Quality Assurance &Accreditation Faculty of Medicine Cairo University Efforts, Achievements & Challenges Lamis Ragab, MD Vice Dean for Postgraduate Studies & Research • The improved health of all people is the main goal of medical education • There is a global and national call for quality improvements and assurance in medical education • There are global changes in health care practice * Clearer professional recommendations * Increased consumerism * Increasing student numbers * Specialization of clinical clerkships • WFME in its 1998 position paper launched the program on International Standards in Medical Education • A mechanism for quality improvement in medical education, in a global context, to be applied by institutions responsible for medical education, and in programs throughout the continuum of medical education • The Faculty of Medicine Cairo University started the activities of Quality Assurance in 2003 • The self- study was conducted in 2003 • Limited to the undergraduate program (using the basic standards of WFME as a Benchmark) • A corrective action plan was suggested to overcome the weaknesses and enhance the strengths • Final report endorsed to the faculty and university councils • Dissemination to the Faculty staff members, students and some stakeholders • December 2004: external evaluators from the WFME invited for a 3-days site visit • The Self –Study helped the faculty in designing the vision towards accreditation • Also, the mission and the strategic objectives of the faculty were reviewed and endorsed to the faculty council for the first time. • Establishment of the Internal Quality Assurance System : under the guidance of the National Committee for Quality Assurance and Accreditation (the National Committee) Projects Project # 1 Development of a Strategic Plan for Quality Assurance Project # 2 Establishment of sustainable QAA Centers in the Egyptian Universities Project # 3 Establishment of an Internal Quality Assurance System in the faculties Project # 4 Development of Academic Reference Standards • Project started in September 2005 • Establishment of project's managerial and implementation committees • The quality unit at the faculty had a place and a structural organization • Program and courses’ specifications of the undergraduate program according to the templates provided by the (NQAAC) • Awareness and orientation seminars to the academic staff, non academic staff, and students to introduce the quality system to the faculty's community • Gradual cultural change especially of the academic staff who actively participated in compiling the documents of the project • Course reports were completed by the staff members in each academic department at the end of the academic year • The project team completed the program report and produced the first Faculty Annual Self-Evaluation Report (2004/2005) following the evaluative framework designed NQAAC ( including 5 major areas: academic standards, quality of learning opportunities, research and other scholarly activity, community involvement, and effectiveness of quality management and enhancement) • Developmental Engagement (DE) site visit in October, 2005. Documents reviewed before the site visit : program specifications, course specifications, course reports, program report and Faculty Annual Self –Evaluation Report • Meetings: faculty staff members, vice deans, under-& postgraduate students and some stakeholders • Revision of students' work and assignments • Oral feedback about the points of strengths and that need further improvement • A comprehensive report of the developmental engagement site visit 2 months later • An action plan to enhance the strengths and improve the areas of weakness to prepare the faculty for accreditation was required Faculty of Medicine Cairo University • Project #3 in cycle one (2004) • Site visit in Oct. 2005 • Action plan in Feb. 2007 • A lag period for few months (transition of leadership) • Quality unit reconstituted in March, 2007 • The faculty submitted the course reports, program report, the second Faculty Annual Report (2005/2006) and an action plan for accreditation to the NQAAC • ■ Follow up visit in April 2007 for one day to monitor and support the faculty in the developmental engagement stage • Oral feedback was given at the end of the day about the achievement of the quality at the faculty in the last year • Report of the team's evaluation and their expectation about the readiness of the