyond". Also we responded to the request of the
IFMSA concerning their "Village Concept". The village
concept is a project on elective periods in developing
countries which enables students from both Network and
traditional schools to gain some experience in commu
nity medicine. IFMSA would like to cooperate with
Network schools which already have similar programs
running in order to avoid an overlap in activities.
Below we give a brief summary of the results of the
student workshop.
1. Expectations of students in respect of their
involvement within the Network.
- learning about the different concepts of innovative
medical education;
- giving feedback on education to faculty members;
- motivating students at home institutions for innovative
medical education;
- giving mutual support as an international organization
to students at the individual institutions in their efforts
to improve their educational systems;
- improving the student-teacher relationship;
- being exposed to a more critical and academic view on
education and health sciences;
- providing exchange possibilities among Network
institutions.
2. Possible activities for students within the Network.
- strengthening relationships with students and faculties
concerned with education at our own and other
institutions;
- participating in the planning, realization and evaluation
of Network meetings;
- organizing parallel student sessions during Network
meetings;
10
between Network students and staff and provide some
continuation in local student activities;
. making a half yearly report on all local Network
student activities which will be sent to the secretariat;
. organizing activities in order to inform students at
traditional schools on innovative medical education;
. collecting all, the necessary data for a Network student
handbook.
5. Fundihg.
The secretariat will rely on the resources of the general
Network secretariat for their expenses during the next
two years. Local contact persons should be able to rely
on the resources of their own institutions for expenses
incurred mainly by copying, mailing, etc. Al the next
General Meeting we will discuss the possibility of having
a budget of our own.
Looking back on our meetings, we think we may con
clude that our workshop has been a very successful and
fruitful event. We also had a lot of fun.
We would like to thank all participants for their enthu
siasm and valuable contributions and the Network as a
whole for making this workshop possible. Hopefully
after two years we will be able to conclude that our plan
of action has been successfully implemented!
The central Network students secretariat,
Tonny Bouts, Hanneke Hamers, Anne van Lammeren,
Harro, Spitsbergen.
Address contact person:
Harro Spitsbergen
Lakenweversstraat 29-bl5
6211 BK MAASTRICHT
The Netherlands
The Network and Other Organizations
World Federation for Medical Education
Report by Dr. Henry Walton*
3
"S'
I would like to inform readers about progress in the
Programme of the World Federation, which sets out to
reorient medical education worldwide (stated in detail in
the "Six Major Themes" document).
The national conferences, where responses from
countries to the 32 issues in the "Six Major Themes
were obtained, are now completed.
Six Regional Conferences will precede the World Confe
rence on Medical Education. The Regional Conference
for Europe took place in Dublin in September 1987.
The Regional Conference for Africa was held in
Brazzaville on 27-30 October, and the corresponding
Conference for South-East Asia took place in New Delhi
on 23-25 November 1987. The Regional Conference for
the Middle East will be held at Amman on 14-17
February 1988. The arrangements for the Western
Pacific Region are in progress; Dr. Mario Chaves of
Brazil heads the Task Force planning the Regional
component from the Americas under the auspices of
PAFAMS (FEPAFEM).
It will interest the Network to hear that the European
Regional Conference, which look place in Dublin in
September 1987, adopted 44 recommendations, and
identified six further uncertain issues for intensive dis
cussions prior to the World Conference on Medical
Education. A follow up European Regional Conference
will be held in Lisbon in April 1988, to which the health
ministers of Europe will be invited.
The Network will welcome confirmation that the World
Conference will take place in Edinburgh on the dates
originally proposed, 8-12 August 1988. The World
Federation expects the Network to nominate medical
teachers who have made major contributions to medi
cal education and who particularly request participation
in the World Conference. Such applications will be most
favourably considered by the World Federation and its
Planning Commission. An Implementation Phase will
follow the World Conference to monitor the actions
taken to promote the recommendations emerging from
the World Conference.
In addition to the formal Programme, and apart from
the National, Regional and World Conferences,
specialist areas have been dealt with in preparation for
the World Conference on Medical
Education:
1. Assessment of clinical competence; two international
conferences have been held in Canada (the Proceedings
of the first Ottawa Conference have been published by
WFME).
2. Medical manpower, unemployed doctors and over
production of doctors have been discussed at a Confe
rence in Acapulco with the World Health Organization
and the Council for International Organizations of
Medical Sciences (CIOMS). Two publications are
available.
3. Continuing Medical Education: a First International
Conference was held in California (30 November-4
December 1986) and a Second International Conference
on CME will be held, also in California, on 28 February-4 March 1988. Those wishing to attend should
contact the WFME office in Edinburgh.
4. An Expert Group on Problem-Based Learning met in
Dundee in September 1987. (Note: the President
reported later at the Pattaya Conference on this PBL
Expert Group).
I wish to conclude by emphasizing again how critically
important the most active participation of the Network
is in the World Federation Programme.
1 want to repeat the good wishes of the WFME on the
Network’s achievements and emphasize the great
benefits for both the Network en WFME in the continu
ing collaboration of our two organizations.
* Dr. Henry Walton is President of the World
Federation for Medical Education, Edinburgh, Scotland.
kllealth Services Management Centre
Overseas Unit
University of Birmingham
Birmingham, United Kingdom
by Dr. D. White*
i
ii
Management in Medical Education?
As a new corresponding member of the Network 1
suppose my first duty is to correspond. This article raises
the question "are the innovative medical curricula
innovative enough in the management of health care?'
By ’management’ in this context I do not mean the top
level of any organisation’s hierarchy, or a set of business
techniques, but the various processes (organising work,
communicating, managing human and material
resources, etc.) involved in getting things done through
people. Because managing can only be through people,
at its heart is leadership - the capacity to mobilise the
willing support of others to achieve worthwile goals which is the cutting edge of change. There is a great deal
to change in our health systems and practice to reach
Health for All. So how shall we get there unless
managerial leadership is widespread at all levels, not
least amongst medical doctors? Bearing in mind that,
very soon after qualifying/registering, such doctors may
well find themselves - at least in the developing countries
where 1 work - in charge of a health centre of first-line
hospital or a district family health programme, has their
training prepared them to manage with confidence the
difficult situations that will certainly arise?
Specifically, can they:
1. Manage themselves - their time, priorities, targets,
standards? If they cannot do that they are unlikely to
manage anyone or anything else.
2. Apply their problem-solving techniques to things that
go wrong in their organisation (overcrowding, staff
shortages, referral system breakdowns, etc.)?
3. Delegate safely; train, motivate, supervise and when
necessary discipline any staff for whom they are
responsible?
4. Conduct a meeting successfully and resolve disputes
fairly? (these tasks will not wait for the doctor to
become more senior). 5. Secure community participation
and intersectoral collaboration, through skills of
consultation and persuasion?
6. Control financial resources in their best use and
develop cost-consciousness amongst all staff?
common? Management has (like medicine) a science
and art of its own, theoretical concepts requiring
frequent practice under supervision and guidance.
Mismanagement can be dangerous to your organisation s
health....
Is there too little time for management in an over
crowded syllabus?
But the innovative schools in this Network have already
shown how the problem-based approach can liberate the
curriculum from over-structed timetables, by designing
learning opportunities and materials for use as the
students find the need and reason to relate their learning
to the problems they arc working on. If managerial
abilities are amongst the required competencies of the
trained doctor then they should and can be acquired in a
similar way, using realistic management tasks and
problems as the learning medium.
Is there a lack of suitable teachers/facilitators,
materials and methods for this kind of training?
This would be credible, if only because schools of
medicine and management have rarely collaborated
closely. But these resources do exist, or could be
developed if needed and wanted. There arc numerous
excellent training films and modules, case studies,
structured exercises, readings and simulation games, all
capable of adaptation or interpretation into particular
settings. These questions have been raised most recently
in my mind by attending the International Workshop on
Innovative Undergraduate Medical Curricula towards
HFA/2000 at the University of Zimbabwe Medical
School, Harare, in June 1987. The solid achievements
and further potential of some of the problem-based,
community-oriented medical schools represented are
very significant; and it seemed that the imagination and
innovative power so obviously behind these develop
ments could give serious consideration to the case for a
more systematic integration of managerial considerations
and competencies into their novel and still-evolving
curricula.
I hope so. What should help towards serious analysis
would be for Network members to see, preferably in the
columns of this Newsletter, some account of their expe
rience (good and bad) from those professional schools
which have explicitly incorporated management into
their curricula, especially if they have evidence or
impressions of its effect, if any, on subsequent work
performance.
No doubt it would be possible to achieve a systematic
sharing, through the Network, of specific learning re
sources with institutions which want to take management
more seriously into their curricula.
Thank you for reading this.
And so on. All these ’managerial’ things and more are
part of the day-by-day context in which the new doctor
works, and must learn to manage. And good
management requires good management training. Is this
attained, or attainable, through your school’s curricu
lum?
But would this training be too early in the evolution of
the doctor?
Not if effective practice requires this kind of basic mana
gerial competence soon after the doctor is launched
from the medical shcool, particularly if you cannot rely
on continuing education to remedy any deficiencies
quickly enough. An appreciation of management needs
to be absorbed steadily within professional education,
not added on later as an afterthought.
Is this plea for better management training in medical
education simply exaggerated?
After all, management is really only common sense plus
experience gained by trial and error. But of good
management is only common sense why is it not more
* Dr. D. White is Coordinator of the Overseas Unit,
Health Services Management Centre, Birmingham,
United Kingdom.
World Health Organisation
Maternal and Child Health Unit
Geneva, Switzerland
12
1
A safe birth delivery kit
Introduction
Home deliveries are still very common in many countries
of the world. Although WHO recommends that all births
should be attended by trained birth attendants, this is
often not the case and even where attendants have been
properly trained, lack of supplies and poor transpor
tation are examples of the kind of obstacles to safe,
clean births. Poor birthing practices together with the
lack of simple supplies can result in the death of a new
born from neonatal tetanus, an infection of the babies
umbilicus.
WHO has produced written guidelines for safe, clean
births. The three principles incorporated are: clean
hands, clean perineum and umbilical cord care, and a
clean surface for the delivery to take place. The guide
lines stress the importance of all these principles and
explain how to prepare delivery kits to ensure proper
cord treatment during the birthing process. The kits
contain only the basic items necessary for a clean safe
delivery.
Questions that need answering
Since the guidelines are new they will need field testing.
Are the instructions clear? What needs deletion and
what has not been included? Can they be easily
translated into other languages? These observations will
help WHO in writing and updating the guidelines for
future editions. The second set of questions which need
answering regard the delivery kit itself. How easy is it to
assemble and distribute? What are the costs involved
and remuneration if any? How do the women and birth
attendants accept the kits and are they used properly?
What kind of educational materials could accompany the
kit to assure proper use? Girl guides could help in
assessing both the written guidelines and in assembling
and distributing the simple kit in villages.
Mechanisms
The guidelines are presently being printed as a prelimi
nary document for field testing. It will be distributed in
bulk to various non-governmental organizations for
further distribution to the field. Field staff, women s
groups, girl guides, etc., will be asked to fill out an attached’card if they desire to participate in testing of the
guidelines by assembling and perhaps distributing
delivery kits. During this introductory phase all information will be sought to improve the guidelines in
their final form.
4
i
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r
f
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,>
Book Reviews
"Innovative Tracks at Established Institutions for the
Education of Health Personnel", edited by Martin
Kantrowitz, Arthur Kaufman, Stewart Mennin, Tamas
Fulop and Jean-Jacques Guilbert. Geneva: World
Health Organization. Price: Sfr. 39.-
Only 1.5 percent of the medical schools in the world can
be considered innovative in the sense that they deli
berately attempt to deal with the challenges medical
education will face by the year 2000: the radically
changed health needs of the population at large and the
information explosion. Most of these institutions have
structured their curricula in a way that makes it quite
difficult for existing schools to follow their example,
even if the need were felt. For instance, thematic, multi
disciplinary education requires a degree of collaboration
among Departments that is almost impossible to achieve
in traditional schools. In addition, the change from a
teacher- to a student-centered curriculum presupposes
attitudinal changes, difficult to induce in a conventional
context. An interesting approach to meet these problems
is the establishment of a second, innovative track in a
traditional school, parallel to the conventional cur
riculum. Since the beginning of the eighties, eight
schools -four of them in the USA- have pursued this
possibility. According to the case studies collected in
this book, the success of this approach is overwhelming.
Not only are these programmes able to survive in an
environment which, at best was indifferent to the innova
tion; they actually begin to influence their conventional
counterparts.
This book is indispensable food lor thought and a source
of original ideas, not only for staff from traditional
schools seeking way to renewal, but for all those involved
in the business of education, development or research in
the health professions.
►"Workbook for Program Evaluation", compiled by
Stewart Mennin and others. A Task Force 7 Production.
Available at the University of New Mexico, School ol
Medicine Primary Care Curriculum.
Price: approx. US$ 23.This workbook is aimed at medical educators in inno
vative programmes. It may have particular relevance to
those in community-oriented medical education pro
grammes in developing countries. Its major goal is to
stimulate interest in and facilitate the development ol
programme evaluation where it is needed most, m
programmes seeking to produce doctors able and
willing to address the health care needs of medically
under-served populations. Some of the most important
and least evaluated changes in medical education are
taking place in developing countries. Most of the mate
rial available in this workbook has been obtained from
schools in developed countries. The book contains
sample evaluation methods and articles how these
methods were and can be used. They are grouped into
the following nine categories:
Organizations in the following countries may have a
particular interest in these delivery kits because of the
high incidence of neonatal tetanus: Bangladesh, Benin,
Botswana, Indonesia, Lesotho, Malawi, Nepal, Pakistan,
Sierra Leone, Somalia, Tanzania, The Gambia, Zambia
and Zimbabwe.
i
Those interested in receiving a copy of the written
guidelines and/or participating in the assembly and
distribution of the simple delivery kits should contact:
Dr Richard J. Guidotti
Scientist, Maternal and Child Health
World Health Organization
Geneva, Switzerland
13
1
1. institutional self-assessment, 2. students’ and
graduates’ knowledge, skills and attitudes, 3. faculty and
student perceptions of the programme, 4. cost effec
tiveness of the programme, 5. impact oi the programme
on own and other institutions, 6. impact of the pro
gramme on community health, 7. relevance of the
programme to health manpower needs, 8. consistency
between the goals of the programme and clinical
education, 9. consistency between learning experiences
in medical education and the needs of the health
services sector.
In other words, this book is a ’must’ for anyone actively
involved in evaluation programmes.
Have you read this?
Benor D., Difficulties in Implementation of Innovative
Curriculum: Issues and Responses, Faculty of Health Sciences, Ben
Gurion University, Bcer-Shcva, Israel.
Clarke R., Student’s approaches to learning in an innovative medical
school; a cross sectional study, British Junl. Educ. Psych, 1986.
Glick S., History, Goals and Accomplishments, Faculty of Health
Sciences, Ben Gurion University of the Negev, Israel, 1987.
Glick S., Naggan L., Prywes M., The Beer Sheva Experiment: An
Interim Assessment, Israel Journal of Medical Sciences,
Jerusalem, Vol.23, Nos. 9-10, Sept.-Oct. 1987.
Mitchell K-, Carney S., An evaluation of student satisfaction with
professional skills teaching in an integrated medical school, Medical
Teacher, no. 9, 1987.
Refaat A., A Conceptual Model for Designing Community-Based
Medical Education, Faculty of Medicine. Suez Canal Unrversrty,
Egypt, 1987.
Richards R., Fulop T., Innovative Schools for Health Personnel,
Report on then schools belonging to the Network of
Community-Oriented Educational Institutions for Health Sciences,
WHO offset publications, no. 102, 1987.
Community-Based Education of Health Personnel, Report of a
WHO study group, Technical Report Series, no. 746, 1987.
Articles/Reports/Newsletters
Summer 1987, World Health Organization.
- WHO Features, No.lll, September 1987.
- WHO Press, Nov.13 and 24,1987.
- World Health, the Magazine of the WHO, August-September,
November 1987.
- Tobacco Alert, WHO Newsletter no.20,April-June 1987: 7 April
1988:No-Smoking Day around the world.
- Joint Medical Newsletter, Faculty of Medicine.
Newscastle/Huntcr Medical Association and Dept of Health, N.S.W
Australia, no.46 cn 47,1987
- 'Hie Clinical Epidemiology Newsletter, No.7,October 1987,
McMaster University, Hamilton, Canada.
- Epidemiologic pour Ic Dcvcloppement. Bulletin du Reseau,
No.87/3, Reseau pour la Formation en Epidemiologic ct Same
Publique dans les Pays cn Dcvcloppement
- European Newsletter on Quality Assurance.
Volume 4,no.3.
- Center for Educational Development. Annual Report 1986-87, The
University of Illinois at Chicago.
- CED Courier. Center for Educational Development, Summer and
Fall 1987.
- Outlook, Educational Commission for Foreign Medical Graduates,
Spring 1987,No.2.
- Work in Progress, United Nations University, Japan, October
1987,Vol.lO,No.3.
- NIMSA Newsletter, Vol.l, 86/87, Nigeria Medical Students
Association Standing Committee on Publications.
- The Student Doctor, Journal of Nigerian Medical Students
Association (NIMSA), Februaiy 1987, 2nd edition.
- Boletin Fepafem, Volumen XXIII,No.2,1987.
- Journal of the Institute of Medicine, Kathmandu, Nepal,
Vol.9,No.l, 1987.
- Images, Institute of Medicine Newsletter, Kathmandu, Nepal,
Vol.2,Nos.7,8and 9,1987.
- Bulctin Pendidikan Perubatan, University of Malaysia,
Jan/Feb,Mac/April 1987.
- Berita Kcdoktcran Masyarakat, April 1987, Gadja Mada University.
- Mothers and Children, Bulletin on Infant Feeding and Maternal
Nutrition, Vol.6,No.2,1987, American Public Health Association.
- Community-oriented medical education, Ilorin experience,
Adedoyin M.A., University of Ilorin, Nigeria.
- Community participation in medical education in Nigeria, Alausa
O.K., Ogun State University, Sagamu/Ogun State, Nigeria.
