Planned or emergent? An evaluation of a Master's in Health Professions Education programme.

BACKGROUND: Programme developers have the responsibility of ongoing programme renewal and evaluation to ensure that curricula remain responsive to rapidly changing educational and healthcare contexts. In reporting on programmes, significant emphasis is often placed on content and outcomes of Master's in Health Professions Education (MHPE) programmes. However, less emphasis has been placed on meaningful evaluation of all aspects of these programmes, particularly from a student perspective including what worked and what needs to be enhanced, as well as any emergent or unplanned factors. As the number of established MHPE programmes increases, so does the need for evaluation models that consider programme complexity. In this article we consider a MHPE programme against a model that provided scope for going beyond 'did it work?' Our intention was to determine whether the renewed MPhil in HPE programme was implemented as planned, and to which extent it achieved the planned outcomes. METHODS: This programme evaluation was conducted in an interpretive paradigm. We collected qualitative data at two points. Firstly, at the start of students' first-year with voluntary participation in focus groups and secondly, a year later with voluntary participation in individual interviews. Two members of the research team performed the initial thematic analysis of both the focus group interviews and the individual interviews. Thereafter, the full author team worked collaboratively discussing the themes until we reached consensus, looking specifically to identify any "emergent" factors. RESULTS: We identified three themes in the student data related to the process of implementing the new programme and the outcomes from it, including those aspects that could be regarded as emergent or unplanned: balancing work, personal lives and studies; managing the hybrid learning approach; and the scholarly journey. CONCLUSIONS: While many of the outcomes of the renewed programme were met, not all manifested as had been planned. The experience of the programme differed from one student to the next such that at the end of the two years they were at different points in their scholarly journeys. We realised that although we sought to be pedagogically sound in the process of curriculum renewal, we did not take into account the complex matrix of influences that sit outside the formal curriculum. Future renewal activities should intentionally and sensitively consider those factors, both planned and emergent, that influence a student's journey towards becoming a scholarly teacher and teaching scholar.

The supervisor's toolkit: A framework for doctoral supervision in health professions education: AMEE Guide No. 104.

Doctoral studies represent a complex undertaking for students and supervisors. Some research describes the experience of students while there are volumes of advice for students considering a doctorate. Yet the terrain for supervisors is less well-trodden and the concept of a pedagogy of supervision is only really starting to emerge. Texts on the doctoral journey from the supervisor's perspective are uncommon and less yet has been written in the context of health professions education. The aim of this Guide, therefore, is to provide guidance for the supervisor's journey, drawing on our collective experience and such literature as there is. We explore the doctoral journey of students and their supervisors, highlighting what the implications are for supervisory practice. Recognising the doctorate as much more than merely conducting a research project, and seeing it as a shared educational endeavour is fundamental to understanding the doctoral journey - a journey that is complex and mutable, constantly shifting as the candidate moves from novice to expert, from dependence to growing autonomy. Our intention is to present this Guide as a toolkit for both the novice and the experienced supervisor as it, on the one hand, seeks to make the practice of supervision more transparent while on the other, challenges the reader to critically reflect on the supervisory space in which they currently reside. Our hope is that the Guide opens up opportunities for generative conversations about the practice of doctoral supervision in health professions education.

Investing in community-based education to improve the quality, quantity, and retention of physicians in three African countries.

CONTEXT: The Medical Education Partnership Initiative (MEPI) is a $US 130 million program funded by the United States government supporting 13 African medical schools to increase the quantity, quality, and retention of physicians in underserved areas. This paper examines how community-based education (CBE) is evolving at MEPI schools to achieve these goals. METHODS: We utilized data from the first two years of site visits and surveys to characterize CBE efforts across the MEPI network and provide detailed descriptions of three models of CBE among the MEPI programs. RESULTS: There is widespread investment in CBE, with considerable diversity in the goals and characteristics of training activities among MEPI schools. Three examples described here show how schools are strengthening and evaluating different models of CBE to achieve MEPI goals. In Nigeria, students are being sent for clinical rotations to community hospitals to offload the tertiary hospital. In Uganda, the consistency and quality of teaching in CBE is being strengthened by adopting a competency-based curriculum and developing criteria for community sites. At Stellenbosch University in South Africa, students are now offered an elective year-long comprehensive rural immersion experience. Despite the diversity in CBE models, all schools are investing in e-learning and faculty development. Extensive evaluations are planned to examine the impact of CBE strategies on the health workforce and health services. DISCUSSION: The MEPI program is stimulating an evolution in CBE among African medical schools to improve the quality, quantity, and retention of physicians. Identifying the strategies within CBE that are reproducible, scalable and optimize outcomes will be instructive for health professions training programs across the continent.