faculty for submission for accreditation The Evaluation Framework • Academic Standards Intended learning outcomes Curriculum Student assessment Student achievement • Quality of Learning opportunities Teaching and learning Student support Learning resources • Research and other scholarly activity • Community Involvement • Effectiveness of Quality Management and Enhancement Governance and leadership Quality assurance system Self-evaluation, plans and impact • External reference standards (Benchmark) approved by the Faculty Council in April 2007: the General Medical Council standards (UK) • The Medical Sector Committee approved the National Academic Reference Standards for the Medical Faculties in Egypt New Higher Curriculum Committee Revision of curricula of: community medicine with integration between Pediatrics & OB-GYN Ongoing revision of curricula of Ophthalmology, Bio, OB-GYN according to the mission لجنة المناهج االسم التخصص التليفون E-mail نادية الفقي لميس رجب زينب حامد نادية بدراوي زهير الحوشي شريف الطوبجي مايسه شوقى 0123239593 mmaissaaz@Yahoo.com وائل غفير 0122116539 Ghafir@mailcity.com عصام الطوخى 0123123103 eeltoukhy@yahho.com عبد الفتاح مرعى 0123367114 marrie73@hotmail.com مصطفى عبد الحميد 0101413128 mostafaseleem@hotmail.com محمد حيدره 0104622809 haidaram@hotmail.com • Establishment of an Assessment Committee and development of a code of practice for student assessment (6/2/2007) لجنة التقييم االسم التخصص التليفون E-mail لميس رجب نادية الفقي نادية بدراوي سهير العطار 0106669199 Sohairaattar@Yahoo.com ابراهيم محمدى ابراهيم 0101648596 I.Mohamady@hotmail.com مصطفي عبد الحميد نادية بدراوى nbadrawi@link.net ناديه الفقى عصمت شيبه زينب حامد سلمى دوراه Zhamed1@yahoo.com قواعد التقييم Code of Practice in the Area of Student Assessment Approved by the Faculty Council in May 2007 • Some departments modified both written and clinical examination to be more objective • Pediatric department arranged OSCE at the end of the year that was appreciated by the students and faculty staff • Program specifications for some postgraduate degrees: Pediatrics, Biochemistry, Dermatology, Andrology, Pathology, Internal Medicine Workshop on Program & Course Specifications (Postgraduate Programs) 5/3/2007 اسماء وبيانات الحاضرين الجتماع توصيف برامج الدراسات العليا يوم 5مارس 2007 م االسم القسم محمول E-mail 1 حنان احمد قطب عبد هللا الروماتيزم والتأهيل 0101401711 hanankotb@msn.com 2 ساميه زكى حسن الروماتيزم والتأهيل 0101770869 samiazakihasan@yahoo.com 3 آمال حسن رزق الروماتيزم والتأهيل 0105124730 rizkah@hotmail.com 4 ساميه محمد حسن فضه الروماتيزم والتأهيل 0127463665 Yasser 47hotmail.com 5 هبه حلمى الحديدى األمراض الجلديه 0105194079 bobahadidi@yahoo.com 6 أميرة أمين زايد األمراض الجلديه 0102581689 hrakhawy@yahoo.com 7 شهيرة عبد الرحمن رمضان األمراض الجلدية 0122199555 Shahiraaramadan@hor mail.com 8 منال محمد محمود مخلوف الباثولوجيا االكلينكيةوالكيميائية 0101271116 manalmakhlouf2@yahoo.com 9 عفاف محمد سامى السقا الباثولوجيا االكلينكيةوالكيميائية 0123435078 Banna_helmy@hotmail.com 10 سحر كمال الدين الباثولوجيا االكلينكيةوالكيميائية 0123113752 msaad@suescem.com 11 نجوى السيد عبد هللا الطويل الباثولوجيا االكلينكيةوالكيميائية 0105257311 drnaltaweel@hotmail.com 12 هاله محمد فراويله الباثولوجيا االكلينكيةوالكيميائية 0123233565 halafarawela2002@hotmail.com تابع اسماء وبيانات الحاضرين الجتماع توصيف برامج الدراسات العليا يوم 5مارس 2007 م االسم القسم محمول E-mail 13 ابراهيم محمد فهمى طب وجراحة أمراض الذكورة والتناسل 0101422856 ifahmy@idsc.net.eg 14 تيمور مصطفى ابراهيم طب وجراحة أمراض الذكورة والتناسل 0105150297 Taymour 1155@link.net 15 هدى محمد حسين رشيد األمراض الجلدية 0101010824 Ho-rash @yahoo.com 16 منال عبد الواحد بصيلة األمراض الجلدية 0102412964 manalbosseila@ yahoo.com 17 عمرو عبد الحكيم راتب األمراض الجلدية 0123112436 ratabderm@ yahoo.com 18 مشيرة عبد الحكيم راتب فسيولوجيا 0106224104 Moshera_rateb@yahoo. com 19 محمد حسين مدحت الكومى األمراض الجلدية 0123415852 mkomy@hotmail.com 20 عمرو محمد جاد هللا طب وجراحة أمراض الذكورة والتناسل 0101001014 gadallaamr@hot mail,com 21 نشوى محمد سعيد الصاوى فسيولوجى 0124107148 Nashwa eltaalawy @hot. Mail com 22 سميحه على مرتضى هستولوجى 0127411677 Prof.Mortada@hotmail.com 23 سهير احمد فوزى توفيق هستولوجى 0127446196 Sohair _Fawzy@hotmail.com 24 شهيرة عبد الرحمن رمضان األمراض الجلديه 0122199555 shahiraaramadan@hotmail.com 25 ابراهيم محمدى ابراهيم فسيولوجيا 0101648596 Ibrahim Mohamdy.