Byline: Sarah. Kiguli, Roy. Mubuuke, Rhona. Baingana, Stephen. Kijjambu, Samuel. Maling, Paul. Waako, Celestino. Obua, Emilio. Ovuga, David. Kaawa-Mafigiri, Jonathan. Nshaho, Elsie. Kiguli-Malwadde, Robert. Bollinger, Nelson. Sewankambo
Background: Uganda, like the rest of Africa, is faced with serious health challenges including human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), other infectious diseases and increasing non-communicable diseases, yet it has a significant shortage of health workers. Even the few health workers available may lack desired competencies required to address current and future health challenges. Reducing Uganda's disease burden and addressing health challenges requires Ugandan medical schools to produce health workers with the necessary competencies. This study describes the process which a consortium of Ugandan medical schools and the Medical Education Partnership for Equitable Services to all Ugandans (MESAU) undertook to define the required competencies of graduating doctors in Uganda and implement competency-based medical education (CBME). Methods: A retrospective qualitative study was conducted in which document analysis was used to collect data employing pre-defined checklists, in a desktop or secondary review of various documents. These included reports of MESAU meetings and workshops, reports from individual institutions as well as medical undergraduate curricula of the different institutions. Thematic analysis was used to extract patterns from the collected data. Results: MESAU initiated the process of developing competencies for medical graduates in 2011 using a participatory approach of all stakeholders. The process involved consultative deliberations to identify priority health needs of Uganda and develop competencies to address these needs. Nine competence domain areas were collaboratively identified and agreed upon, and competencies developed in these domains. Discussion: Key successes from the process include institutional collaboration, faculty development in CBME and initiating the implementation of CBME. The consortium approach strengthened institutional collaboration that led to the development of common competencies desired of all medical graduates to address priority health challenges in Uganda. It is important that the MESAU consortium continues engaging all stakeholders in medical education to support the implementation and sustainability of CBME in Uganda.
Globally, there has been a realization that many health professionals cannot effectively manage the health problems of their patients and communities because they are not adequately trained in some essential competencies required for their jobs. [sup],, Gaps in key competencies, including effective communication skills to patients and families as well as professionalism, have been described in medical education programmes. [sup], This has led to many institutions adopting competency-based medical education (CBME). [sup], CBME has been defined as an outcomes-based approach to the design, implementation, assessment and evaluation of a medical programme, using an organizing framework of competencies. [sup], This process requires that the priority health needs of the population are identified, before mapping out the specific learning outcomes or competencies. The competencies are then considered in the design of the curriculum or learning experiences for the trainees. [sup],,
The approaches proposed to plan and implement CBME include: The Can Meds, [sup] the six competencies developed by the Accreditation Council for Graduate Medical Education (ACGME) [sup] and the Scottish doctor. [sup] Institutions...