- Text of slides: Introduction of parallel track in the medical school
of the University of Bari, Albano O. et al., University of Bari, Italy.
- Effects of prior examples on rule-based diagnostic performance,
Allen S.W. et al., McMaster University, Hamilton, Ontario, Canada.
-Adapting health training materials to develop a community-oriented
health training program: experience of a medical relief operation at
the Thai-Kampuchean border, American Refugee Comm., Thailand.
- Annual Report 1986, The African Medical and Research
The Network Secretariat received:
Foundation, Headquarters: Nairobi, Kenya.
- Informative brochure on the Bangiamung Hospital. Director of
- Emirates Medical Journal, Volume 5,no.2,August 1987. Official
Publication of the Emirates Medical Association.
- Curriculum, Community Health Strand, Arabian Guif University,
College of Medicine & Medical Sciences, Bahrain, 1987.
- The Work of WHO in the European Region,1986, Annual Report
of the Regional Director, WHO Regional Office for Europe.
Banglamung Hospital, Thailand.
- Report on Baqai Medical College. Pakistan.
- Community-targeted, problem-based medical education, an
innovation in medical education in Thailand, Chulalongkorn
University, Bangkok.
- Medical Education: A view from Assiut, Egypt, El-Akkad I.N.,
Copenhagen.
- World Health Forum, Vol.S.Nos 2 and 4,1987, An International
Journal of Health Development. World Health Organization.
Assiut University.
- llic role of medical students health surveys in health planning.
Elsayed II. ct al.. Suez Canal University. Ismailia, Egypt.
Geneva.
- Light on the City, Urban Primary Health Care, Newsletter 19,
14
!
- Effect of a training program on performance of students who
failed assessment in problem-solving and clinical skills, Hassan I ct
al., Suez Canal University, Ismailia, Egypt
- I'he suitability of the primaty health centers as educational sites,
Hassan F. ct al., Suez Canal University, Ismailia, Egypt.
- Assessment of MESRAP graduates (a comparative study),
Ilpngladarom T. et al., Chulalongkorn University, Bangkok.
Thailand.
- 'Die development of medical education in 'Fhailand, Hongladarom
1. ct al., Chulalongkorn University, Bangkok, Thailand.
- Health for Ail; leadership initiative of the World Health
Organization, Khanna S.. World Health Organization
- Linkages framework from national to provincial level; Khon Kacn
model. Khon Kacn University, Thailand.
- Community-based internship program for dental students. Misrachi
C., University of Chile, Santiago, Chile.
- First annual report 1986, Mohan Dai Oswal Cancer Treatment &
Research Foundation, Ludhiana, India.
- Community orientation through educational integration, Nordin
K.. Health University of Ostcrgotland. Sweden.
- Retrieval factors in medical expertise: Improvement Independent
of Stable Knowledge, Norman G. et al.. McMaster University,
Hamilton, Ontario, Canada.
- Community-based education for health personnel. Ocana A. et al.,
University of the Philippines, Manila.
- longitudinal teaching of primary medicinei in a community setting:
a fifteen year experience, Salafsky B. et <al.. University of Illinois,
Rockford, U.S.A.
- What learning material should be included in the
problem-solving block, Sanusi R., Gadjah Mada University,
Yogyakarta, Indonesia.
- Implementing a major curriculum change n an established medical
school, Shahabudin S.H. et al., Univ. Kebangsaan Malaysia, Kuala
Lumpur, Malaysia.
- Introducing students to problem-based community-onented
programs, Telder T. ct al., University of Illinois, Chicago, U.S.A.
- The selection of working location in relation to selection of
medical students, Vatanasapt V. et al., Khon Kacn University,
Thailand.
-- Program
Program for
for new medical students, class of 1991 - 14th July to 14th
August 1987, Zachariah A., Christian Medical College, Ludhiana,
India.
- Summing-up of second semester of 1986 PCB class, You-Zhang Z.
cl al., Shanghai Second Medical Univ., China.
- Designation Ceremony of the Faculty of Health Sciences.
University of Ilorin as a collaborating centre of the WHO tn
research & manpower development on community-based educational
programs. University of Ilorin, Nigeria.
Copies are available at the Network Secretarial.
Advertisement
Specialist in Evaluation/Measurement in Medical
Education
The Arabian Gulf University
College of Medicine & Medical Sciences
Bahrain
Applications arc invited from suitably qualified
applicants for appointment in the Division of Medical
Education at the College of Medicine. The appointment
will be on an annual conlracl which is renewable. The
selected candidate would be placed al an appropriate
faculty level depending on his/her qualifications and
experience.
The curriculum of the College is innovative with
problem-based, community-oriented learning. The pre
dominant methods used in instruction are small group
tutorials and self-directed study. Assessment is used for
providing regular feedback to students and also for
quality control and certifiction. A criterion referenced
format with satisfactory/unsatisfactory outcome has been
accepted by the University. Differenct instruments have
been tried to assess student’s cognitive ability at diffe
rent levels with emphasis on problem-solving and clinical
reasoning. A computerised Multiple Choice Question
Bank is available. Computer simulations have been tried
out to refine assessment methods in clinical reasoning.
The College seeks an original thinker who is familiar
with the assessment procedures in medical schools, who
is able to guide all evaluation activities and to undertake
and guide in research. The appointee will work in a
team with members from basic and clinical science
disciplines.
.
f
A medical qualification and experience in health profes
sionals training would be an advantage, in addition to
educational qualifications.
Monthly salary: From BD 1000.000 for Assistant
Professor up to BD 2050.000 for a Senior Professor, plus
30% or 50% allowance (for practising physician) (1 BD
= $ 2.60).
Noteworthy benefits:
- Free return air ticket annually for faculty member and
family
- Monthly transport allowance
- Relocation allowance
- End of service gratuity
- Free public medical care covering family
Interested applicants are requested to send their
curriculum vitae, including the names of three referees,
personal particulars, qualifications with dales, career
history, leaching experiences, research accomphshmenls
and appropriate clinical experience to:
Dr AH Matar
Acting Dean
College of Medicine <& Medical Sciences
Arabian Gulf University
P.O. Box 22979
1
*
Manama. Bahrain
15
i.
AGENDA 1988
Workshops/M eeti ngs/Cou rses
February 9-12, 1988
Ilorin, Nigeria
First Educational Workshop
Nigerian Network Schools of Health Sciences
Contact person:
Dr. S.K. Odaibo
Chairman, Organizing Committee
First Educational Workshop
Nigerian Network Schools
Faculty of Health Sciences
University of Ilorin
Ilorin, Nigeria
Geneva, Switzerland
16th Meeting of the Network Executive Committee
Contact person:
Mrs. Ine Kuppen
Coordinating Secretary Network
Rijksuniversiteit Limburg
P.O. Box 616
6200 MD Maastricht
The Netherlands
May 17-20,1988
Hamilton, Canada
McMaster Workshops in Health Sciences Education:
Role of the Tutor in Small Group Learning
Contact person:
Miss Annette Sciarra, Workshop Coordinator
Education Services, Room 3N51
Faculty of Health Sciences
McMaster University
1200 Main Street West
Hamilton, Ontario L8N 3Z5
Canada
February 14-17, 1988
Amman, Jordan
Regional Conference on Medical Education
in cooperation with the World Federation for Medical
Education Contact person:
Dr. Kandil Shaker-Shubair
Director, Center for Educational Development for
Health Personnel University of Jordan,
Amman, Jordan
May 1988
Chicago, U.S.A.
Course in Community-Based Medical Education
Contact person:
Thomas Telder
Assoc. Director for Educational Programs
Center for Educational Development
808 S. Wood Street (m/c 581)
Chicago, IL 60653, U.S.A.
(Tel. (312)996-3590)
April 10-15,1988
Westbury Wiltshire, Britain
Disability and Rehabilitation in the Developing World:
Residential Course
May 23-27,1988
Westbury Wiltshire, Britain
Disability and Rehabilitation in the Developing World:
Non-Residential Course
Anyone who is working or is about to work overseas
with people with disabilities (including learning
difficulties) and those interested in work in this field education, health, rehabilitation, administration and
campaigning, is welcome. Practical and theoretical,
participatory sessions provide a forum for participants
and tutors to share their experiences, skills and ideas
and to look at some of the fundamental issues behind
Disability and Development. Emphasis is on working
with people as allies and on ways to improve com
munication and training skills and encourage local
initiatives.
Contact person:
International Disability Education and Awareness
William House
101 Eden Vale Road
Westbury, Wiltshire BA13 3QF
Britain (Tel. 0373 827635)
May 26-27,1988
Linkoping, Sweden
Second General Meeting of the European Network for
Development of Multiprofessional Education in Health
Sciences (EMPE)
Representatives of institutions actively interesed in
multiprofessional education at all educational levels are
cordially invited to attend.
Contact person:
Prof. Nils-Holger Areskog
Dept, of Clinical Physiology
Linkoping University
581 85 Linkoping, Sweden
June 6-9,1988
Hamilton, Canada
McMaster Workshops in Health Sciences Education:
Visitors’ Workshop
Contact person:
Miss Annette Sciarra
May 2-13, 1988
Geneva, Switzerland
42th World Health Assembly
May 5-8, 1988: Technical Discussions
June 20-July 8,1988
Maastricht, The Netherlands
Visitors’ workshops
June 20-24: Introductory Workshop.
June 27-July 1: Learning through problems;
opportunities and limitations.
May 12-14, 1988
WHO Headquarters
16
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July 4-8:
New methods in student assessment and skills training.
Contact person:
Miss Willie Schippcr
Office of the Dean, Faculty of Medicine
University of Limburg
’ P.O. Box 616
6200 MD Maastricht
The Netherlands
3
July 5-22, 1988
BLAT, BMA House, Londen, U.K.
BLAT/WHO Course on Modern Methodology for
Teachers of Health Sciences
A 3-week intensive course. Instituted in 1978 at the
request of WHO, the course provides teacher training
and covers in a very practical manner a range of
educational topics: curriculum design, lecturing, small
group work, medical and health education. Participants
are drawn from all disciplines.
Contact person:
Head of Information Services
BLAT Centre for Health and Medical Education
BMA House, Tavistock Square
London, WC1H 9JP, United Kingdom
-fl
■A
a
October 9-13, 1988
Beer Sheva, Israel
International Symposium on the Role of Student Health
Professionals in Community Health Education
Contact person:
Chaim Yosefy, Symposium Organizer
Center for Medical Education
Faculty of Health Sciences
Ben Gurion University of the Negev
P.O. Box 653
Beer Sheva 84105, Israel
October 10-13, 1988
Jerusalem, Israel
First Jerusalem Health Exposition
Contact person:
Atzeret
29b Keren Hayesod St.
P.O. Box 3888
Jerusalem 91037, Israel
October 25-28, 1988
Hamilton, Canada
McMaster Workshops in Health Sciences Education:
Role of the Tutor in Small Group Learning Workshop
Contact person:
Miss Annette Sciarra
Each academic yean Oct-Dec, Jan-March, April-June
BLAT, BMA House, London, U.K.
BLAT/Institute of Education of The University of
London: Diploma in Primary Health Care Education
A three unit course on design, planning, and
implementation, of health education programs. It is
intended for all health professionals with field
experience who are or will be teaching others, and who
need to know more about primary health care and
educational techniques. Topics covered include policy
issues, appropriate technologies, changing patterns of
health, planning for primary health care education,
innovation and change. Students are encouraged to work
on their own needs in a flexible manner.
For more information and application forms write to:
Head of Information Services
BLAT Centre for Health and Medical Education
BMA House, Tavistock Square
London, WC1H 9JP, United Kingdom
November 21-23,1988
Hamilton, Canada
McMaster Workshops in Health Sciences Education:
Visitors’ Workshop
Contact person:
Miss Annette Sciarra
More details about the Network activities can be found
in the section ’’Forthcoming Events Network
Institutions".
August 30-September 16,1988
Newcastle, Australia
TEN YEARS OF INNOVATIVE MEDICAL
EDUCATION: A CELEBRATION
August 30-Sept. 2: Problem-Based Learning: Education
for the Professions.
September 5-6: A Case Study in Innovation.
September 7: David Maddison Lecture.
September 8-9: Comparison of Goals and Strategies in
Innovative Medical Schools.
September 12-16: Priorities for the future.
Contact person:
Information Officer Faculty of Medicine
University of Newcastle
New South Wales, 2308
Australia
*
MpH3>0
I 35117
newsletter
Network of Community-Oriented Educational Institutions for Health Sciences
Number 9 / July 1988
Editorial
•s
We were pleased to receive so many positive and stimulating reactions to our
last Newsletter. Thanks. This issue contains again interesting information
about the Network activities, progress and plans for the future. There arc
special contributions from the “coming” and “going” Secretary General.
Dr. Zohair Nooman and Prof. Dr. Co Creep. We would like to take this
opportunity to express our gratitude to Co Creep for all he did for the
development and establishment of the Network. We have often called him our
“supertank” because he generated so much energy that it was sometimes
difficult to follow him. Without him the Network would not have been where
it is now.
We would also like to welcome to the Secretariat Dr. Zohair Nooman, who
took over Co Creep’s job as from July 1,1988. We look forward very much
to working with him.
A small Editorial Board has been appointed consisting of Prof. Dr. Charles
Engel, Wellcome Tropical Institute, London, U.K.; Prof. Dr. Fernando Mora
Carrasco, Universidad Autdnoma Metropolitana-Xochimilco, M6xico, and
Miss Anne van Lammeren, 6th year medical student, Rijksuniversiteit Lim
burg.
Your contribution will be most welcome. Please send us information about
programs, educational workshops, conferences and courses, interesting
articles, publications, and educational activities at your institution.
Deadline = November 1,1988 1
Special thanks to Dr. Charles Engelfor his ftlinguistic" support.
We look forward to hearing from you.
On behalf of the Secretariat ^gang”
Editor : Mrs Ine Kuppen
PuNished by the Network Secretarial
Rijksuniversiteit Limburg
P.O. Box 616
6200 MD Maastricht, The Netherlands
Tel. 043 - 888.888/888.303 ,
Telex: 56726
Telefax: 43 - 219552
Contents
Editorial
Chairman's Column
News from the Secretariat
The 1989 Network Conference
Recent Events
The Network Task Forces
News from Network Institutions
Forthcoming Network Events
New Network Members
News from Network Students
Other Organizations
Book Reviews
Pag.
1
1
2
4
5
6
6
9
11
11
12
13
13
15 .
Ine Kuppen
♦
■ J
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Chairman’s Column
a person of such experience, commitment and vision to serve us.
Zohair was the founding dean of one of the most important
experiments in medical education of the past decade - the Faculty of
Medicine, Suez Canal University in Egypt. He is a past-chairman of
the Network Executive Committee, and has travelled widely on
Again it is my pleasure to greet all members and friends of the
Network on behalf of my colleagues on the Executive Committee.
The Committee recently held its first meeting (in Geneva) since our
September 1987 general biennial meeting in Pattaya, Thailand. Our
discussions were featured by excitement about important develop
ments in various parts of the world; and by the realization that we are
in a time of transition. A comment about both features.
First, about transitions. At the end of June, Professor Jacobus (Co)
Creep handed over the Secretary General responsibilities after eight
years of service to the Network. During these years, the Network has
grown and matured. Co’s particular contributions have been his
commitment to the Network’s goals and values, and his seemingly
boundless energy. Colleagues in many countries around the world
will remember his visits and his presentations about the Network. All
of us associated with the Network are grateful for his dedication and
his service. And I am pleased to say that Co will continue his
behalf of the Network in many parts of the world.
At the Executive Committee meeting, we also said farewell and
thank you to Dr. Tamas Fiildp, the Director of the WHO Division of
Health Manpower Development. Tamas played a major role in
facilitating the founding of the Network and has been a strong, often
“bchind-thc-sccncs" supporter and encuurager of the Network since
it began in 1979. We wish Tamas well in his further ventures in the
health care field, as he steps down from his post in Geneva later this
year.
The last six months have seen growing interest in the Network, and
some remarkable developments. As an example, the Executive
Committee received a report about the formation of a Middle East
regional grouping of institutions who arc working together on
Network-related activities. These universities include the Universi
ties of Gczira and Khartoum in the Sudan, Suez Canal University in
association with the Network as a senior consultant
Those of you who attended the Patuya meeting know that Co’s able
successor will be Dr. Zohair Nooman, who became our new
Secretary Genera! in July. The Network is most fortenate in having
■____________________________________________________________________________________________________________________________ •
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1
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________________
I
Egypt, and the University of Sana’a in the Yemen Arab Republic. A
focus of activity has been a major transformation of the medical
education program in Khartoum. Similarly, leaders in medical
education from all eight medical schools in Thailand have been
working together in a national effort for change in medical education
to produce graduates whose competencies are more attuned to the
developments. Innovative health science education is here to stay.
One main concern today is how to keep the innovation impulses
active, how to keep the educational enzymes flowing.
At our biennial meeting in Ismailia (1985) the participants made
some recommendations about the activities of the Secretariat and the
health needs of the country.
The Executive Committee is just completing a “Plan of Action”
document, which reflects the new directions of the Network
(discussed at the Pattaya meeting) in terms of specific activities for
the current two-year period, 1988-89. This document will shortly be
distributed to all members (extra copies will be available from the
Secretarial). Several member institutions have sent in written sum
maries of the Network-related activities within these institutions. I
encourage all institutional correspondents to send these to us as soon
as possible. Already, the available statements present a rich array of
descriptions about how the goals of the Network are implemented as
appropriate to the opportunities at each location. All are characteri
zed by imagination, determination and a vision of what is possible.
tarial support.
As Secretary General I can assure you that many things have
happened to the Secretarial since then. First of all, the WHO
recognized our existence. In January 1987, the NGO status (Non
Governmental Organization) of the World Health Organization was
granted. Our midwife, foster parent and benefactor considered us an
equal partner for life. The communication centre has grown up with
a data base with increasing amounts of hard and software.
A brochure was written in 1987 with the basic information about the
aims, objectives and activities, and the by-laws changed after
Executive Committee. A strong Network has to have a strong secre
Pattaya.
Many new institutions applied for membership, and today we have
100 full, associate and corresponding members.
