Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
Interactive Research and Development (IRD), Florida Castle, Dhaka, Bangladesh.
BMC Med Educ. 2024 Jun 6;24(1):629. doi: 10.1186/s12909-024-05558-0.
Bangladesh has a shortfall of health professionals. The World Health Organization states that improving education will increase recruitment and retention of health workers. Traditional learning approaches, in medical education particularly, focus on didactic teaching, teaching of subjects and knowledge testing. These approaches have been superseded in some programmes, with a greater focus on active learning, integrated teaching and learning of knowledge, application, skills and attitudes or values and associated testing of competencies as educational outcomes. In addition, some regions do not have continuous professional development or clinical placements for health worker students, contributing to difficulties in retention of health workers. This study aims to explore the experiences of health professional education in Bangladesh, focusing on what is through observation of health professional education sessions and experiences of educators.
This mixed method study included 22 observations of teaching sessions in clinical and educational settings, detailed analysis of 8 national curricula documents mapped to Global Competency and Outcomes Framework for Universal Health Coverage and 15 interviews of professionals responsible for health education. An observational checklist was created based on previous literature which assessed training of within dimensions of basic clinical skills; diagnosis and management; professionalism; professional development; and effective communication. Interviews explored current practices within health education in Bangladesh, as well as barriers and facilitators to incorporating different approaches to learning.
Observations revealed a variety of approaches and frameworks followed across institutions. Only one observation included all sub-competencies of the checklist. National curricula documents varied in their coverage of the Global Competency and Outcomes Framework domains. Three key themes were generated from a thematic analysis of interview transcripts: (1) education across the career span; (2) challenges for health professional education; (3) contextual factors and health professional education. Opportunities for progression and development post qualification are limited and certain professions are favoured over others.
Traditional approaches seem to predominate but there is some enthusiasm for a more clinical focus to education and for more competency based approaches to teaching, learning and assessment.
孟加拉国缺乏卫生专业人员。世界卫生组织表示，改善教育将增加卫生工作者的招聘和留用。传统的学习方法，特别是在医学教育中，侧重于讲授教学、学科教学和知识测试。在一些项目中，这些方法已经被取代，更加注重主动学习、知识的综合教学和学习、应用、技能和态度或价值观的整合以及相关能力的测试作为教育成果。此外，一些地区没有为卫生工作者学生提供持续的专业发展或临床实习，这导致卫生工作者的留用困难。本研究旨在探讨孟加拉国卫生专业教育的经验，重点是通过观察卫生专业教育课程和教育工作者的经验来了解情况。
这项混合方法研究包括对临床和教育环境中的 22 次教学课程进行观察，对 8 个国家课程文件进行详细分析，这些文件与全球能力和全民健康覆盖成果框架相匹配，以及对负责健康教育的 15 名专业人员进行访谈。根据以往文献，创建了一份观察检查表，评估基本临床技能培训、诊断和管理、专业精神、专业发展和有效沟通等维度内的培训。访谈探讨了孟加拉国健康教育的当前实践，以及纳入不同学习方法的障碍和促进因素。
观察结果显示，各机构采用了各种方法和框架。只有一次观察包括检查表的所有子能力。国家课程文件在全球能力和成果框架领域的涵盖范围有所不同。从访谈记录的主题分析中生成了三个关键主题：（1）职业跨度内的教育；（2）卫生专业教育面临的挑战；（3）背景因素与卫生专业教育。资格后晋升和发展的机会有限，某些职业比其他职业更受欢迎。
传统方法似乎占主导地位，但人们对教育更注重临床和更注重基于能力的教学、学习和评估方法表现出一定的热情。
