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ISLAMABAD: Education and training of the Health care professionals needs
a serious revisit. It is mandatory to include behavioral sciences in the
curriculum and a programme of human resource development for every
person who is involved in the patient care. This was stated by Professor
Mushtaq A Khan, a highly respected child specialist & Ex-Dean and
Executive Director of Pakistan Institute of Medical Sciences, Islamabad
while chairing a seminar on Medical Education for Health care
Professionals organized by the Department of Medical Education of
Pakistan Institute of Medical Sciences, Islamabad.
Professor Mushtaq A Khan, Prof. Khaleeq-uz-Zaman and
others speaking at a seminar on Medical Education for Health care
Professionals organized by the Department of Medical Education of
Pakistan Institute of Medical Sciences, Islamabad
The theme of the seminar was “BE A SELF LEARNER AND HENCE BECOME A LIFE
LONG LEARNER” It was well attended and some audience remained seated
even on the stairs and included all categories of the health care
professional i.e. students, qualified senior & junior nurses,
paramedics, junior doctors and specialists. This was the first time that
an educational activity was attended by all categories of health care
providers as a team in PIMS.
Prof. Mushtaq A Khan said that the doctor patient relationship cannot
flourish without his skill of communication with ordinary people and
medically lay public. Lack of proper documentation and casual record
keeping are the other factors which affect patient care. This cause lack
of continuity in care of individual patients. As a result Research
cannot be performed due to lack of data and hence new local evidence
cannot be produced for the benefit of ultimate beneficiary i.e the
patient. There is a need to lay special emphasis on documentation and
communication skills in all training programmes. Not documented means
not done. Free & frequent communication in simple language satisfies the
patient and hence reduces complaints against doctors. Proper
documentation protects doctors in case a complaint is made. So
communication & documentation helps to flourish not only a good doctor
patient relationship, it also saves the doctor from unnecessary stresses
and finger pointing by the public.
The first speaker Professor Dr. Tanweer Khaliq, General surgeon at PIMS
talked about, ten steps approach for imparting the surgical skills. He
emphasized on the step by step approach where a trainee is taken from a
less complicated to more complex task. The trainee progressively learns
more & more difficult manures till he becomes an independent expert.
Dr. Muhammad Saiq from Plastic surgery talked about various ways of
research by which new evidence can be produced and the high authenticity
of the evidence so produced. He emphasized the need to produce high
quality evidence by experimental & quasi experimental local studies in
our own environment. Such research is always more useful which is
produced by local scientists in local circumstances and which involves
local people. He emphasized that SEARCH IS IMPORTANT BEFORE RESEARCH to
prevent the process of reinventing the wheel.
Dr. Mohsin Mahmood from the World Bank talked about the objectives of
the health professionals education. The objectives need to be SMART! i.e
SPECFIC MEASURABLE, ATTAINABLE REPRODUCIBLE AND TIME-BARRED. Without
clean and crisp objectives Education and training become a haphazard
process. The trainee cannot remain focused and the trainer also looses
the direction to guide the trainee. This creates confusion instead of
clarity in the mind of the learner.
Dr. Samina Mohsin talked about the basics of evaluation and emphasized
that evaluation must be done more often during the training period and
the competency certification must not be entirely left to the final
evaluation.
Brig. Mawadat Rana talked about cognitive philosophy and explained how a
trainee learns better when he gets emotionally involved and starts
enjoying learning the new concepts. He suggested that the
trainer/supervisor should adopt the strategies which should encourage
emotional element and make learning an enjoyable experience. It can only
be done when the learner is actively involved and learning is based on
the principle of experiential learning. This will make him a life long
learner.
Professor Umar Ali Khan, Associate Dean of Ripha Academy of Research &
Education made an excellent presentation about scholarship. He defined
scholarship as an original research done by an individual scholar which
is peer reviewed and is disseminated. This newly discovered knowledge
adds to the existing knowledge and helps in solving the problems. It
services the community only when it is communicated with other scholars.
This helps bridge theory and practice. Such a scholarship is useful only
when it has clear goals, executed with adequate preparation, bring out
significant results, presented in the effective way and its critique is
done dispassionately.
Prof. Umar further stated that it is mandatory that excellent teaching
and scholarship be acknowledged & rewarded if an institution or society
wishes to fulfill its mission. This will broaden the vision of members
of the organization. As a result the professionals will make their daily
work scholarly and this will simultaneously achieve both objectives of
daily care to patients and will also be an ongoing research.
It was followed by a very interesting presentation by Professor Jehangir
Akhtar, Dean of Shifa Trust Eye Hospital & Dean, Faculty of Medicine at
the Quaid-e-Azam University, Islamabad. He beautifully described the
change in the emphasis in training programmes. Previously more emphasis
was put on the moral and ethical training of students. With the advent
of “information technology” more attention is being paid to the minutest
and sometimes irrelevant details. In this magnification of details the
holistic approach to the patient has suffered. Where specialization has
helped to achieve higher academic standards it has taken the physicians
attention away from the patient as a whole. With the specialized
education and training the trainees achieve a profession, which is like
a community or club which should have high moral and ethical standards
and a dignified attitude towards themselves and their patients. But
under the socio-economic stress of modern times, both on the doctor and
patients the trust between them is unfortunately breaking. This has
resulted in the deterioration of the doctor/patient relationship which
at times appears to have a businessman and client status. By attaining
training the trainees get into a profession by virtue of which they go
looking for a job for their bread and butter. Clear concepts about the
profession and the job are important. ONE CAN SACRIFICE A JOB BUT NOT
ONES PROFESSION. Prof. Jehangir emphasized the professionals to improve
themselves in all aspects of behavior and their dealings with the
patients according to the norms of the society.
Prof. Khaleeq-uz-Zaman talked about system approach in medical
education. He said that most of the supervisors in health profession
education are not trained in health professional’s education. The
education needs to be learner oriented and the objective should be
weather the learner has achieved certain competencies or not. The
teacher centered and programme centered education & training does not
fulfill the objectives. Once the objectives are clear, the instructional
strategies can be individualized and based on principles of adult
learning. Evaluation must be done to ensure that the objectives are
achieved i.e the learner has learnt the required competencies. This will
inculcate the skill of self-learning and hence a qualified doctor will
become a life-long learner by ensuring his continuous medical education
& professional development to achieve the capabilities to treat the
patient with latest knowledge and skill. He will also inculcate the same
approach in his trainees and educate the community at large. In order to
achieve this end it is mandatory that departments of medical education
be established in all the medical institutions and be manned by
qualified educationists. These departments must have a well thought of
educational programme & curriculum. Only then the health professionals
will be trained in all aspects in a well organized way. The results of
such programme will soon be obvious when the standard of professionals &
hence the patient care will improve.
The presentations were followed by a lively discussion. Every
participant received a certificate OF CME (Continuous Medical Education)
equal to 03 credit hours. Feedback from the participants showed that
most of the participants had a great learning experience and most of
them enjoyed their participation. They also proposed that there should
be regular such programmes featuring the basics of Medical/Paramedical
Education & Training of Health Professionals. (PR)
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