Despite considerable financial problems we were able to enlarge the
communication base with evaluation instruments, problem-based
learning workshops, teacher training, manuals on how to innovate.
Dr. Richards and Dr. Ftlldp evaluated ten Network schools with a
Dr. Vic Neufeld, chairman
clearly positive outcome.
By using both telefax and telephone, we were able to improve our
direct communication and telecommunication; interactive computer
communication is around the comer. Traditional communication
was maintained through Newsletters. The Newsletters 5 through 9
News from the Secretariat
The Network: A Retrospective View
by Dr. Jacobus Creep, Secretary General 1980 - July 1988.
were published in the last two years.
Many monographs and books were published,and the Network has
started, its own Journal: the Annals of Community-Oriented
At the time the Network was bom in 1979, a birth in which the active
father Dr. Tamas FUldp helped as midwife and foster parent, nobody
could have envisaged the fantastic growth and development that the
Network would undergo over the eight years that were to follow. In
the Secretariat, we fostered the baby with communication and
coordination, and we conducted its activities. During meetings of the
Executive Committee and the core of Network activities, the
organization of the biennial meetings in Bellagio (1981), Havana
(1983), Ismailia (1985) and recently Pattaya (1987), we have seen
the baby grow up into an adult able to handle its own future, a future
so eloquently laid down in a discussionpaper by Vic Neufeld which
Education.
As the membership grew the scope of communication between the
institutions has grown. We are no longer an exclusive deans ’ club but
a club with all sorts of communications between faculties in which
interactive correspondence and communication between students
play equally important roles. The columns of the Chairman and
Secretary General and the reports of the many activities of Network
schools have clearly shown that the aims of the Network and its
Secretariat are being met.
We are strengthening membership mstitutions in the achievement of
innovation in medical education and in promoting population
concepts of health science in the curriculum. An ever growing
number of institutions around the world is genuinely interested in
was discussed and amended in Pattaya.
We also went frequently around the world to emphasize the nature of
the Network. We have been actively involved in meetings from
Japan to Mexico and from Linkdping to Bahrain.
The Network has now become an adult institution, with help from
changes in society, with help from the ever-increasing chorus of
criticism about traditional medical education, with help from the
rising international feeling that independent learning and problem
solving skills and the relevance of population-based teaching are of
utmost importance and will create the doctors of the future. With the
help of the ever-increasing groups of member institutions, we will be
able to make the Network a strong one.
Many historic, educational highlights of the last eight years have
helped to create an awareness of the need for a critical attitude
towards traditional medical education.
New pathways have helped to change the medical education
environment and new pathways will enable the Network to progress
with confidence. The climate has become increasingly positive for
this growing up. New aspects such as epidemiology .communication
skills, medical management, and educational reward systems, have
transformed the Network into a sophisticated and demanding teen
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change.
The Executive Committee met 7 times in the last 36 months, mainly
in Geneva, Maastricht and, recently, in Pattaya. The Minutes of these
meetings are available for your inspection.
New faculties, which want to start innovative curricula, have placed
an ever-growing burden on the rather small resources of the
Executive Committee and the Secretariat The Network is actively
involved with new institutions e.c. in Al Ain, Kano and Taipei; new
schools that have decided on a problem-based curriculum.
The Secretariat has also played a very active role in many facets of
change in medical education. The finances of the Secretarial and the
Executive Committee remain a problem. The World Health Organi
zation, the Ministries of the Dutch and Canadian govemmenls, and
the Rijksuniversiteit Limburg have helped us to slay alive on a low
budget.
In the 8 years I have served as your Secretary General I have watched
the Network grow and develop. Participation in this process has been
extremely rewarding. Many problems in medical education and
health science created the leadership and the resources to solve them.
Through the activities of the Network, its members and the
ager growing rapidly into adulthood.
In view of this, the role of the Secretariat and the Executive
Committee has been one of encouraging and supporting these
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Dr. Jacobus Creep
Secretariat we have made innovative medical education productive.
It is extremely rewarding for a veteran in the field like your Secretary
General, to see the successful turnabout in medical education today,
a turnabout that took barely a decade. The Netwcric has gained a
worldwide reputation due to the cooperation of its members, and the
present phase of the evolution in medical education is highly
promising. As a manager of the Secretariat I must say that thanks to
a first-rate group of people in die Secretariat, we have already
accomplished a number of our goals today.
By the middle of July I have served you on a voluntary basis for 8
years. Although the constitution allows me to serve yet a third term,
I have decided, as manager of this team, to step down. Although
thinking backwards is intuitive and suggestive, and forward thinking
requires detailed information rather than intuition, I am very
optimistic in my predictions of the future for the Network. Despite
the many changes around us, I am confident that die Network is
stable and will continue. There are, indeed, important changes
occuring around us. This month Dr. Halfdan Mahler, our philo
sopher, has left the WHO and the Japanese leader Dr. Hiroshi
Nakajima, his successor, has already supported the Network from his
office in Manila. We congratulate Dr. Nakajima on his new
prestigious position. We hope that despite his busyschedule he will
help the Network in the same way as he has done in the past
I am sure we will succeed in shaping the future in the knowledge that
we can meet new goals, clearly above those we have already
achieved. I am grateful to all who have surrounded me and who have
helped the Network become a thoroughly international achievement
In the next paragraph my successor and friend. Prof. Dr. Zohair
Nooman, will look into the future of the Network 1 like to take this
opportunity to wish him all the best in this challenging job.
I know that the Network Secretariat will be kept safe and stable in his
capable hands.
Jacobus Creep
Dr. Zohair Nooman
A Point of View on the Network’s Plan of Action
for the next two years
by Dr. Zohair Nooman, Secretary General from July 1, 1988
The mission of the Network
It is the prevailing notion in health personnel education (HPE) that
it should be renovated to make it relevant and responsive to the health
needs of the people. The assumption is that health care systems
would be similary reoriented and that the graduates of health
personnel educational institutions would be instrumental in both
effecting this re-orientation and satisfying its needs.
Community-oriented health personnel education is presented as the
new pathway to which HPE should be directed to satisfy the above
requirements. The Network is the gathering of the pioneering
institutions thathave adopted - or are adopting - community-oriented
education(COE). The Network is therefore the spear head of the
movement of innovating HPE along the lines of COE, the aim being
that this movement would ultimately encompass HPE institutions
world wide. The Network is in fact the instrument to effect this
global change. This to my mind is the mission of the Network, and
its fulfilment - if ever it could be achieved - represents the goal of the
Network.
Considering the spread of die community-oriented educational
movement since the formation of the Network in 1979,the progress ,
has been satisfactory. However, the tasks that still need to be
accomplished before actual change has involved the bulk of HPE
institutions all over the world, are at least extremely challenging.
Areas of challenge
Community-oriented education is still a novelty. Although there are
standing definitions of COE and Community-Based Education
(Network, 1979, WHO, 1987), and although there arc broad
similarities in philosophy and approach between the various COE
institutions, there is no standard acceptable model as yet Practically,
each COE institution has its own formula, and none of them has a
convincing evidence that its graduates are superior to graduates of
conventional programs in its own country or world wide.
“Convincing” to the point of urging established institutions to
undertake the tasks - often of considerable magnitude - implied by
the proprosed change.
»>
The road to change
Even if established institutions are convinced by the rationale and
superiority of COE, the road to change from conventional to
innovative is not clear yet. Tracks represent a good idea, but its
propagation world wide, particularly in most countries with meager
resources, is difficult. Established medical schools in developing
countries with limited economic and human resources, often with
underdeveloped health delivery systems as well, have difficulties in
maintaining a good quality educational program of any sort,
conventional or innovative. This increases the complexity of the
desired change. Two battles need to be won at the same time: the
acquisition of resources and the orientation towards COE.
The 1989 Network Conference
“Academic Institutions and Health Services as
Partners in Health Care Development”
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September 17-22,1989
Rolduc International Conference Center
Kerkrade, The Netherlands
Two major sets of problems thus face the COE movement and its
spear head, the Network.
Solving the problems of community-oriented education What does
it mean to be a community-oriented educational institution? What
should the curriculum look like?
Solving the problems of introducing change in established HPE
institutions will go a long way towards introducing change in
established medical schools.
The Network is actively working to provide answers to some of those
questions:
- Task Force 2 aims at working out how priority health problems,
properly identified,would be utilized to construct a medical
Air Photo Rolduc
curriculum.
- Task Force 3 aims at elucidating how COE is being
implemented in various COE programs, its different
components, settings, problems of implementation and working
The 1989 Network Conference will be held September 17-22,
1989. The meeting will be organized by the Faculties of Medicine
and Health Sciences of the University of Limburg. Several
international experts have been invited to join the Organizing
Committee to assure a pertinent and attractive meeting. The venue of
the Network General Meeting and the Conference will be the former
monastry of Rolduc in Kerkrade, The Netherlands. Kerkrade is
situated about 20 miles east of Maastricht, close to the border with
out solutions.
- Task Force 4 addresses students’ evaluation.
- Task Force 6 addresses program evaluation.
Problem of introducing change in established medical schools
Clarity of the content and methodology of COE, and demonstration
of its decisive benefits over conventional curricula by evaluation of
the programs and their graduates, are prerequisites for acceptance of
change in other than pioneering situations. Lobbying is not enough.
Task Force 5 is active in this respect and the “track” model is
available. Specific conditions prevail in different countries and even
in different schools, and it seems that in developing countries the
challenges are different in nature than in developed countries. The
objective being the development in suitable alternative strategies for
re-orienting established medical schools; new avenues have to be
West-Germany.
The 18th and 19th of September, Monday and Tuesday, have been
reserved for the 6th General Meeting of the Network.
The Conference “Academic Institutions and Health Services as
Partners in Health Care Development” will run September
20-22, Wednesday through Friday morning.On Friday afternoon an
optional site visit of the Faculties of the University of Limburg will
be organized. A social programme including Holland’s neigh
bouring countries, West-Germany and Belgium, will be available for
those accompanying Conference participants. The Organizing
Committee recognizes the need to convince all of you that the
expression “a Dutch treat” can have a generous meaning !
The Conference will focus on interactions of Health Services and
Academic Institutions that are of mutual benefit and which may
promote community-oriented health education. Attention will be
paid to educational approaches most suitable to fit these interactive
models of cooperation. Topics currently considered include:
- How to establish priorities in health care development.
- Translating (interjnational health policies into plans of action.
- Participation of Health Services and Academic Institutions in
multi-disciplinary socio-economic development projects.
- Input by consumer organizations in health care policies.
- Ideas for bilateral partnerships with Network Institutions in
explored by Task-Force 5.
I will end my first contribution to the Newsletter in my function of
Secretary General with some words to Co Creep. For eight out of the
nine years which constitute the age of our vigorously growing
Network, Co Creep has been the Secretary General. A good deal of
the global spread of the Network membership and ideas could fairly
be attributed to the immense activity of Dr. Creep as he traveled all
over the world to “spread the gospel”. Together with my colleagues
in the Executive Committee and the Secretariat, we feel assured with
the continuity of Dr. Creep’s contribution to the Network as Senior
Consultant in the years to come.
Zohair Nooman
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strengthening District Health Systems.
- Educational strategies for training and evaluation of students in
health care settings.
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knowledge of each other and a free and extensive exchange of
ideas.
3) Greater awareness of the relevance of community-oriented
medical educational programs became evident.
4) Practical guidelines were determined to assist individuals and
institutions interested in comm uni ty-based programs.
5) Some difficult issues such as base of these programs ; post
graduate training and lack of or inadequate modem teaching
aids were addressed and reasonable practicable suggestions
offered.
In general, the format of the Conference will be based on brief
plenary sessions for keynote addresses and/or short panel discus
sions, followed by in-depth small group discussions. There will be
ample space and time for the exhibition and viewing of posters.
The first circular on this Conference, including a call for papers and
a provisional subscription form, will be sent out in October 1988.
Please reserve the Conference dates in your next year’s diary
now I
Dr. Gerard Majoor, Conference Coordinator
The future
The Nigeria Network schools have planned biennial meetings to
rotate through the various constituent medical schools. Bayero
University will, for example, most probably host the 1990 workshop
in Kano.
Participants were all convinced of the need to keep alive the
awareness and conviction that one strategy for health for as many as
possible is health delivery at the primary level. Two activity
recommendations were made :
1) Schools of each country should aim at organizing a National
workshop in 1989. Countries with 1 or 2 schools could
organize a joint seminar with neighbouring countries.
2) Between the University of Ilorin, acting as coordinator and Moi
University in Kenya, the holding of a workshop in Kenya in
1989 should be explored.
Recent Events
First International Workshop
on Innovative Medical Education
February 1988
Ilorin, Nigeria
Report by Dr. Toye Ogunbode*
i
The first international workshop by Nigeria Network schools was
held in Ilorin, Kwara State, February 10-12, 1988 al the University
of Ilorin. The meeting was organized by representatives from Bayero
University, Kano ; Abofemi Awolowo University, De-Ife ; and the
University of Ilorin.
The objectives of the meeting were :
1) To demonstrate the Ilorin model of community-based and
service program ( COBES);
2) To suggest guidelines for the establishment of communityoriented/based programs;
3) To discuss other components of innovative medical education :
problem-based and student -centred learning;
4) To evolve an action plan, to facilitate the achievement of
comm unity-oriented medical education programs and relate to
the Brazzaville October 1987 Conference proposals towards
community-orientation by all African Medical Schools by the
The summary report can be obtainedfrom
Dean’s Office
Faculty of Health Sciences
University of Ilorin
P.O.B. 1515
Ilorin, Nigeria
♦ Dr. Toye Ogunbode is dean of the Faculty of Health Sciences,
Ilorin, Nigeria.
The University of Limburg Educational
Workshops for the Health Sciences
year 1992.
Participants
Mainly senior teachers in leadership positions of medical schools
e.g. deans of medical schools, chief medical directors, coordinators
of primary health care programs, or chairmen of community
medicine departments. No less that 60 staff members attended.
June - July 1988
Maastricht, the Netherlands
Report by Irma Kokx ♦
(group picture on page 16)
The formal of the workshops in Maastricht, The Netherlands,
consisted this year for the first time of three weeks, June 20 - July 8,
1988..
Introductory 'Workshop I: “New Ideas for Health Professions
Education; the Maastricht Approach”, dealt in short with the most
important Maastricht aspects of problem-based learning.
25 Participants listened to small lectures and were involved in small
group discussions and simulation sessions. Arrangements for
individual visits were carried out.
The second Workshop had as main theme: “Learning through
Problems: Opportunities and Limitations". The participants learned
about the construction of didactic problems other than clinical ones.
The selfmade problems were tested on students in small group
tutorials. In the second half of the week attention was given to the role
of the tutor. The total number of participants was up to 37. The
sessions in which they could interact with students, were
appreciated. Last but not least. Workshop III: “New Methods in
Student Assessment and Skillstraining”, attracted 31 subscriptions.
The participants learned about new approaches to student
Student activities
Students were very actively involved in the workshop. Participants
visited the four COBES sites of Esie, Ganmo, Okelele and Shao. At
each site, the students put the participants through a summary of their
experiences on the sites. They explained entry to the community
through courtesy call and explanation of their objectives to the
village heads. Their interaction with the community health was also
narrated. Then visitors were shown the students’ residences in the
villages and the communal way by which their activities are planned,
developed, executed and coordinated. At the end of the tour students
gave an account of the posting. The set objectives of the Faculty were
listed and reports given, followed by presentation op optional
projects, independently selected and carried out by students.
Outcome
1) A model of community-based medical educational program was
demonstrated showing a great deal of student centred effort.
2) The staying together of participants in the same group
throughout the discussion and field visits permitted personal
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The University of New Mexico, School of Medicine,(UNMSON)
has been nominated by the WHO to be a Collaborating Center in
problem-based and community-oriented learning. Program
Evaluation will be a core component of our activities.
The UNMSOM has been funded by the W.K. Kellogg Foundation to
disseminate its innovation in medical education worldwide. Program
Evaluation, Task Force 7, and decision-linked research and analysis
assessment In addition, the experience of the Maastricht Skills
Laboratory in the design of structured training programs was a topic
in this week. Some colleagues from Chicago and Galveston joined
the staff of the Maastricht medical school in the organization and
execution of the workshop.
In general the participants were satisfied with the organization of the
workshop. Suggestions were made, however, to bring back the
format of the Workshops to two weeks instead of three.
will feature prominently in this effort.
Dr. Walton, editor of Medical Education, has invited us to submit an
editorial discussing Program Evaluation and Task Force 7.
Drs. Rezler and Mcnnin are submitting a proposal for a RIME
symposium at the next AAMC meeting dealing with evaluation
methods in problem-based curricula.
A paper will be submitted to the next AM EE meeting addressing
Task Force 7 issues: innovations in medical education, program
♦ Irma Kokx is Educational Psychologist at the Department of
Educational Development and Research, University of Limburg,
Maastricht, The Netherlands.
evaluation, and the change process.
Drs. Rezler, McGuire (CED), and Mennin have been conesponding
in an attempt to expand the scope of Task Force 7 to include
institutional collaboration with respect to research on Program
The Network Task Forces
Task Force 3: Students’ Training
in Community Health Care Settings
Evaluation.
Dr. Boelcn (WHO) has requested updates from each of eight schools
which participated in the conference on innovative tracks held in
Albuquerque, October 1986.
The UNMSOM has received a major grant from the Rockefeller
Foundation and Pew Trust Fund to develop a social medicine
program which focuses on medical education during the clinical
years. A significant part of this effort will feature program evalua
tion, dissemination, and studies of the change process. The work of
Task Force 7 will be expanded and integrated into this project.
Report by Dr. Zohair Nooman, leader
The goals of task force 3 are
To develop guidelines for strategies for planning, implementation
and evaluation of programs for students’ training in community
health care settings within the context of community-based
education. Guidelines will be included in a manual which also
describes examples from the experiences of various institutions.
To provide a forum for bringing together planners and implementors
of community-based educational programs who are actively
involved in setting up and implementation of students training in the
community, in a manner that would facilitate their sharing of
information and learning from each other’s experiences.