@Hotmail.com • External Evaluators for two postgraduate programs (Master Degree of Pediatrics and MD of Neurosurgery) • In general terms, the Egyptian MD candidates were fairly well prepared and had an adequate fund of knowledge. Most demonstrated an adequate knowledge of the field and appropriately managed the clinical cases presented to them . • Another significant difference between the US ABNS and Egyptian MD examinations is with regards to the area of test objectivity. • Another major difference in the US and Egypt systems are that the US examinees are expected to pass the oral boards on the first try .From my understanding, approximately 80% of the candidates do so .A lower pass rate suggests that the examinees were poorly trained or that there were potential testing irregularities that precluded the examinees from obtaining a higher pass rate .Also, the examinees are allowed to sit for the oral boards three times .If they are not successful by the third try, they must re-take their written examinations before being allowed to re-take the oral boards. • • • • • Having participated and observed MD examination process, I would make the following major suggestions: There should be a single Egyptian board examination comprised of a highly objective written examination. The oral board examiners should be selected from a pool of MD’s (that do not necessarily need to be University Professors) and this pool should be rotated yearly so as to increase the objectivity of the examiners. Prior to sitting for the oral boards, the potential examinees should have: a) passed their written exams b) submitted practice data which should be reviewed for safety and consistency. • They are allowed to go for a maximum of three times for their oral exams; at which time if they fail all three times they should repeat the written exams again. • A 70-80% pass rate should be expected in board exams. • Residency programs should provide teaching and clinical scenarios that simulate the oral board (MD) testing experience so that the examinees have a rational framework for thought processes. • The oral board (MD) testing experience should be made as objective as possible through the incorporation of known/expected clinical scenarios and patient encounters. There should be specific objective measures (fund of knowledge, management skills, interpretation of diagnostic tests, etc) rated during the exam independently by each examiner followed by a conference after the first testing sessions. 2) Quality of Learning Opportunities: • ○Lectures Students divided into 5 groups(300/group) Audiovisual facilities in 11 lecture halls (capacity 300-1000 students) • ○ Early clinical exposure in some departments (physiology and pathology) • ○ Student handbooks (under-&postgrad) • ○ Student support office (Academic year 2006-2007) • Academic support & counseling committee (approved by Faculty Council 10/2007) • ○ Learning resource centre: training on models and facility for e-learning • 3) Effective Quality Management and Enhancement : • ○ Functioning reporting system; reports of the academic year 2005/2006 were completed • ○ Revision of the mission, approved by the Faculty Council in September 2007 • ○ Establishment of an internal audit committee for the educational program • ○ Regular meeting between the members of the quality assurance unit and the dean and the three vice deans • ○ Realistic action plan covering all areas in the educational program, with a justified budget • 4) Research and Other Scholarly Activities: • ○ A strategy and plan for research activities based on the research strategy of the University • ○ New postgraduate bylaws adopting the credit hour system (ECTS) • What is ECTS? • The European Credit Transfer and Accumulation System is a student-centred system based on the student workload required to achieve the objectives of a programme, objectives preferably specified in terms of the learning outcomes and competences to be acquired. العالقة بين البرنامج التدريبى و الشهادات األكاديمية Academic Degree Professional Degree المدة First Part Basic training سنة1.5 Second Part Specialized training سنة1.5 MD Advanced training سنتين • Data base for the international publications and projects األبحاث المنشورة بالدوريات العالمية السنة األبحاث المنشورة بالدوريات العالمية لجنة مارس لجنة فبراير 2000 54 59 2001 53 63 2002 39 47 2003 31 40 204 35 48 2005 33 42 2006 46 55 2007 15 19 المجموع 306 373 األبحاث المنشورة بالخارج السنة 2000 2001 2002 2003 2004 2005 2006 2007 المجموع األبحاث المنشورة بالخارج لجنة فبراير لجنة مارس لجنة ابريل 54 53 39 31 35 33 46 15 