News from Network Member
Institutions
Steps achieved so far
-An extensive survey questionnaire was developed and mailed to 73
schools- Results of the preliminary analysis of responses were
reported in Thailand in September 1987. -Further analysis has been
carried out in preparation for a one week meeting in June 1988.
McMaster University Faculty of Health
Sciences hosts a one day Mini-Workshop on
Academic Leadership for Women in Health
and Development
Subsequent plan of action
(June - August 1988)
-A joint Gezira-SCU Working Group meeting was scheduled to be
held in Ismailia in June 1988 to finalize the data analysis. A narrative
description will be prepared from each response and sent to each
i
Report by Dr. Sharon Bearpark
In April 1988 the Network (through Mc.Master University )was
given a financial contribution from the Canadian International
Development Agency (CIDA) to help to promote the leadership of
women health professionals within the Network as well as to educate
Network members as to women’s health care concerns.
The overall goal of the project is to “strenghten the capacity of
women health professionals in Network schools in training,
education and development”. On June 2,1988 McMaster University
hosted a mini-workshop with three major goals :
- To bring together women in health care professions from both
developed and lesser developed countries to share experiences
and discuss their roles in health care.
- To discuss potential activities that the Network could carry out
to promote women in health and development, and
- To identify next steps in carrying out this project of the
Network.
Participants in the workshop included: Dr. Esmat Ezzal, Dean. Suez
Canal University Faculty of Medicine, Drs. Aleya Hammad and
Dumedha Khanna of the World Health Organization, Dr. Elizabeth
Hillman, Memorial University, Faculty of Medicine, Newfound
land, and thirteen other women students and faculty members from
the McMaster Schools of Medicine and Nursing.
school for revision.
(September 1988 - February 1989)
- Narrative received from schools will be put into final form.
- Pending availability of funds, preparation for a meeting of some ten
representatives of responding schools to share their views on:
- Problems of implementation of COE
- Students’ evaluation in COE programs.
To be held in Ismailia in March-April 1989.
The final report will be presented at the 6th General Network
Meeting, September 1989.
Task Force 7: Program Evaluation
Report by Dr. Arthur Kaufman, leader
Since the Network meeting in Pattaya, we have been very busy
working to disseminate and expand upon the work of Task Force 7.
A brief summary follows:
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A tri-partite agreement between the Faculties of Medicine from
Khartoum, Gezira and Ismailia is being developed, that will serve the
immediate needs of supporting and facilitating the steps to innovate
the curriculum in Khartoum with the least possible difficulties and
set backs. Financial support has been requested from the WHO/
The one day workshop proved to be very thought provoking and
stimulated much discussion on “women ‘s health issues” versus
those of the family ; the career tracks for women health professionals
in different cultures and the role of leadership training for health
professionals. The outcome of the day was a draft proposal for a
project entitled: Collaboration for change; Leadership Training
for Health and Development.
Further review of the proposal will be required to discuss the
feasibility of carrying out astudent and faculty exchange program for
leadership training between Network schools. The WHO will
collaborate
on the development
of this project and a follow -up
report
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with details of the project will be circulated to Network member
institutions later this year.
We would welcome suggestions from Network members as to how
to facilitate collaboration between Network schools that focusses on
both leadership development for health professionals and women s
health issues. The workshop was able to come up with several
recommendations, but we would welcome any contributions from
other Network members. We will keep you informed o four progress.
Emro.
♦Dr. ZohairNooman is Vice Dean of the Faculty of Medicine,
Ismailia, Egypt
Master of Sciences in Health Development
in Thailand
by Dr. Charas Suwanwela *
The Master of Science in Health Development Program.
Chulalongkorn University, is administered by the Faculty of
Medicine, Chulalongkorn University, aiming at preparing health
professionals for leadership roles in health research, health
management and health professions education. The aim is to produce
health professionals with the following attributes:
An ability to use a wide range of processes of inquiry leading to
accurate and creative analyses of problems and, therefore,
appropriate action plans;
- An ability to use analytical skill in decision-making, leadership
and self-directed lifelong learning;
- A vision about, and commitment to improving health care that
has both breadth and depth and recognizes the interrelated
economic, social, political elements of health and health
development;
- A willingness to take calculated risks despite uncertainty; and
- Skills in motivating others to commit themselves to the
achievement of improved programs and systems.
The program is heavily based on the problem-solving approach in the
community and actual work in the real environment interspersed
with teacher directed workshops. The collegial atmosphere between
students and faculties is promoted. The program is developed in
collaboration with many international agencies such as the
University of Newcastle, Australia, and the British Council.
Correspondence can be sent to :
Dr. Sharon Bearpark
McMaster University
Faculty of Health Sciences (HSC 2E16)
1200, Main Street West,
Hamilton, Ontario
Canada, L8N-3Z5
I
The Khartoum Initiative for Change
by Dr. Zohair Nooman*
s
The World Health Organization, East Mediterranean Office,
assigned Suez Canal University, Ismailia, Egypt, for a consultancy
visit to the Faculty of Medicine, Khartoum, Sudan. Consultants
reviewed and evaluated the undergraduate curriculum, discussed
with the faculty their plans for innovation and conducted workshops
on community-oriented/based education and problem-based
learning. The following “ten commandments” were developed
during the workshops:
1. Integration of basic clinical and community health sciences;
2. Early exposure ,clinical experiences; 3. Reduction of didactic
teaching as far as feasible; 4. Increase of more effective learning
methods with stepping up the active role of the student in learning as
far as possible; 5. Priority health problems should constitute the core
of the curriculum and the main medium and stimulus for learning;
6. Health settings in the community as close as possible to their
prospective work settings; 7. Encourage learning experience that
serves to build the competencies of the student in self-directed
learning; 8. COE experiences should:
- Constitute a sizeable part of the curriculum from beginning to end;
- Be faculty-based (multidisciplinary);
- Be used to trigger learning of basic, clinical and community health
sciences;
- Always include elements of serving the people;
Be tailored to be relevant to the objectives of the phases of the
curriculum;
- Subject to continuing and summative evaluation. 9. The wholistic
approach should be always emphasized: e.g. whenever students arc
exposed to clinical experiences, the population and preventive
aspects should be emphasized; lO.Evaluation should be appro
priate to the learning methods and should address process as well
as, or even more than, knowledge, and should address skills and
attitudes as well as knowledge.
Chulalongkorn University, whose human resources are capable to
assist in country wide development in all aspects, has a firm policy
of contributing its resources for development of instruction, research
and service at the regional and community levels. Throughout the
years, many departments and institutions at Chulalongkorn Univer
sity have accumulated strengths in various fields. For example, the
Department of Obstetrics and Gynecology, Faculty of Medicine and
the Institute of Health Research have wide international experience
in human reproduction research. The Medical Education Unit,
Faculty of Medicine, is the WHO Training Center in Medical
Education. The Drug Dependence Program of the Institute of Health
Research has been the collaborating centre of WHO for many years
Examples of other activities that have gained international recogni
tions include health economics and medical education innovative
activities and research. The Faculty of Political Sciences, the Facukv
of Mass Communication and the Faculty of Education have had a
keen interest in population health and quality of life. Finally, the
Clinical Epidemiology Unit, Faculty of Medicine, founded with
partial assistance from the Rockefeller Foundation, has been
assisting in the design, measurement and evaluation of health care
programs at various levels; e.g. inter-faculty and national. Clinical
Epidemiology Unit staff are conducting high quality clinical or field
research in their respective areas of interests. The unit is
accumulating resources and potential to become the Regional
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as well in the community must therefore be assured. The preceding
statements express a concept of involving students which may be
considered ambitious, but that is radically opposed to a “tourist”
passage through the community. Also, effective service by students
ethically legitimates this educational activity, and avoid that the
community is only used for learning and that false expectations may
be raised.
The installment of the educational program in primary health care
centers regional or national health institutions, who are responsible
for the health centers. Theoretically, good care is the best support for
learning. The ideal situation is that both tasks, care and teaching,
should centre on the same community group. The integration of
members of the teaching staff and university students in the Primary
Health Care Centers:
- will promote new ways of development of their activity;
- increases both quantitatively and qualitatively their operational
capacity in program execution;
- will significantly contribute to raise the quality level of service
given to the community.
Creating a new way for the relationship between the university and
the community. Traditionally, this extension has happened in a one
way direction: from the university to the people. Frequently through
massive communication media. There are few worthy examples of
bi-directional interactions. If the. teaching program attains the
foreseen expectations, interaction of the community with the
students and their teachers, will produce a remarkable change in the
relationship of the university with the society. These changes do not
have to be limited to education of health professionals.
The release of a complex process ofchanges and adaptations doesnot
occur without difficulties. In fact, there exists an educational doc
trine postulating the integral study of the biological, psychological
and social dimension of man and health, but yet the old tradition
limits teaching to illness and the hospital. The existence of a doctrine
is not enough to transform the educational reality in all its aspects.
For each situation, the convenience and need to constitute a new
teaching group to educate in the community should be analyzed.
Whatever the choice, it is necessary to prepare training activities;
however it is also necessary to know that special skills are needed for
education in the field and for evaluating proces and outcome. The
changes affect all those participating in the activity, (teachers,
students, personnel of the health care team, community, etc.as well
as institutions). A signed agreement is not enough to assure the
desired integration. The agreement opens the doors for implemen
tation but this involves difficulties that will only be overcome by
transforming reality through action.
Last, but of great significance, education of health professionals in
the community will contribute to an internal process of adoption of
values that identify the student above all, with a social mission of
service, as opposed to individualistic values such as the desire for
personal profit. The teaching activity in the community will identify
the students and their teachers with the need improve reality.
Training Centre for Clinical Epidemiology. With its existing
strength, the Faculty of Medicine, has worked towards the
development of several international courses for foreign scholars to
study in Thailand. The current Master Degree Program in Health
Development represents one such activitiy. It is designed to develop,
through innovative educational program health professionals to
become leaders capable of applying new technologies to advance the
quality of life of the people. There are several new technologies to
achieve goal, but the most important in which the Faculty has the
expertise are three new areas: 1. Health Research; 2. Health Program
Management; 3. Health Professions Education.
1) Health Research is designed for health professionals who
desire to become competent health researchers: students study
in depth research methodology and research and practise skills
which will enable them to find appropriate solutions for local
health problems.
2) Health Development Program Managemen is designed for
health professionals who are responsible for health
development programs or projects. Emphasis is laid on health
planning and new technologies in management of health
development programs.
3) Health Profession Education is designed for leaders in health
professions education. Students study in depth curriculum
planning and its implementation, as well as skills in managing
organizational changes and innovations.
♦Dr. Charas Suwanwela is Dean of the Faculty of Medicine,
Chulalongkorn University, Bangkok
Some Implications of the Teaching Activity
in the Community: Montevideo, Uruguay
by Dr. Pablo V. Carlevaro*
Teaching in the community promotes the development of a new
educational space, without which it is not possible to satisfy the basic
objectives in the education of physicians and other health
professionals.
The following are some implications of this process.
Performance of an integral education without amputation of the
social content from the health problems. This substantially changes
the traditional model, which is restricted to the clinical-biological
aspects of the in-patient and the theoretical study of the pathology.
Achievement of professional education is based on the real needs of
the community. This makes it possible to:
- incorporate epidemiology as an essential instrument;
- generate a health perspective that gives real significance to
promotion, prevention and rehabilitation;
- modulate and give priority, according to existing needs, to
appropriate educational contents;
- develop the operational capacity of working not only in the
community but also with local community, promoting education
for participation and self-care in relation to the health problems,
with emphasis on improvement through transformation and
change.
The development of an educational activity intimately related to
solving problems and to participation by the students in the
achievement of specific tasks as members of the health learn. These
tasks will be geared to their level of training and will always be
supervised by professionals. Students will be the most humble
members of the team, but they will be a part of this team. This means
that they will assume responsibilities that will contribute and benefit
the health care the community .Their permanence in the health team
♦ Dr. P. Carlevaro is Dean of the Faculty ofMedicine,
University of Uruguay, Montevideo, Uruguay.
The El Hosh project in Sudan
Report by Dr. Louis Boon *
As part of a “twinning” of the University of Gezira in Wad Medani,
Sudan, and the University of Limburg in Maastricht, The
Netherlands, these universities arc planning to participate in a project
aimed at upgrading the general living conditions in the health district
8
community benefitted little from such students’ interactions.
Another problem associated with field programs has been its high
cost Therefore, it is now felt that it will be necessary to turn to the
community to overcome some of these problems. If we can
demonstrate that it is a beneficiary, the community will become a
“resource” for our programs. Field education is to be made more
community based, using community resources for the benefit of the
community, and student learning into long term student interaction
to produce change in health status of selected communities. This will
generate additional confidence in our students in their role as agents
of change. This will also have the advantage of making the
community more responsive. Such schemes, to be succesful, must
take into account both the “felt” and ‘ observed needs of the
students, the community and the IOM. The series of workshops,
currently being organized, are aimed at developing and sustaining
community-based field education programs which would optimize
student learning and meet community health needs on a long term
Former hospital El Hosh
basis.
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of El Hosh, a provincial town situated in the centre of the Gezira, the
* Dr. Madan P. Upadhyay is Dean of the Institute of Medicine,
irrigated area south of Khartoum.
The goal of the project is the establishment of a centre for the
improvement of rural health care, education, agriculture and
community development in the El Hosh district The centre will be
housed in the former hospital of El Hosh. The first step will be the
rehabilitation of the iron frame that are all that is now left of the old
hospital. We will try to raise funds to revitalise the project and to
broaden its scope. One of the fascinating aspects of the El Hosh
project is that it implies collaboration between several faculties of the
University of Gezira, especially those of Medicine, Economics and
Rural Development, Agriculture and Education. Close collaboration
by these faculties is necessary to execute the intersectoral approach
University of Kathmandu, Nepal.
Forthcoming Events
Network Institutions
Network Commemoration
of WHO’s 40th Anniversary
During the 41st World Health Assembly in May 1988 at WHO
Headquarters, a solemn ceremony took place to celebrate the 40th
Anniversary of the World Health Organization (1948-1988).Within
the Network this Anniversary is also commemorated. For example:
The Sudan Faculty of Medicine, Khartoum, has planned the
that is the essence of the project.
The centre will deal with problems as the product of networks of
interrelated causal chains. It will not,for example, consider health
problems in isolation, but look into the agricultural or cultural
practices that are at the root of them. Health education is an important
activity. However, this would be more effective if it were already
introduced in the primary schools. For that purpose teachers have to
be given extra training. Such training,can be provided in the district,
as a result of collaboration between the faculties of medicine and
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following activities:
- Four three-day workshops for faculty members related to
community-orientation and Health for All in the Year 2000;
- A workshop on community-orientation of the Faculty
Curriculum;
- The Education Development Center will publish a quarterly
Newsletter. The first issue will deal with the various activities of
the World Health Organization in the Sudan in general and in
education.
A delegation of the University of Limburg visited Wad Medani last
March, to discuss collaboration and to formulate the joint project.
During our talks the determination of the various faculties to
cooperate in the project was impressive. Discussions with the deans
of the various faculties made it clear that the university is convinced
that an integrated approach is necessary. The deans were eager to
start the project. We also visited El Hosh to talk to local authorities
and to inspect the site of the centre. We left with apositive impression
of the viability of the project The difficult task ahead is now to raise
the Khartoum Faculty in particular.
The Center for Educational Development (CED) and the
University of Illinois College of Medicine Rockford (UICOM-R)
arc sponsoring a short course on preparing leaders for community-
oriented health professions education.
Details of these and other commemorative educational workshops
can be found in the “Agenda 1988-1989” and in this “Events”
the necessary funds to build the El Hosh centre.
section.
♦ Dr. Louis Boon is the Dean of the Faculty of Health Sciences,
Rijksuniversiieit Limburg, Maastricht.
International Symposium on the Role of the
Student in the Health Professions and
Community Health Education
Initiatives in Field Education in Nepal
October 10-13,1988
Beersheva, Israel
by Dr. Madan P. Upadhyay *
Educational programs al the Institute of Medicine (IOM) are aimed
to provide students with real life experiences. The Field Education
Program assists students and faculty to meet this objective. While
students gain appropriate field skills, the complaint is that the
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This symposium will take place from October 10-11, 1988 in
Bccrshcva, followed by two days in Jerusalem.
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Course goals
This course will help participants to :
- Determine what comm unity-oriented and comm unity-based
education means for health care personnel in their home setting
- Evaluate how problem-based learning may or may not
contribute to community-oriented education
- Explore why and how an educational leader must articulate a
vision that is informed by intemal and external historical, social,
The symposium is the outcome of the experience in Becrsheva
where, for the past 6 years, an extensive school education program
has been carried out by medical and nursing students.
The Symposium proposes to bring together primarily students, but
also physicians and other health professionals from different cultures
and backgrounds, engaged in community health education, in the
hope that the sharing of experiences and ideas will advance the field.
The first two days will be held in Becrsheva and will be devoted to
the following topics:
1) Role of student in community-education.
2) Students as change agents in community health.
3) Methods of activating health education in schools.
4) Methods of training students to carry out this task.
5) Methods of evaluating the students’s activities and the project’s
efficiency.
6) Collaboration with other schools and educational institutions
and their contribution to these projects.
7) Research concerning health education as an efficient tool in
reducing disease risk factors, such as smoking.
The third and fourth days of the Symposium will be held in Jerusalem
in conjuction with the First Jerusalem Health Symposium and
Exposition: Developing Strategies for Health Promotion.
Featured that day will be school health education and W.H.O.
programs for health communities, both of special importance to
students and health professionals active in health education.
economic, and political forces
- Plan, develop, and evaluate approaches for controlling the
direction of educational reform so that it is relevant to the health
needs of a given population
- Effectively use managerial skills such as communicating,
conflict management, empowerment of others, coalition
building, structuring decision-making systems, and the
manipulation of reward systems
- Analyze, interpret, and adapt a health sciences school as a
complex multitask, multifunction organization of professions
- Explore why and how to develop community-oriented primary
care units for education and the delivery of services.
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Approach
The approach to the course will be problem-based using a case study
format. Participants will actually work through the problem analysis,
curriculum design, and leadership strategy of an educational
problem that currently exists in an educational government, or health
services delivery organization. The focus on application and the
shared experiences of participants and workshop leaders along with
independent study will make it possible for participants to adapt the
case model for use in their home institutions. Some of the problem
work will be carried out in community health centers in the College
of Medicine at Rockford. This will allow participants to observe the
CHC program of primary care as it interfaces with the community.
For more details please contact:
Dr. Chaim Yosefy, Coordinator
c/o Atzeret Ltd
P.O.B. 3888
Jerusalem 91037
Israel
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Questions about the program may be directed to :
Dr. Thomas Telder
Ass. Director of CED for Ed. programs
Center for Educational Development
The University of Illinois at Chicago
Room 986, 808 South Wood Street
Chicago, Illinois 60612 U.S .A.
Leadership Development for Community
Oriented Health Professions Education
October 31 - November 11,1988
Rockford, Illinois, UJS.A.
In commemoration of the Health Manpower Development
movement, fostered by the World Health Organization more than
twenty years ago, the Center for Educational Development (CED)
and the University of Illinois College of Medicine at Rockford are
sponsoring a short course in preparing leaders for communityoriented health professions education. CED, as a WHO Collabora
ting Center for Health Manpower Development, and the Illinois
College of Medicine as a Network member school are pleased to be
able to collaborate in this leadership development program for health
care personnel, administrators and community leaders.
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2nd International Seminar on Primary
Health Care: Family physicians,
a response to community needs
November 14-18,1988, Havana, Cuba
International Conference Center
For the past 28 years the Ministry of Public Health of the Republic
of Cuba has given top priority to development strategies for the
national health care system. The results have allowed Cuba to reach
the goals of the "Health for All by the Year 2000” program. 15 years
ahead of the deadline set by the World Health Organization.
The 1st International Seminar on Primary Health Care was
successfully held in Havana in June 1986. The second seminar, 2
years later, will be held on the 40th anniversary of the founding of
WHO and on the 10th anniversary of the Alma-Ata primary care
meeting. Participants will have an opportunity to analyze and
exchange experiences on the progress made in the implementation of
Audience
This program is for health care personnel in faculty or administrative
positions who arc responsible for, or interested in leading
community-based health professions education programs.
Purpose
A growing body of knowledge based on theory, research and practice
has coalesced relevant to the development and implementation of
community-oriented approaches in health professions education.
Together, the faculty and participants in this course will address the
why and how of community-oriented education for health care
personnel and lake an important step toward addressing primary
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the Health for All strategics.
health care needs.
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Christian Medical College
Vcllorc,632002
Tamil Nadu, India
Cuba has witnessed a revolution in the health sphere brought about
by the development of new models of primary health care,
community-based family physicians and specialists in
comprehensive medical care.
Associate member institutions
Purposes of the seminar
Analyze Cuba’s experience with family physicians;
Exchange experiences on the diverse models of primary health care
and family medicine;
Analyze Cuba’s experience in training specialists in comprehensive
health care;
Analyze the impact of diverse primary health care models on the
attainment of Health for All by the Year 2000.
Community Health Research & Training Unit
University of Western Australia
Claremont, Australia
Corresponding members
Dr. Julian Tudor Hart
The Queens
Glyncorrwg
West Glamorgan
Wales SA13 3BL, United Kingdom
Some topics
- Family physicians: Cuban experience;
- Integration of services, teaching and research in primary health
care;
- Training physicians in the community;
- Community health problems and medical curricula design;
- Family physicians and health promotion;
- Epidemiology in the promotion of health;
- Active community participation in solving health problems;
- Family physicians as educators and “guardians of health”;
- A systematic approach to the interrelationship among doctors’
offices, polyclinics, hospitals, medical schools and research
institutions;
- The role of nurses in the family physician model.
Dr. Una V. Reid
WHO/Pan American Health Organization
Box 508
Bridgetown
Barbados, W.I.
Dr. Jones Koleade Bamgbose
Faculty of Health Sciences
Obafemi Awolowo University
1392
De Ife040
Nigeria
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Pre-seminar workshops
On November 10-12,1988 the following pre-seminar workshops
will be offered:
- Epidemiology in health promotion;
- Community-Based rehabilitation;
- Community-Oriented Medical Education.
These workshops, conducted by well-known specialists, will take
place in the Havana’s International Conference Center.
News from Network Students
by Anne van Lamm er cn
As you all know, we organized a student Network workshop during
the meeting in Pattaya, September 1987. Our main problem is to
establish a student communication Network. To have a contact
person is very important for the exchange of information. From the
Network institutions which are not included in the list below, we
would like to receive the name and address of the student corres
pondent as soon as possible. We also distributed a questionnaire to
all Network institutions. This questionnaire contains questions about
the faculty and the educational system. We are collecting these
questionnaires in order to compile a handbook with relevant infor
mation about every faculty. We would like to stress the importance
of the handbook and to urge everyone to return the questionnaire as
soon as possible. Until now we received responses from:
- Faculty of Medicine, Suez Canal University, Ismailia, Egypt;
- School of Medicine, Gadjah Mada University, Yogyakarta,
Indonesia;
- Christian Medical College, Ludhiana, India;
- Faculty of Medicine. Sherbrooke University, Fleurimont,
Quebec, Canada
- University of Borin, Borin, Nigcra;
- Bayero University, Kano, Nigeria;
- Arabian Gulf University, Manama, Bahrain.
We want to thank the cpvrtact persons of these faculties for taking
the lime to answer our questions. We hope that we will receive
many more answers, so that we can compile the handbook.
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AU mail should be addressed to:
Prof.dr. Cosme Orddnez, Coordinator
International Seminar on Primary Health Care
Palacio de las Convenciones
Apartado 16046, Havana, Cuba
Telex: 511609 paleo cu
Fax: 20-2350
New Network Members
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Full member institutions
Faculty of Medicine
Health University of Linkdping
Linkbping. Sweden
Medical Faculty
University of Tampere
Tampere, Finland
School of Medicine
Mercer University
Macon, Georgia, U.S.A.
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Faculty of Medicine
Prince of Songkla University
Songkla, Thailand
COMMUNITY HEALTH
CELL
326, V Main, I Block
Koraniongala
Bangalore-560034
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Student correspondents
- Stefano Pirrelli and Paolo Gianninni, University of Bari. Bari,
Italy;
- Antonella Lotti and Marina Metta, University of Milan, Milan,
Italy;
- Zvi Klein and Zachi Ben Zion, Ben Gurion University of the
Negev, Beer-Sheva, Israel;
- University of Zimbabwe, Harare, Zimbabwe;
- Mr. Suntom, Prince of Songkla University, Songkla, Thailand;
- Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;
- Tanapom Komolvipat, Siriraj Hospital, Bangkok, Thailand;
- Top Buranas Smutharaks, Chulalongkorn University. Bangkok,
Thailand;
- Patinya Pholipatama, Prapokklao Hospital, Chanlaburi,
Thailand;
- Syfon Suvan and Pacharee Suwil, Khon Kaen University, Khon
Kaen, Thailand;
- Chawamad Suibnugam, Cholburi Hospital, Cholburi, Tliailand;
- President of Havana FEO Cuba, Havana, Cuba;
- Detti Siti Nurdiati, Universitas Gadjah Mada, Yogyakana,
Indonesia;
- Bada Samuel Akin, University of Ilorin, Ilorin, Nigeria;
- Ron Balkissoon and Lisa Moore, McMaster University,
Hamilton, Canada;
- Mohammed El Sanusi, University of Gezira, Wad Mcdani.
Sudan;
- Sonjay Kalra and Puneet Sharma, Christian Medical College,
Ludhiana, India;
- Sahar Dawidar and Sherien Shalby, Suez Canal University,
Ismailia, Egypt;
- Anne Taylor, University of Southampton, Southampton,
England;
- Student Consultative Committee, University of Newcastle,
Australia.
A detailed list can be obtainedfrom the Student NetworkSecretariat:
Anne van Lammeren
Lakenweversstraat 29 B 15
BK Maastricht
The Netherlands
Regional Conferences
The national reports have been analyzed, and regional discussion
documents were compiled for further intensive consideration at the
Regional Conferences. These critical components of the Program
have been extremely productive and compelling. The European
Regional Conference took place in Dublin in September 1987. the
African Regional Conference at Brazzaville in October 1987, and the
South-East Asian Regional Conference in New Delhi in November
1987. The Regional Conference for the Middle East took place at
Amman, Jordan, on 14-17 February 1988. The Regional Conference
for the Western Pacific was at Kuala Lumpur on 7-11 March 1988.
The approach in the Americas is particularly intensive and syste
matic, designated as Project EMA. being conducted by a Task Force
under the auspices of the Pan-American Federation of Associations
of Medical Schools.
The extent of the documentation for the World Conference thus
exceeds that anticipated. From the European Regional Conference,
for example, 34 pressing recommendations have emerged.
The Federation has also explored a seventh theme, ‘‘The Medical
School as a Social Organization”, to investigate further the resistance
to change of curricula which demonstrably are outmoded and
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otherwise inappropriate.
The Need for Ministerial Consultations
As so many of emerging recommendations have legal, legislative
and statutory implications, there has been a crucially important
further development in relation to the World Conference. M inisterial
Consultations are being called at regional level, to be attended by the
Ministers of Health, Ministers of Education, health-care administra
tors and medical educators. The Ministerial Consultation for Europe,
for example, will be at the Gulbenkian Foundation, Lisbon, under the
auspices of the Minister of Health, H.E. Leonor Beleza; the Minister
of Education, H.E. Roberto Cameiro; the Regional Director of the
WHO European Office, Dr. J.E. Asvall; and the President of the
World Federation. The Minister of Health of Nigeria,
Dr. O. Ransome-Kuli, will take akey initiative in the African Region,
as will the Minister of Health of India, Mr. Morital Vora, for SouthEast Asia. Dr. Z. Hamzeh of Jordan and Dr. G. Soberon of Mexico
will assist correspondingly in the Middle East and the Americas. The
Western Pacific Ministerial Consultation will be assisted by Y Data
Chan Siang Sun of Malaysia.
Other Organizations
World Federation for Medical Education
“Program and strategy for world action in medical education:
the World Conference”
by Dr. Henry Walton*
The Progam
The World Conference on Medical Education will be held in
Edinburgh on 8-12 August 1988. The progress of the Program of the
World Federation, of which the World Conference is a key
development, was reported at the Executive Committee of the
Network in May 1988. The Planning Commission met again in June
when the arrangements were confirmed. The progress of the
Federation’s Program can be mentioned briefly.
National Reports
Most informative and telling national reports were received from
countries in response to the 32 issues raised in the Six Major Themes
document The document had been translated into most of the main
languages.
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The Implementation Phase
The recommendations of the World Conference will be presented, as
a Declaration, to the World Health Organization’s Executive Board
in January 1989, and to the World Health Assembly at its meeting in
Geneva in May 1989. By then, the Implementation Phase of the
Federation’s Program will already be in progress. The Ministerial
Consultations are an essential component of the Implementation
Phase. The recommendations will then go to the World Health
Assembly in May 1989. Il is expected that the Edinburgh Declaration
will have the influence in medical education which the Alma-Ata
Declaration has had in the field of health care.
The World Conference
The World Conference will be based on the great volume and
worldwide coverage of preparatory work already completed. The
World Conference, as always intended, will be invitational, very
definitely a working conference, charged to review intensively the
Regional Reports and other pertinent documentation. The objectives
which will be achieved on compctiton of the World Conference,
therefore, arc the following:
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programs. Establishing links with the health care system and a sound
faculty development program are seen as necessary strategies.
The text part of the book is only 65 pages, which indicates that the
authors have tried to digest the wealth of material they had collected
in this project. The obvious problem with a broad study like this is
that it is hard for the reader to obtain a good view of source material
on each program and it is not always clear from the text whether the
outcomes represent the authors’ view or the schools’ view'on a
particular problem. The study will hopefully be the first of a series of
in depth analyses on the impact of Network schools. As an
introduction for those interested in outcome studies this book is
highly recommended.
- Participants will have had an ample opportunity to express their
views on the Six Themes, and other items which seem relevant
to the formulation of broad policies for the conduct of medical
education.
- These views will have been summarized and synthesized into a
set of nationally relevant educational principles and practices
that should characterize the program of medical education,
against which individual institutions can judge their present
status and future progress.
- A mechanism for worldwide dissemination of these policies and
strategies will have been established.
- A follow-up plan will have been formulated, to promote the
accepted practices which will have been incorporated into
institutional programs over the ensuing 5 years, or incorporated
in action plans for the subsequent decade.
*Dr. Peter Bouhuijs is a member of the Department of
Educational Development and Research,
Rijksuniversiteit Limburg, The Netherlands
Venue of the World Conference
The Old College, University of Edinburgh, South Bridge, Edinburgh
EH8 9YL, Scotland, United Kingdom.
Secretariat
World Federation for Medical Education, The Medical School,
University of Edinburgh, Teviot Place, Edinburgh EH8 9AG,
Scotland, UK; Tel. (031)226 3125; Telex: 727442 (unived g).
Articles / Reports / Newsletters
received by the Secretariat.
- Peer Learning in Health Science Education, an Alternative
Didactic Method, Richard Steele, M.D., International Federation
of Medical Students Association, Geneva, 1987.
- Highlights of the Work of WHO, Four Decades of Achievement,
1948-1988, WHO Geneva, 1988.
- La supervision des Personnels de Santo au niveau du District,
Flahault e.a., WHO, Geneva, 1988.
- Summary Report, First International Workshop on Innovative
Medical Education, Ilorin, Nigeria, February 1988.
- Final report. Regional Conference on Medical Education, WHO
Regional Office, Brazzaville, October 1987.
- La educacidn del personal de salud centrada en la comunidad,
serie Informes Tdcnicos, 746, WHO, Geneva, 1987.
- World Health Forum, International Journal of Health
Development, WHO, Geneva, 1988, Vol. 9, no. 2.
- Report Conference University of Edinburgh, May 1987, Medical
Education, 1988, no. 22, p. 67-77.
- Newsletter. Institute for Medicine, Kathmandu, Nepal, 1988,
* Dr. Henry Walton is President of the World Federation
for Medical Education
Book review
“Innovative schools for Health Personnel”
by R. Richards & T. Fiildp.
WHO Offset Publication no. 102. Geneva 1987,
by Dr. Peter Bouhuijs
This book contains the results of a study launched by WHO to
investigate ten schools belonging to the Network of CommunityOriented Educational Institutions for Health Sciences. The book is
partially a follow-up of the studies reported by Katz & Fiildp in 1978
and 1979. At that time most programs described were in their early
days, and hence it was hard to evaluate their outcomes. The general
purpose of the current study was to determine to what extent these
schools had undertaken community-oriented and problem-based
medical education, and to ascertain in what ways and to what degree
new approaches were affecting health care delivery, especially pri
mary health care. The ten programs involved were Maastricht, BeerSheva, Yaounde, Kathmandu, Tacloban, Newcastle, Mexico City,
Hamilton, East Lansing, and Albuquerque, a truly international
sample of Network schools. Data on each of the schools were
collected by questionnaire, document analysis, and interviews
during site visits.
The book contains short descriptions of the programs of each school
and summarizes the outcomes in a number of Tables. In this way it
is possible to gain a quick overview of similarities and differences in
various programs. The outcomes seem to indicate that schools tend
to be strong in either community orientation or a problem-based
approach. The summary and comments section includes a number of
observations on issues which are important for all Network schools:
the role of leadership, the relation with the heal th care system, and the
importance of program evaluation. The authors conclude that there
is sufficient evidence that the schools in the study have an impact on
health systems. A number of recommendations are formulated
regarding the strengthening of the community component in
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Vol. 3, no. 2.
- Outlook, Educational Commission for Foreign Medical
Graduates, Winter 1988, no. 5.
- Fepafem Informa, no. 30, April 1988.
- Health Promotion for working populations. Report of a WHO
Expert Committee, Technical Report Series 765.
- Continuing the Education of Health Workers, a workshop
manual, by F.R. Abbatt and A. Mejia, World Health
Organization, Geneva, 1988.
- WHO Basic Documents, 37lh Edition, Geneva 1988.
- World Health Forum, Vol. 9, No. 1, 1988, An International
Journal of Health Development, WHO.
NGO-WHO Newsletter No. 2, Partners in Health. World Health
Organization, Geneva, March 1988.
WHO Features, No. 117, March 1988.
- Joint Medical Newsletter, Faculty of Medicine, Newcastle/
Hunter Medical Association and Dept, of Health, N.S.W.
Australia, No. 49, 1987.
- European Newsletter on Quality Assurance, Volume 5, Nos. 1
and 2,1988.
- Outlook, Educational Commission for Foreign Medical
Graduates, Summcr/Fall 1987, No.3,4 and Winter 1988, No. 5.
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- The GME Correspondent, published by the Association of
American Medical Colleges, Vol.l, No.l, March 1988.
- Pafams Update, Panamerican Federation of Associations of
Medical Schools, Vol. 4, No. 3-4, 1987
- Boletin Fepafem, Federacidn Panamericana de Asociaciones de
Facultades de Medicina, Vol. 23, No. 3, Septiembre-Diciembre
1987.
- Fepafem Informa, Marzo-Abril 1988. ’
- Journal of the Institute of Medicine, Kathmandu, Nepal, Vol. 9,
Nos. 2 and 3, 1987.
- Images, Institute of Medicine Newsletter, Kathmandu, Nepal,
Vol. 3, Nos. 1, 2, 3,4,5 and 6, 1988.
- Buletin Pendidikan Perubatan, University of Malaysia, May/
June, July/August 1987.
- Padayon, a publication of Philippine Youth Health Program,
Vol. 2, No. 2, November 1987.
- Epidemiologic pour le Developpemcnt, Bulletin du Reseau No.
!
9, Mars 1988.
REMINDER
In case you have not yet paid your 1988 membership fee, we kindly
request you to send a cheque with the amount due a.s.a.p but before
September 1, 1988 to
Network Secretariat
atL Miss Ingrid Regout
Rijksuniversiteit Limburg
P.O.B. 616
6200 MD Maastricht
The Netherlands
MEDUCS
A NEW BULLETIN OF THE SWISS
ASSOCIATION FOR MEDICAL EDUCATION
1
Target groups of MEDUCS are government bodies, teachers as well
as students of medical and allied health professions. The main
articles will be preceeded by an abstract in English. The
contributions themselves may be in German, French, Italian or
English. To inform readers about educational developments outside
Switzerland, MEDUCS would be glad to receive contributions.