306 59 63 47 40 48 42 55 19 373 66 82 54 46 55 51 59 19 432 األبحاث المنشورة بالدوريات العالمية م عدد األبحاث القسم لجنة فبراير لجنة مارس 1 التشريح 0 0 2 الهستولوجى 0 0 3 الكيمياء الحيوية الطبيه 17 17 4 الطفليات 0 0 5 الباثولوجيا 0 0 6 الميكروبيولوجيا الطبية والمناعه 0 0 7 الفارماكزلوجيا 0 0 8 الفسيولوجيا 4 4 9 األمراض الباطنه 8 8 10 األمكراض الصدرية 0 0 11 األمراض الجلديه 4 4 12 طب وجراحة أمراض الذكورة والتناسل 81 81 13 األمراض العصبيه 2 2 14 األمراض النفسية 0 0 15 أمراض القلب 6 6 16 طب األطفال 47 47 17 طب الصناعات واألمراض المهنية 0 0 18 الطب الشرعى 0 0 األبحاث المنشورة بالدوريات العالمية م عدد األبحاث القسم لجنة فبراير لجنة مارس 19 الصحه العامه 0 0 20 طب األمراض المتوطنه 28 28 21 الحاالت الحرجه 3 9 22 الباثولوجيا االكلينكية والكيميائية 7 7 23 الجراحة العامه 16 18 24 طب وجراحة العين 3 3 25 األنف واألذن والحنجرة 2 22 26 جراحة المسالك البولية 0 0 27 جراحة العظام 1 1 28 التوليد وأمراض النساء 63 80 29 التخدير 7 8 30 األشعة التشخيصية 3 4 31 عالج األورام والطب النووى 0 0 32 جراحة القلب والصدر 0 0 33 جراحة المخ واألعضاب 2 2 34 الروماتيزم والتأهيل 2 23 35 طب العائلة 0 0 306 373 المجموع األبحاث المنشورة بالخارج السنة 2000 2001 2002 2003 2004 2005 2006 2007 المجموع عدد األبحاث 71 86 62 50 61 67 79 24 500 • 5) Community Involvement: Wide community contribution كلية الطب كلية طب قصر العينى قطاع خدمة المجتمع وتنمية البيئة الوحدات ذات الطابع الخاص 42وحدة كلية الطب نماذج الوحدات ذات الطابع الخاص مركز رعاية الحاالت الحرجة كلية الطب نماذج الوحدات ذات الطابع الخاص مركز رعاية الحاالت الحرجة كلية الطب نماذج الوحدات ذات الطابع الخاص مركز تطوير التعليم الطبى كلية الطب نماذج الوحدات ذات الطابع الخاص وحدة السكر والغدد الصماء والميتابوليزم كلية الطب نماذج الوحدات ذات الطابع الخاص وحدة معمل قصر العيني لألوعية الدموية كلية الطب نماذج الوحدات ذات الطابع الخاص وحدة معمل قصر العيني لألوعية الدموية كلية الطب مساهمة الوحدات ذات الطابع الخاص فى دعم صندوق خدمة المجتمع وتنمية البيئة بالكلية وحصة المستشفيات : * قامت الوحدات بدعم صندوق خدمة المجتمع وتنمية البيئة بمبلغ ( حوالى 425000جنية ) * قامت الوحدات بدعم حصة المستشفيات بمبلغ ( حوالى 920000جنية ) Web-Site • www.med.cu.edu.eg • E-mail service to staff members • Training programs • Departments’ websites • • • • • • • • Title of Department displayed as Cairo University Kasr Al Aini Faculty of Medicine Department of (BOLD CHARACTERS) Web page contnet: Short history and introduction to the department Mission Statement Information on the following topics (LINKS) – • Schedule of academic / scientific activities, e.g. lectures, staff rounds, workshops, conferences… – – • • • • • • • Education : undergraduate, postgraduate and residency/fellowship programs also Research : research interests of the department / collaborative research activity if applicable Clinical services / Patient care : Unit components (Inpatient, outpatient sections and special facilities as ICU, Endoscopy, Pulmonary lab, cardiac catheter. lab, operating theatre …etc), OP Clinic schedule and how to refer a patient Chairman and Faculty members and physicians in the department:–Names / Titles / and areas of special interest. Sub-specialties if applicable Contact information (telephone, fax, address, email…) Societies and affiliations - added as LINKS to the department website Photos of faculty and staff / section and clinic / as available Any additional information that you would like to include about your service Support the Department or Make a Donation: guide to the public. E-Library • Project funded by HEEPF • Linked to 7 faculties of Medicine المكتبة االليكترونية • توفير قاعدة بيانات UpToDateعلى موقع المكتبة االليكترونية تشمل قواعد البيانات للممارسة اإلكلينيكية فى التخصصات اآلتية :ـ الباطنة بكافة فروعها ـ األمراض المعدية ـ األطفال ـ التوليد وأمراض النساء ـ طب األسرة ـ طب الطوارئ. International Relations • 108 Malaysian undergraduate students • Joint postgraduate degrees (Pediatric Cardiology, Medical Ethics) • Action plan for accreditation was designed and approved by the faculty council for implementation during this academic year Problems • • • • • Big number of students Admission policy Finance Policy making State regulated education Problems (Cont.) • Staff resistance • Communication • Daily problems overwhelming the essential problems • Part-timers • Transition of power • Administrative skills What do we need for accreditation? • Review of the undergraduate programme • Development of all postgraduate programmes • Development of the research area • Private tutoring • Achievement of the action plan in the due time