For the details about membership, subscription to MEDUCS, etc.
please contact:
Dr. Jucrg F. Steiger
Division for Instructional Media
University of Bcmc, Medical Faculty
Insclspital 38
CH-3010 Bcmc, Switzerland
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October 25-28,1988
Agenda 1988
Hamilton, Canada
McMASTER WORKSHOPS IN HEALTH SCIENCES
EDUCATION: ROLE OF THE TUTOR IN SMALL GROUP
LEARNING WORKSHOP
Contact person:
Miss Annette Sciarra, Workshop Coordinator
Education Services, Room 3N51
Faculty of Health Sciences
McMaster University
Main Street West
Hamilton, Ontario L8N 3Z5
Canada
tel. (416) 525 9140, ext. 2714
August 8-12,1988
Edinburgh, Scotland, UK
WORLD CONFERENCE ON MEDICAL EDUCATION
(by invitation only)
Secretariat: World Federation for Medical Education, The
Medical School, University of Edinburgh
Teviot Place
Edinburgh EH8 9AG
Scotland, UK
Tel. (031) 226 3125; Telex 727442
August 30-September 16,1988
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October 31-November 11,1988
Newcastle, Australia
TEN YEARS OF INNOVATIVE MEDICAL EDUCATION
A CELEBRATION
August 30-Sept. 2: Problem-Based Learning: Education for the
Professions
September 5-6: A Case Study in Innovation
September 7: David Maddison Lecture
September 8-9: Comparison of Goals and Strategies in Innovative
Medical Schools
September 12-16: Priorities for the Future
Contact person:
Information Officer Faculty of Medicine
University of Newcastle
New South Wales, 2308
Australia
Rockford, Illinois, U.S.A.
LEADERSHIP DEVELOPMENT FOR COMMUNITYORIENTED HEALTH PROFESSIONS EDUCATION
Contact person:
Dr. Thomas V. Telder
Ass.Director of CED for Educational development
The University of Illinois at Chicago
Room 986, 808 South Wood Street
Chicago, Illinois 60612 U.S.A.
tel. (312) 996-7949, telex 4930122
November 14-18,1988
Havana, Cuba
2nd INTERNATIONAL SEMINAR ON PRIMARY
HEALTH CARE: FAMILY PHYSICIANS,
A RESPONSE TO COMMUNITY NEEDS
Contact person:
Prof.dr. Cosme Orddnez, Coordinator
International Seminar on Primary Health Care
Palacio de las Convenciones
Apartado 16046, La Habana, Cuba
telex 511609. telefax 202350
September 4-9,1988
4
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I
Marburg, West-Germany
17th EUROPEAN CONFERENCE ON PSYCHOSOMATIC
RESEARCH: PHYSICIAN IN THE 21st CENTURY: NEW
PARADIGMS TO COPE WITH SPECIALISATION AND TO
PROMOTE HEALTH
Contact person:
Prof.dr. Wolfram Schtlffel
Psychosomatic Division, Centre of Internal Medicine,
University of Marburg
3550 Marburg, West-Germany
November 19-27,1988
Kingston, Jamaica
MEDICINE AT THE UNIVERSITY OF THE WEST INDIES
THEN AND NOW
Contact person:
Prof. S.R. Wray
Dean, Faculty of Medical Sciences
University of the West Indies
Mona, Kingston, Jamaica
October 10-13,1988
Jerusalem, Israel
FIRST JERUSALEM HEALTH SYMPOSIUM
AND EXPOSITION
DEVELOPING STRATEGIES FOR HEALTH PROMOTION
Organizers and Secretariat
Atzeret Ltd.
29b, Keren Hayesod Street
P.OJB. 3888
Jerusalem 91037, Israel
Israel
tel. 02 - 247646, telex 25615, fax 02 248910
November 21-23,1988
Hamilton, Canada
McMaster workshops in health sciences
EDUCATION: VISITORS’ WORKSHOP
Contact person:
Miss Annette Sciarra
October 10-13,1988
September 17-19,1989
rs
INTERNATIONAL SYMPOSIUM ON THE ROLE
OF THE STUDENT IN THE HEALTH PROFESSIONS
AND COMMUNITY HEALTH EDUCATION
For more detials please contact
Dr. Chaim Yosefy, Coordinator
c/o Atzeret Ltd
P.O.B. 3888
Jerusalem 91037
Israel
Rolduc International Conference Center
KERKRADE, THE NETHERLANDS
6TH. GENERAL NETWORK MEETING
September 20-22,1989
SCIENTIFC INTERNATIONAL CONFERENCE
ON ACADEMIC INSTITUTIONS AND HEALTH
SERVICES AS PARTNERS IN HEALTH CARE
Further details follow.
15
i
I
Network of Community-Oriented Educational Institutions for Health Sciences
Number 10 / Decemberl988
Editorial
This issue of the Newsletter will reach you later than we had hoped. However,
we intend to ensure that the two issues for 1989 will appear rather more
punctually - in March and October!
With your help we hope to increase the amount of information in future issues,
so that the Newsletter will become a major service to members of the Network.
A larger number of copies will be sent to each member institution, so that the
information can become directly available to each staff member. We also plan
to distribute Spanish and French editions in 1989 I
The Annals, which will be issued in May 1989, will represent a further
important service to members of the Network. Here, too, we hope to be able
to post sufficient copies to each member institution for local distribution to the
academic staff. We plan to enlarge the content of the Annals to include not
only a preface and referred papers on community-oriented education, but also
a set of invited papers on an important theme of topical interest, abstracts of
papers published on medical education from member institutions, an over
view of events in medical education across the world during 1988, and
publications issued in 1988 in relation to medical education.
In this issue further information can be found about the Tenth Anniversary
Conference of the Network which will be held in the Netherlands, 17-22
September 1989. The Scientific Conference is entitled Academic Institutions
and Health Care Systems as Partners in Health Care Development, and will be
preceded by the 6th General Network Meeting.
We look forward to your contribution !
With our very best wishes for 1989.
Editor Mrs Ine Kuppen
Published by the Network Secretariat
Rijksuniversiteit Limburg
P.O. Box 616
6200 MD Maastricht, The Netherlands
TcL 043 - 888.888/888.303/888.313
Telex: 56880 fg ri nl
Telefax: 43 - 437266
Contents
Editorial
Chairman’s Column
Visits by the Secretary General
News from the Secretariat
Recent Events
The Network Task Forces
News from Network Institutions
New Network Members
International News
News from Network Students
Have You Read This?
Articles / Reports / Newsletters
International Events 1989
Other
Pag.
1
1
2
3
4
5
5
7
7
10
11
12
13
15
Ine Kuppen
Chairman's Column
1
important in our work within the Network. The statement
(reproduced elsewhere in this Newsletter) will be useful to
many of you in your work with colleagues, government
agencies and other groups. Secondly, the conference brought
together representatives from agencies who do not normally
meet to discuss the education of health professionals. These
included the WHO (represented by the new Director-General,
Dr. Nakajima), UNICEF and UNESCO. The conference
recommended further interaction among these agencies, fo
cussing on new initiatives in medical education.
Since my last message to you (in the July 1988 Newsletter),
there have been several important events which effect the
Network. I will comment on two of these. As many of you
know, an important conference, the World Conference on
Medical Education, was held in Edinburgh in August 1988. It
was organized by Professor Henry Walton of the World
Federation of Medical Education. Many Network individuals
and institutions participated in the preceding national and
regional conferences leading up to the August Conference. At
the conference itself, five members of your Executive Com
mittee participated actively in group discussions and other
deliberations. Many other members and friends of the Net
work did the same. The chief rapporteur was Dr. Jack Bryant,
from a Network member institution, the Aga Khan University
in Pakistan.
I believe that there were two particularly important outcomes.
A statement called the "Edinburgh Declaration” was pro
duced, which reinforces many of die ideas we hold io in:
I also want to report to you that the Network Executive
Committee recently held its semi-annual meeting in Havana,
Cuba, November 17-19. The meeting was held in conjunction
with a large seminar on Primary Health Care. Your Executive
Committee was provided with a particularly good opportunity
to leam about current developments in health professions
education in Latin America, ar-1 meet many of the key leaders.
1
Visits by the Secretary General
Between 12 and 14 September 1988 Dr. Zohair Nooman
visited Dr. Suchart Indaraprasit, Vice-Dean of Ramathibodi
Medical School and Director of Ramathibodi Hospital. Stu
dents at this medical school spend six months in a provincial
hospital during their three year clinical course. One month of
this period is spent practising as a doctor outside the hospital.
These and other community-based experiences were intro
duced some 20 years ago. At Chulalongkorn Medical School
Dr. Nooman studied the recently introduced communitytargeted and problem-based track for a small number of
students who had already qualified with a Master of Science
degree. The staff indicated that they lacked facilities for
community-based experiences for their students. Siriraj
Medical School, Mahidol University, is 100 years old, with a
2000 beds hospital, reminiscent of Cairo University Medical
School. The newly appointed Deputy Dean of Education is
keen to introduce change. The visit to Thailand concluded
with a fruitful meeting with Dr. Dekhanom Muangman, Dean,
Faculty of Public Health, Mahidol University and President,
Asia-Pacific Consortium for Public Health, who growed keen
to introduce problem-based learning in his curriculum.
Vic Neufeld, Chairman Network and Cosme Ordonez,
coordinator International Seminar
I am proud to tell you that one of our Executive Committee
members, Professor Pablo Carlevaro of Uruguay, is one of
these strong and highly regarded leaders. With the great help
of Professor Cosme Orddfiez of Havana, we held a special
"Network Day" on November 18, where we met with about
eighty interested colleagues. It was clear to me that we have
much to learn from the Latin American experience, particu
larly with respect to how the socio-political context affects
health and health care; these factors have direct implications
about the structure and process of health professions educa
tion.
During the period 21-28 September 1988 Dr. Nooman partici
pated as a resource person at the Health Sciences Education
National Conference and Workshop, organized by the Con
sortium of Health Sciences of the Directorate General of
Higher Education of the Indonesian Government He also
visited the Faculty of Medicine, Gadjah Mada University at
Yogyakarta.The four day workshop and conference in Jakarta
was attended by all 24 Deans of Medicine or their senior
representatives. All medical school have adopted the Core
Curriculum. Many schools have a community-based pro
gram. While some departments at Gadjah Mada have intro
duced problem-based learning, a visit by Dr. Victor Neufeld
appears to have stimulated interest at other schools.
The workshop was planned to develop problem-based learn
ing for the whole curriculum. Dr. Esmat Ezzat, Dean at Suez
Canal University, and Dr. Louis Branda of McMaster Univer
sity also participated as resource persons. Additional visits
were made to Gadjah Mada Faculty of Medicine in
Yogyakarta (25-27 September) and to Dr. Theresia Sri Sukesti. Head of Community Health Services, St. Carolus
Hospital, Jakarta (23 September).
I am sure I speak for my colleagues on the Network Executive
Committee when I tell you that the Network continues to
grow, struggle and mature. Several new full membership
applications were approved. I was particularly impressed by
how "global" we are - we had reports of Network action from
every part of the world. The Executive Committee focussed
particularly on the concept of "institution strengthening", and
are preparing a position paper on this important issue. I was
very pleased to see evidence of the hard work and commit
ment of our new Secretary-General, Dr. Zohair Nooman, and
of our colleagues in the Secretariat.
Finally, it is not too early to plan to attend our next biennial
meeting in September 1989 in the Netherlands (more details
can be found elsewhere in this Newsletter). 1 hope each
institution is planning to send a strong team. My hope is that
each member institution will be able to send at least three
people, including one student.
Dr. Vic R. Neufeld, Chairman
Contributions for the next issue of the Newsletter
should be sent to Mrs. Ine Kuppen,
not later than mid January, 1989
2
filling out the registration form, please contact Mr. Harro
Spitsbergen via the Conference Secretariat to announce your
participation and to give your suggestions for special student
meetings during the conference.
News from the Secretariat
Change of address
Registration fee
The conference registration fee is Dfl 400 until June 1,1989
and Dfl 500 thereafter. Fee includes admission to all confer
ence sessions, welcome reception, 3 dinners, 3 lunches,
morning and afternoon coffee and tea, conference abstract
booklet and proceedings.
On December 15,1988, the Network Secretariat
moved into another office:
Dr. van Kleefstraat 25
'6217 JJ Maastricht
The Netherlands
Fellowships
Postal address:
Potential participants who have difficulty overcoming for
eign exchange limitations should indicate so. A limited
number of fellowships are available. These fellowships
amount to a maximum of Dfl. 1500 (approx. USS 750) per
participant In addition, the registration fee may be waived for
some participants. Please apply directly to the Conference
Secretariat
Network Secretariat
Rijksuniversiteit Limburg
P.O. Box 616
6200 MD Maastricht
The Netherlands
For more information please contact:
Conference Secretariat
Network 10th Anniversary Conference
Mrs Pauline Schoennnakers
University ofLimburg
P.O. Box 616
6200 MD Maastricht
The Netherlands
Tel. 43-888303/313 (unchanged)
Telefax no. 43-437266
Telex no. 56880 fg rl nl
10th Anniversary Conference
Tel. (31)43-888 3131303
Telex: 56880fg rl nl
Telefax: (31) 43-437266
of the Network on ’’Academic Institutions and
Health Care Systems as Partners in Health Care
Development”
r
September 20-22,1989, in Rolduc Coherence Centre,
Kerkrade, the Netherlands
7
A ’x
FACULTIES
MEDICINE ANDiFfeALTH^GIENCES
>
UNIVERSITY OF LIMBURG. MAASTRIIiChjSWE NETHERLANDS
f
8
IN
----- jnwithX^
IRIENTED EDUCATIONAL
THE NETWORK OF (
IS FOR HI tTH SCIENCES^.
Preceded by the Biennial General Meeting of the Network
September 18-19,1989
By now you may have received the "Call for Papers" and
registration form.
work
Anniuersa
Conference
Topics
The 10th Anniversary of the Network provides an excellent
opportunity for an in-depth discussion of one of the major
objectives of the Network: to promote cooperation between
Health Educational Institutions and Health Care Systems. In
addition, educational strategies facilitating the pursuit of this
goal will be highlighted.
I
>
•A
\
”Academicinstitutions and Health Care Systems
as Partners in Health Care Development”
i
Student participation and meetings
:■
>5?/ \
Students from Network schools are encouraged to join the
meeting. Although funds for travelling should be provided by
their home institution, students may apply for a special
registration fee. Moreover, the Rolduc Monastery has a few
rooms for up to 8 guests, which reduces the costs of lodging
and breakfast to Df! 29.00 per person per night. In addition to
R<
DUC, KERKR SIDE, THE
V 19-22 SI
Prec<
3
s
989
il meetifla of
biennial
^ember 18 ancW^, 198p
nel
work" was part of the Seminar on Primary Health Care. About
80 representatives from different schools in Latin America
participated. Dr. Vic Neufeld, Chairman of the Network,
opened the meeting and introduced the Network in general
Dr. Zohair Nooman, Secretary General, presented Imple
mentation of Comm unity-Based Medical Education . Dr.
Cosme Orddfiez reviewed "Innovations in Medical Educa
tion" in Latin America.
The Network is promoting a change in medical education that
is inevitable: incorporation of the community as a natural
selling for medical education. Each school has its own views
and reasons for change in medical education. Each school has
its own plans for the impiementauon of change. Participants
actively exchanged experiences and ideas. It was proposed to
’
.. •
reg*
win be held in October 1989 in Montevideo, Uruguay, and the
second in April 1990 in Havana, Cuba.For more information
please contact Prof.Dr. Pablo Carlevaro, Dean Faculty of Me
dicine. Slate University of Uruguay, Montevideo, Uruguay.
Recent Events
A Latin American Meeting
for the Network linked to the Second Interna
tional Seminar on Primary Health Care: Family
Physicians - a Response to Community Needs
November 14-18,1988, Havana, Cuba
Seminar
In 1988 36% of all Cubans had a family
fam ily doctor providing their
primary care. 72% of the family doctors are in urban areas, 5%
in rural areas, and 15% in the mountains. The remaining are
'
in schools and in industry.
I
i
Ten Years of Innovative Medical
Education, a Celebration
August 30 - September 16,1988
University of Newcastle, Australia
Over 700 participants from 20 countries attended the work
shops and seminars organized to celebrate the first ten years
of innovative medical education at the Newcastle Faculty of
Medicine. Events were built around the themes of explaining
the Newcastle approach, reviewing and evaluating its success
and looking into future developments.Twenty separate events
ranged from a multi media display that encapsulated the
history and philosophy of the Faculty to a concert program
performed by Faculty staff and students in Christ Church
Cathedral.
lt is expected that there will be20,000 family doctors by 1995,
with this number possibly being expanded to 25,000. The
intent is that a family doctor win look after between 500 and
700 patients. There wiU also be family doctors in all schools
and in all work places of any significant size. At the present
time, over 1000 Cuban doctors are providing health care
services in over 30 countries throughout the world.
The participants of the Second Seminar on Primary Care,
~
which included some 1500 people from
over 30 countries,
most
encouraged
by
the
progress
of the Cuban family
were .....
„
.
. .
doctor concept. The Latin countries were particularly enthu
siast and saw it as a necessary development within their own
countries.
Dr. Carl Moore of McMaster University has produced a full
report which is available from the Secretarial.
|
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i
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Network Day
On November 18,1988 a Network Day was organized in order
io exchange informauor. or. the objectives, plans and aclivities of the Network in Latin America. The "Day of the Net-
'
1
4
The World Health Organization was represented by the retir
ing Director of Health Manpower Development, Dr. Tamas
Fiildp and by his sucessor. Dr. Eric Goon. Representatives
from other Australian medical schools and Newcastle s sister
schools at McMaster in Canada, Maastricht in Holland and the
Arabian Gulf University in Bahrain contributed to the discusssions.
jons.
a meeting that focused on regional opportunities for mitiayves jn medical education saw the WHO representatives
encouraging Newcastle to play a greater role in the Network
of Community-Oriented Educational Institutions for Health
Sciences. Important contacts were forged with medical
schools and organizations in various countries including
Nepal, Thailand, Malayisa, Indonesia and Fiji.
The second David Maddison Lecture, delivered by Dr.
Donald Lindberg, Director of the National Library of Mcdicine in Washington D.C. addressed the issue of medical
information systems and their management.
The students' Medical Society participated in the celebrations
with a number of social events which included a dinner and
the annual medical students ball. MEDSOC was responsible
also for the organization of a seminar on Alternate and Com
plementary Approaches to Health at which a variety of prac
titioners including an acupuncmnst, chiropractor and natural
therapist, as well as general pracutioners, interacted and
contrasted their approaches to a patient's multi faceted health
problem.
The celebrations reinforced the message that to continue its
work, the Faculty of Medicine at Newcastle must remain
innovative in its approach to medical education, maintain its
strong links with the community which fought hard for its
establishment and continue to promote its already significant
international profile.
The Network Task Forces
Task Force 5: Change in Established
Schools for Health Sciences
By Dr. JM. Creep, leader
How to initiate change
How to implement change
How to sustain the survival of change
Until quite recently I was Dean of the Medical Faculty of
Maastricht, a relatively small faculty. I am, therefore, well
aware of a Medical Faculty - financial pressures, personnel
problems, pressures to contribute to the health care of a
population, pressures for more research, and, not least, pres
sures for change in the education that the faculty offers to its
students.
We have our own views on the reasons why change in medical
education should be considered. Each dean has his or her own
plans for the change they would like to introduce in the
curriculum of the Medical Faculty. It is here that I would value
your help. I am the chairman of a Task Force in the Network
of Community-Oriented Educational Institutions for Health
Sciences, which has been given the task of considering the
problems involved in changing medical education. Your
thoughts, views and experiences and, indeed, your recom
mendations would be most valuable.
I appreciate the innumerable demands on your time, so that a
few brief notes would be most welcome when you could find :
a moment. In return, members of my Task Force, and the
insights and experiences of the member institutions of the
Network in developed and developing countries may possibly
be of assistance to you. The member institutions are widely
distributed across the world, so that one of the members is
likely to be in your region and able to assist you directly.
However, you should feel free to contact us in the Network
where you will find colleagues of our Task Force with similar
problems and willing to shan- their experiences with you
I would very much like to hear from you and I would greatly
value your collaboration.
Contact address.
Prof.dr. J.M. Creep
Chairman Task Force 5 of the Network
Chairman of the Department of Surgery
Academic Hospital Maastricht
P.O. Box 1918
6201 BX Maastricht
The Netherlands
Telefax: (31)43-477 645
News from Network
Institutions
External Formative Program
Evaluation in Sherbrooke
September 18-21,1988
University of Sherbrooke, Canada
by Dr. Jacques E. DesMarchais *
In North America, every medical school is usually subjected
to program evaluation for accreditation purposes. Less fre
quently, such evaluation is intended to stimulate improve
ment without making moral judgment.
The Faculty of Medicine, University of Sherbrooke, Province
of Quebec, has changed its traditional curriculum to a prob
lem-based and community-oriented program. September 1st,
1987, the first cohort of 100 students commenced the new
program. Because Sherbrooke has become the first estab
lished medical school to initiate a complete curriculum
change in the last 40 years, it was decided to subject the
implementation of the first year to a formative program
evaluation by external consultants.
From September 18 to 21,1988, four medical educators were
invited to review the strengths, weaknesses and the problems
between the intended educational change and its current
implementation. Dr. Jean-Jacques Guilbert, formerly at the
World Health Organization, and Dr. Vic Neufeld, the Chair
man of the Network, joined Dr. Gilles Hurteau, Dean of the
Ottawa Medical School, Canada, and Dr. Robert Colvin,
pathologist, engaged in the New Program at Harvard Medical
School, U.S.A.; as external evaluators.Their visit was a
golden opportunity for a core of internal change agents and
developers to seek advice and consultation on difficulties
encountered in the first year of implementation. The change
was intended to solve many characteristics of the "Curriculopathy". However, Jean-Jacques Guilbert found a new curricu
lum disease, "the coveritis syndrome’', characteristic of the
dedicated and responsible group of teachers who tried to
transform their traditional course contents into problems loi
its 16 year old curriculum to strengthen primary health care
strategies and to emphasize medical educauon to ensure that
doctors arc able to actively participate in achievmg Health for
problem-based learning. By and large, the visit was very
helpful to cristallize results of the first year of change and to
give those in charge an occasion for their first trial of criticism
in a non-threatening atmosphere.
i
All by the Year 2000.
Dr and Mrs. Owor were involved m meetings, discussion
groups and in tutorial groups. During this time Mary Owor
became a willing participant in discussion groups involving
the School of Nursing and the Aga Khan Project.
As a result of these discussions McMaster University and
Makerere University are exploring new areas of collabora-
lion.
Medical Education in China for the 21st
Century: the Context for Change
Drs A KauimanandJ. Hamilton from the University ofNew
Mcxico, U.S.A., and Newcastle. Australia, respectively were
invited to participate with seven other temporary a^isers in
a national conference in Beijing on the subject Med.cal
Education in China for the 21st Century .
rino/;
Their impressions and experiences in the winter of 1986 are
recorded in their paper Medical Educauon in China for the
21st century: the context for change (1988).
Medical Education, 22,253-260.
from left to right: Dr. Gilles Hurteau. Ottawa: Dr. Vick
Neufeld, McMaster, both from Canada: Dr. Jean-Jacques
Guilbert, Switzerland; Dr. Robert Colvin. Harvard U.S.,
and from Sherbrooke. Dr. Jacques E. Des Marchats,
Dr. Bertrand Dumais, Dr. Guy Lacombe.
We would like to publicly congratulate our four visitors for
their expertise and "esprit de fonctionnement". 1 consider this
visit as a by-product of the Network Organization because its
proposal evolved from contacts made at the Pattaya Meeting.
The Christian Medical College and
Hospital, Vellore, India
* Dr. Jacques E. DesMarchais is Associate Dean of Educa
tion at the University of Sherbrooke, Faculty of Medicine.
Canada
Dr A Joseph, Professor and Head of the Department of
Community Health at the Medical College reported on the
teaching program aimed at producing basic doctors who can
function in any setting in his paper "Training doctors for
primary health care: the VeUore Model (1985)".
World Health Forum, 6, 118-121. This journal is available
free of charge on application to: World Health Organization,
Distribution and Sales, 1211 Geneva 27, Switzerland.
McMaster University and Makerere
University explore new areas of colla
boration
From October 18th to October 28th McMaster University
hosted Dean Raphael Owor and his wife, Mary. Dr. Owor is
Dean of Makerere University, Kampala, Uganda and was m
Canada to strengthen links with Canadian institutions and to
gather information relevant to curriculum development m
both Medicine and Nursing.
Mrs. Mary Owor, who is a nutritionist, works for UNICEF
Kampala in primary school education. At the present she is
very active in the initiative to teach, at a very early age,
children about the facts about AIDS. Mary had just been to a
conference in Mexico where she presented a paper.
Makerere University has a long tradition of community outreach. This leadership began in the 1960's and has continutcd
through more than two decades of war, political instability
and economic constraints.
Like most of the leading medical faculties throughout the
world, Makerere University has recognized a need to change
(Copies can be obtained at the Secretariat)
Survey of Education Projects with
University-Government Community
Linkages
’ ; been received from the
small planning grant has
^^ivuv. —
_________
Rockefeller
Foundation
to develop the concept of universities
collaborating
collaboratingwith
withgovernments
governmentsand
andcommunities
communitiesininaade
defined
fined
region for the purpose of- community-oriented
a health nmfw.
profes
sions education (the "district locus concept).
■i The first step is to look al the experiences of others who have
6
undertaken such initiatives. A formal iiteratwe search is
under way, however, I suspect the most innovative work is to
be found in local reports and ongoing efforts.
If you are now involved in such a project, or know of one that
has been carried out, would you please send whatever infor
mation you have on it to the research assistant Mr. Thomas
Gassert, c/o Office of Education, C-662 MSB, UMDNJ-New
Jersey Medical School, 185 South Orange Avenue, Newark,
NJ, 07103-2757, U.S.A.
College of Osteopathic Medicine
Michigan State University
East Lansing, U.S.A.
New Network Members
School of Medicine
University of Zambia
Lusaka, Zambia
Faculty of Medicine
University College and Middlesex School of Medicine
London, United Kingdom
AMREF Training Centre
Dipl, in Community Health
Nairobi, Kenya
Full member institutions
Faculty of Medicine
University of Leon
Leon, Nicaragua
School of Medicine
Southern Illinois University
Springfield, Illinois, U.S.A.
Faculty of Medicine
University Kebangsaam Malaysia
Kuala Lumpur, Malaysia
Medical School
University of Bari
Bari, Italy
Gondar College of
Medical Sciences
Gondar, Ethiopia
Faculty of Medicine
Universidad de la Frontera
Temuco, Chile
Corresponding Members
College of Human Medicine
Michigan State University
East Lansing, U.S.A.
Carlos A. Montoya
Hospital Infantil Universitario
Carrera 25, no. 49-48
Manizales, Caldos, Colombia
Faculty of Health Sciences
Rijksuniversiteit Limburg
Maastricht, The Netherlands
Faculty of Health Sciences
Obafemi Awolowo University
Ile-Ife, Nigeria
International News
Know your WHO Regional Offices better
Faculty of Medicine
State University of Uruguay
Montevideo, Uruguay
Associate member institutions
Department of Medicine
Dayanand Medical College
Ludhiana, India
Community Medicine Development Foundation, Inc.
(COMMED)
University of the Philippines Manila
Manila, Philippines
!
7
A better understanding of the existing structure of World
Health Organization Regional Offices and the support that
they offer to member countries may be of help to Network
member institutions.
The World Health Organization (WHO) is committed to the
proper training and use of health professionals, so that they
can meet the priority health needs of communities, families
and individuals in the spirit of the primary health care ap
proach. WHO supports Member States in these efforts by
providing fellowships, advisory services and by facilitat
ing meetings and the exchange of information.
WHO’s support to Member States is planned every two years;
the planning exercise is a joint effort of governments, the
WHO Representative (when there is one), and the WHO
Regional Office. The WHO staff member at regional level
4. European region:
who can best advise on ways to secure WHO support for
education and training activities is the Regional Adviser in
health manpower development. The addresses of tlie six
Regional Offices, as well as the countries belonging to each
WHO Region, appear below.
WHO/Regional Office for Europe
8, Scherfigsvej, 2100 Copenhagen 0, Denmark
Any request for WHO's collaboration or support should
be discussed first at national level with the responsible
officer at the Ministry of Health and with the WHO
Representative. It is very important that proposals be in
accordance with national health policies and programs
and that they outline a set of coordinated activities rather
than a series of ad hoc interventions.
■
Countries belonging to the European region:
Albania, Austria, Belgium, Bulgaria, Byelorussian SSR,
Czechoslovakia, Denmark, Finland, France, German
Democratic Republic, Germany, Federal Republic of,
Greece, Hungary, Iceland, Ireland, Israel, Italy, Luxem
bourg, Malta, Monaco, Netherlands, Norway, Poland,
Portugal, Romania, San Manno, Spain, Sweden, Switzer
land, Turkey, Ukrainian SSR, USSR, United Kingdom of
Great Britain and Northern Ireland, Yugoslavia.
5. South-East Asian region:
1. African region:
WHO/Regional Office for South-East Asia
World Health House, Indraprastha Estate
Mahatma Gandhi Road, New Delhi-110002, India
WHO/Regional Office for Africa
P.O.B. 6, Brazzaville, Congo
Countries belonging to the African region:
Algeria, Angola, Benin, Botswana, Burkina Faso, Bu
rundi, Cameroon, Cape Verde, Central African Republic,
Chad, Comoros, Congo, Cote d’Ivoire, Equatorial Guinea,
Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bis
sau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali,
Mauritania, Mauritius, Mozambique, Niger, Nigeria,
Rwanda, Sao Tome and Principe, Senegal, Seychelles,
Sierra Leone, South Africa, Swaziland, Togo, Uganda,
United Republic of Tanzania, Zaire, Zimbabwe, Namibia.
Countries belonging to the South-East Asian region.
Bangladesh, Bhutan, Burma, Democratic People’s Re
public of Korea, India, Indonesia, Maldives, Mongolia,
Nepal, Sri Lanka, Thailand.
6. Western Pacific region:
WHO/Regional Office for the Western Pacific
P.O. Box 2932,1099 Manila, Philippines
Countries belonging to the Western Pacific region:
Australia, Brunei Darussalam, China, Cook Islands,
Democratic Kampuchea, Fiji, Japan, Kinbati, Lao
People's Democratic Republic, Malaysia, New Zealand,
Papua New Guinea, Philippines, Republic of Korea,
Samoa, Singapore, Solomon Islands, Tonga, Vanuatu,
Viet Nam.
2. American region:
WHO/Regional Office for the Arncricas/Pan American
Sanitary Bureau (PAHO)
525,23rd Street, N.W.
Washington, D.C. 20037, U.S.A.
Countries belonging to the American region:
Antigua and Barbuda, Argentina, Bahamas, Barbados,
Bolivia, Brazil, Canada, Chile, Colombia, Costa Rica,
Cuba, Dominica, Dominican Republic, Ecuador, El Sal
vador, Grenada, Guatemala, Guyana, Haiti, Honduras,
Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru,
Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the
Grenadines, Suriname, Trinidad and Tobago, United
States of America, Uruguay, Venezuela.
World Conference on Medical Education
of the World Federation for Medical Education
Edinburgh, August 1988
’The Edinburgh Declaration’
3. Eastern Mediterranean region:
WHO/Regional Office for the Eastern Mediterranean
P.O. Box 1517, Alexandria-21511, Egypt
Countries belonging to the Eastern Mediterranean region;
Afghanistan, Bahrain, Cyprus, Democratic Yemen,
Djibouti, Egypt, Islamic Republic of Iran, Iraq, Jordan,
Kuwait, Lebanon, Libyan Arab Jamahiriya, Morocco,
Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan,
Syrian Arab Republic, Tunisia, United Arab Emirates,
Yemen .
I
The aim of medical education is to produce doctors who will
promote the health of all people, and that aim is not being
realized in many places, despite the enormous progress that
has been made during this century in the biomedical sciences.
The individual patient should be able to expect a doctor
trained as an attentive listener, a careful observer, a sensitive
communicator and an effective clinician; but it is no longer
enough only to treat some of the sick. Thousands suffer and
die every day from diseases which arc preventable, curable or
self-inflicted, and millions have no ready access to health care
of any kind.
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11. Increase the opportunity for joint learning, research and
service with other health and health related professions, as
part of the training for teamwork.
These defects have been identified for a long tune, but efforts
to introduce greater social awareness into medical schools
have not been notably successful. Such facts have led to
mounting concern in medical education about equity in health
care, the humane delivery of health services, and the overall
costs to society.
This concern has gathered momentum from national and
regional debates which have involved large numbers of indi
viduals from many levels of medical education and health
services in most countries of the world, and has been brought
into sharp focus by reports which followed from the six
regions of the world and which address the basic issues. Italso
reflects the convictions of a growing number of doctors in
teaching and clinical practice, other health professionals,
medical students, and the general public.
Scientific research continues to bring rich rewards; but man
needs more than science alone, and it is the health needs of the
human race as a whole, and of the whole person, that medical
educators must affirm.
Many improvements can be achieved by actions within the
medical school itself, namely to;
12. Clarify responsibility and allocate resources for continu
ing medical education.
Reform of medical education requires more than agreement;
it requires a widespread commitment to action, vigorous
leadership and political will. In some settings financial sup
port wil inevitably be required, but much can be achieved by
a redefinition of priorities, and a reallocation of what is now
available.
By this Declaration we pledge ourselves and call on others to
join us in an organized and sustained program to alter the
character of medical education so that it truly meets the
defined needs of the society in which it is situated. We also
pledge ourselves to create the organizational framework
required for these solemn words to be translated into effective
action. The stage is set; the time for action is upon us.
followed by:
1. Enlarge the range of settings in which educational pro
grams are conducted, to include all health resources of the
community, not hospitals alone.
Ministerial Consultation for Medical
Education in europe
2. Ensure that curriculum content reflects national health
priorities and the availability of affordable resources.
Lisbon, 31 October - 3 November 1988
3. Ensure continuity of learning throughout life, shifting
emphasis from the passive methods so widespread now to
more active learning., including self-directed and inde
pendent study as well as tutorial methods.
’The Lisbon Initiative’
Delegations of the Ministries of Health and Education and
other authorities in charge of higher education and health of
the Member States of the European Region of WHO, meeting
in Lisbon in November 1988, expressed their wish for a reo
rientation in medical education relevant to health needs.
The Ministerial Consultation recalls that all Member States of
the European Region adopted in 1984 a joint Health for All
policy and that in 1987 the Regional Committee requested the
European Office of WHO to consider the implications of this
HFA policy for health personnel development and to submit
it back in 1990. It also welcomes the important process started
by the World Federation for Medical Education through its
Edinburgh Declaration. The Consultation is also encouraged
by the support given by UNESCO through WHO to improve
medical education in Europe.
In line with this philosophy and based on the statements of the
delegations and discussions in the working groups, the par
ticipants of the Ministerial Consultation in Lisbon propose
that action should be considered by all European countries on
the following principles:
4. Build both curriculum and examination systems to ensure
the achievement of professional competence and social
values, not merely the retention and recall of information.
5. Train teachers as educators, not solely experts in content,
and reward educational excellence as fully as excellence
in biomedical research or clinical practice.
6. Complement instruction about the management of pa
tients with increased emphasis on promotion of health and
prevention of disease.
7. Pursue integration of education in science and education
in practice, aslo using problem solving in clinical and
community settings as a base for learning.
8. Employ selection methods for medical students which go
beyond intellectual ability and academic achievement, to
include evaluation of personal qualities.
Other improvements require wider involvement in order to:
1. A national medical education policy should reflect a
clearly defined national health policy stemming from the
European HFA strategy;
9. Encourage and facilitate co-operation between the Minis
tries of Health, Ministries of Education, community health
services and other relevant bodies in joint policy develop
ment, program planning, implementation and review.
2. Clear and effective mechanisms should foster close coop
eration between health and educational sectors in the es
tablishment of policy and programmes in the field of
health professional education;
10. Ensure admission policies that match the numbers of
students trained with national needs for doctors.
9
3. Educational programmes in individual universities and
medical scholls reflect the above-mentioned national poli
cies;
4. Mechanisms and resources should be promoted for con
tinuing education as an essential feature of medical educa
tion in cooperation with professional societies.;
5. All phases of medical education should take place in
appropriate settings which reflect all aspects of health and
health services.
The Ministerial Consultation welcomes the educational inno
vations undertaken in many countries and institutions. The
progress of such innovations should be monitored and as
sisted by WHO Regional Office, UNESCO and associated
scientific bodies such as AMEE and AMDE as required. The
World Conference on Medical Education has proposed an
International Collaborative Programme on Reorientation of
Medical Education. Close collaboration should include the
interchange of advice and exchange of expertise between all
countries at both institutional and national levels.
The Ministerial Consultation was most encouraged by the
strong decision taken by the Ministers of Education and
Health of Portugal to take immediate steps to start the process
for ensuring change in line with the Edinburgh Declaration
and the European HFA strategy. The Ministerial Consultation
proposes that all other countries should consider to follow this
example.
The study and development of teaching-service integra
tion programs, PROAIDA;
-
The Latin American Program for the Development of
Medical Education, LAPRODEME;
-
Medical Education in the Americas,EMA, reexamines the
priorities and strategies of medical education in the 21st
century, coordinated by the Brazilian Association of
Medical Education;
-
The Panamerican Consortium for the Development of
Health Policies is a joint program with the Department of
Community Medicine, Mount Sinai School of Medicine,
City University of New York promote the exchange of ex
periences, technology and expertise in primary care and
medical education between South, North and Central
America and the Caribbean.
Dr. Pablo A. Pulido M., Executive Director, FEPAFEM
Apartado Postal N. 60.411, Caracas 1060-A,Venezuela
News from and to Network
Students
International Symposium on the Role
of the Student Health Professional in
Community Health Education
Panamerican Federation of
Associations of Medical Schools
(PAFAMS)
October 10-13,1988
Beer Sheva, Israel
Report by Alison Diamond & Danusia Kanachowski *
In 1987 the Panamerican Federation of Associations of
Medical Schools, celebrated its 25th anniversary as an inde
pendent, non-governmental, non-profit, educational organi
zation dedicated to bettering health service by improving
education in the medical and biomedical sciences. Its mem
bers are the national and regional associations of medical
schools (as well as a few individual schools) in North, Central,
South America and the Caribbean. 325 medical schools, a
majority of the medical schools in the Americas, are repre
sented in PAFAMS.
PAFAMS investigates educational problems, joins in the
search for solutions and organizes programs for an ongoing
exchange of information in medical education through its
Information and Documentation Center in Health Services
and Education (CIDEMS).
PAFAMS’ programs over the past decade reflect the response
to the health needs of the community:
-
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We, a nursing and a medical student, had the opportunity to
attend the International Symposium on the Role of the S tudent
Health Professional in Community Health Education, in Beer
Sheva and Jerusalem, Israel. We represented students from
the Faculty of Health Sciences at McMaster University in
Canada. Our primary reasons for attending the symposium
were to network with students from other health science
education institutions and to learn from their experiences in
community health education.
Participants included 16 students and 1 faculty member rep
resenting Network and other institutions from Sweden, Ger
many, Holland, Zambia, the United States and Canada. The
majority of participants were medical students although nurs
ing, dentistry and pharmacy were sparsely represented. The
presentations included a diversity of topics drawn from the
Israeli experience and several from the experiences at two
American (non-Network) universities. During the sympo
sium, the scheduling of more discussion time might have
provided a better learning experience since many people
appeared to have little or no prior involvement in community
health education. An evaluation on the final day would have
A study of the training and use of the family practitioner
in Latin America and implementation of undergraduate
family medicine programs;
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♦ Escuelas Innovadoras para Personal
de Salud.
been valuable to provide the organizers with feedback. This
information would have been useful to the participants in the
planning of future activities and events. Our Israeli hosts were
very hospitable and provided a number of opportunities to
leam about their history and experience their culture. At our
request, visits to both an urban and a rural (Bedouin) health
care clinic were organized. This was one of the highlights of
our trip, as we experienced health care in a different cultural
setting.
The fact that an international symposium organized by and for
student health professionals was conceived and occurred is
both positive and exciting. It was disappointing to a number
of participants, including the organizers, that so few Network
institutions and countries were represented. This might re
flect: a lack of awareness, interest, financial resources, or
other logistical and political impediments. In the planning of
future Network student activities these are vital considera
tions. Another imprtant consideration is the encouragement of
diverse representation from the health professions to reflect
the concept of working together as a community health care
team.
Informe sobre Diez Escuelas de la Red de Instituciones de
Formacidn Comunitaria sobre Ciencias de la Salud; R.
Richards y T. FulOp en colaboracirin con J. Bannerman, G.
Greenholm, J.-J. Guilbert y M. Wunderlich. OMS Publicacidn en Offset, No. 102, ISBN 92 4 370102 9.
This book reports the findings and observations of a study
focused on ten medical schools that have undertaken commu
nity-oriented and problem-based education. The study, which
included schools located in Australia, Cameroon, Canada,
Israel, Mexico, Nepal, the Netherlands, the Philippines and
the U.S.A., was designed to uncover differences in the ways
these schools have evolved while also establishing standards
for measuring and comparing the extent of their success in
meeting stated objectives. Apart from recording the results of
a major cross-institutional review of educational changes, the
book also succeeds in identifying a number of fundamental
questions, component methods for achieving objectives, and
potential areas of impact where the success of these methods
can be effectively measured.
* Alison Diamond & Danusia Kanachowsld are students at
McMaster University, Canada
* Innovative Tracks at Established
Institutions for the Education of Health
Personnel.
An Experimental Approach to Change Relevant to Health
Needs, by M. Kantrowitz, A. Kaufman, S. Menn in, T. Fiildp
and J.-J. Guilbert. WHO Offset Publication, No. 101, ISBN 92
4 170101 3.
This book provides a highly practical and instructive guide for
educators seeking to reform programs and methods of teach
ing at established medical schools. Focused on practical
problems, the book describes an approach to change involv
ing the establishment of an innovative curricular "track" as a
curriculum distinct from, but running parallel with, the al
ready existing curriculum. To facilitate understanding of how
the strategy works in real situations, the book draws upon
ideas, experiences and discussions presented during a confer
ence attended by educators at eight institutions that have used
the track approach as an agent of change, some for as long as
15 years.
Have you read this?
*
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Report of a WHO Study Group on Multiprofessional Educa
tion of Health Personnel: The Team Approach. WHO Tech
nical Report Series, No. 769, ISBN 92 4 120769 8
This report presents and explains the concept of multiprofes
sional education as a strategy for improving the competence
of health professionals, particularly concerning their ability to
provide health and medical care relevant to real health needs.
The reports opens with a definition of muliprofessional edu
cation as a training process by which students of different
health professions learn together the skills necessary for
solving the priority health problems of individuals and com
munities that are known to be amenable to team-work. Read
ers are then given an explanation of the rationale and purposes
of multiprofessional education, including its relevance to
community needs, its place in strategies for achieving health
for all, and the appropriateness of its team-work approach in
view of the many health problems having socio-economic as
well as medical determinants.
*
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Learning Together to Work Together for
Health.
♦ Community-Based Education of
Health Personnel.
Report of a WHO Study Group, WHO Technical Report
Series, No. 746, ISBN 92 4 120746 9.
This book contains a detailed explanation of the meaning of
community-based education, including its objectives, con
ceptual foundations and relationship to current theories of
education and methods of teaching. The report, which is
addressed to the directors, deans and faculties of medical and
other health-related schools, opens with a discussion of trends
that have created a demand for health personnel capable of
responding more effectively to community needs. Trends in
both industrialized and developing countries are considered.
Innovative Schools for Health Personnel.
Report on Ten Schools belonging to the Network of Commu
nity-Oriented Educational Institutions for Health Sciences,
by R. Richards and T. Fiildp in collaboration with J. Bannerman, G. Greenholm, J.-J. Guilbert and M. Wunderlich. WHO
Offset Publication, No. 102, ISBN 92 4 170102 1.
______________________________________________
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COMMUNITY HEALTH CEU
326, V Main, I Block
Koramongala
Jor 0.^6^034————————
♦ Continuing the Education of Health
Workers. A Workshop Manual
Articles / Reports / Newsletters
by F.R. Abbatt and A. Mejia. WHO, Geneva, 1988. ISBN 92
4 154220 9.
This learning package is designed to help decision-makers
and planners develop a well-conceived system for continuing
the education of health workers. Recognizing the need to
stimulate broad-based interest and support the book advo
cates use of a workshop, attended by policy-makers and
people with influence in the health care system, as a starting
point for the assessment of needs and formulation of plans. To
this end, the book doubles as an introduction to the compo
nents of effective continuing education and a practical how
to manual for organizing and conducting a workshop.
received by the Secretariat
Medical Teacher, Vol. 10, No. 1-2, 1988.
WHO Report, 41 st World Health Assem bly, Geneva, May
1988.
-
Escuelas Innovadoras para Personal de Salud, R.
Richards, T. Fiildp, et al., ISBN 92 4 370102.
Coexistence of Tradition and Change, Moshe Prywes
M. D.
-
Learning together to work for health, WHO, Techn. Rep.
Series, No. 769.
-
Emirates Medical Journal, Volume 6, No. 2, August 1988.
-
Joint Medical Newsletter, Faculty of Medicine, Newcastle/Hunter Medical Association and Dept of Health,
N. S.W. Australia, No. 51, 52, 53, 54 (July, Sept., Nov.
1988).
-
Outlook, Educational Commission for Foreign Medical
Graduates, Spring/Summer 1988, No. 6-7.
-
Pafams Update, Panamerican Federation of Associations
of Medical Schools, Volume 5, No. 1-2, Jan.-June 1988.
-
Federacidn Panemericana de Asociaciones de Facultades
de Medicina, Volumen XXIV, No. 1, Enero-Abril 1988.
-
Fepafem Informa, Julio-Agosto 88.
-
Newsletter Health for All 2000: Alma-Ata Ten Years
After, WHO Division of Strengthening of Health Serv
ices, Spring 1988.
-
NGO-WHO Newsletter No. 3, Partners in Health, World
Health Organization, Geneva, June 1988.
-
World Health, Magazine of the WHO, August-Sept, Oct
1988.
-
Horizons Health/S ant6. International Federation of Phar
maceutical Manufacturers Associations, Sept. 1988, No.
5.
European Newsletter on Quality Assurance, Vol. 5, No. 3,
1988.
-
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Images, Institute of Medicine Newsletter, Kathmandu,
Nepal, Vol. 3, Nos. 8 and 9 (August Sept. 1988).
-
Journal of the Institute of Medicine, Kathmandu, Nepal,
Vol. 9, No. 4, Dec. 1987.
-
Buletin Pendidikan Perubatan, Universili Kebangsaan
Malaysia, Nov ./Dec. 1987.
-
Padayon, a publication of Philippine Youth Health Pro
gram, Vol. II, No. 1, June 1987.
-
the GME Correspondent, AAMC, No. 1,1988.
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International Events 1989
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May 14-17,1989
MEDICAL EDUCATION
WORKSHOP SERIES:
Montreal, Canada
XII PANAMERICAN CONFERENCE
January 12-14,1989
ON MEDICAL EDUCATION:
CRITICAL ISSUES IN MEDICAL EDUCATION
Springfield, Illinois, U.S.A.
Performance-Based Assessment
Contact persons:
Dr. de Guise Vaillancourt
Executive Director
The Association of Canadian Medical Colleges
151 Slater St
Ottawa, Ontario, Canada KIP 5H3
Tel. (613)237-0070
Fax: (613)563-9745
or:
Dr. Pablo A. Pulido M.
Executive Director
Panamerican Federation of Associations of Medical Schools,
PAFAMS
P.O. Box 60.411
Caracas 1060-A, Venezuela
Tel. (02)939064 or 938979
Fax: (58-2)936346
Telex: CMDLT-VC 24627
April 2-7,1989
Springfield, Illinois, U.S.A.
Visitors Workshop
April 26-29,1989
Monterey, California, U.S.A.
Problem-Based Learning
June 6-9,1989
Springfield, Illinois, U.S.A.
Training and use of Simulated Patients
June 19-22,1989
Springfield, Illinois, U.S.A.
Tutorial Skills
All workshops are hands-on, skill acquisition sessions taught
by Southern Illinois University faculty and other prominent
medical educators.
For further information contact
Janet Allison
Office of Continuing Education
Southern Illinois University
School of Medicine, P.O. Box 19230
Springfield, IL 62794-9230 (217/782-7711), U.S.A.
June-July 1989
Maastricht, The Netherlands
VISITORS’ WORKSHOPS:
June 26-30,1989:
Learning through problems: opportunities and limitations
July 3-7,1989:
New methods in student assessment and skills training
March 13-15,1989
Caracas, Venezuela
MEDICAL EDUCATION IN THE AMERICAS
More information can be obtained from :
Miss Willie Schipper
Faculty of Medicine
Rijksuniversiteit Limburg
P.O.B. 616, Maastricht
The Netherlands
tel. 043 - 888643
telex no. 56880 fg rl nl
telefax no. 43 - 437226
PROGRAM
TASK FORCE MEETING
Contact persons:
Dr. Mario M. Chaves, Program Coordinator
Brazilean Association of Medical Education (ABEM)
Rua Leopoldo Bulhoes
1480 3er andar
Manguinhos, 21041
Rio de Janeiro, Brazil
Tel. 260-6161
or:
Dr. Roberto Ronddn Morales
Program Director, PAFAMS
Apartado Postal No. 60.411
Caracas, 1060-A, Venezuela
Tel. (58-2)939064 or 938979
Fax: (58-2)936346
Telex: CMDLT-VC 24627
July 4-12,1989
London, United Kingdom
BLITHE/WHO ANNUAL COURSE IN MO
DERN METHODOLOGY FOR TEACHERS OF
THE HEALTH SCIENCES
Intended for all teachers in the health sciences, who wish to
improve their existing teaching skills and learn new ones, for
example, problem-solving, group work, lecturing, critical
incident The course is highly participative and practical,
including educational visits to other establishments.
13
August 7-18,1989
London, United Kingdom
BLITHE/WHO COURSE ON MANAGING A
HEALTH RESOURCE CENTRE
The course will provide a basic training for anyone faced with
the problems of managing and developing a resources collec
tion. Although the subject content will be orientated towards
health, the basic techniques may be of interest to people from
other disciplines.
Contact person:
Mrs. Bernadette s. Carney
Head of Information Services
British Life Insurance Trust for Health Education
BMA House, Tavistock Square
London WC1H9JP, U.K.
September 18-19,1989
Rolduc Conference Centre, KerLsde, The Netherlands
6TH BIENNIAL GENERAL NETWORK
MEETING
September 20-22,1988
Rolduc Conference Centre, Kerkrade, The Netherlands
10TH ANNIVERSARY CONFERENCE OF THE
NETWORK ON ACADEMIC INSTITUTIONS
AND HEALTH CARE SYTEMS AS PARTNERS
IN HEALTH CARE DEVELOPMENT
January 8-12,1990
Maastricht, The Netherlands
INTRODUCTORY WORKSHOP:
New ideas for health professions education; the Maastricht
approach
Contributions for the next issue of the
Newsletter should be sent to Mrs. Ine Kuppen,
not later than mid January, 1989
14
NEW in 1989
Teaching and Learning
in Medicine
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An International Journal
Editor: Terrill A. Mast, Ph.D.
Associate Editor: Howard S. Barrows,
M.D.
Southern Illinois University School of Medicine
Teaching and Learning in Medicine will serve as
an international forum for scholarly state-of-theart research on teaching and learning
processes as they relate to the education of
medical professionals. Published quarterly, it
will address practical issues and provide the
analysis and empirical research needed to
facilitate decision-making about medical educa
tion at all levels.
The journal is intended to serve a readership of
medical school faculty, medical education
researchers, medical school administrators and
libraries, as well as staff members at offices of
medical education, educational development,
evaluation, and measurement. The journal will
publish the following types of manuscripts:
Applied Educational Research, Editorials,
Reviews of Literature, Basic Research,
Developments or work in progress, News of
conferences, and calls for papers, reviews of,
books and software.
EDITORIAL BOARD
Stephen Abrahamson, Ph.D.
Kenneth R. Cox, M.D.
Charles E. Engel
Roland Folse, M.D.
Jean-Jacques Guilbert, M.D.
Christine McGuire
V.R. Neufeld, M.D.
Hannes G. Pauli, M.D.
Henk Schmidt, Ph.D.
T. Joseph Sheehan, Ph.D.
Reed G. Williams, Ph.D.
Qui Xu-Xiang, M.D
Instructions for Contributors
Manuscripts should be prepared in accordance with the “Uniform Requirements for
Manuscripts Submitted to Medical Journals” (published each February in the Annals of
Internal Medicine and the British Medical Journal), which calls for references cited within
text to be identified by superscripts in the order in which they appear.
An abstract of no more than 200 words should accompany each manuscript, typed on a
separate sheet. The cover letter should include a statement that the manuscript is not being
simultaneously submitted elsewhere and should identify the category for which the
manuscript is being submitted. Authors are responsible for obtaining permission from
copyright owners.
Subscription information:
Submit four copies of manuscripts to:
Volume 1, 1989 (quarterly)
Terrill A. Mast, Editor
$25.00 individual: $50.00 institution
Teaching and Learning in Medicine
Lawrence Erlbaum Associates. Inc.
Southern Illinois University School of Medicine
Journal
Subscription Dept.
P.O. Box 19230
365 Broadway Hillsdale, N.J. 07642
Springfield, IL 62794-9230
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