EVALUATION TECHNIQUES IN PUNJAB, PAKISTAN: EIGHT YEARS OF REFORMS IN HEALTH PROFESSIONAL EDUCATION

Authors

  • Junaid Sarfraz Khan
  • John SG Biggs
  • Malik Hussain Mubbashar

Abstract

Pakistan, the most populated country in the WHO Eastern Mediterranean region has a populationof over 170 million, spread over five provinces and four federally administered areas. It has agrowth rate of 1.9%. Punjab is the most populous and developed province with an estimatedpopulation in 2010 of 81 million. In 2008, Punjab’s development index of 0.60 and a literacy rateof 80% were the highest in the country. In Pakistan, the number of doctors and nurses has risenfrom 48 to 71 per 100,000 and from 16 to 30 per 100,000, respectively between 1990 and 2003.The major challenge, still, is the imbalance of the population to health-care workers ratio. At thetime of creation of Pakistan, King Edward Medical College was the only fully functioning medicalcollege. Over the years, as a result of health reform initiatives, a number of government medicalcolleges were established in the country. University of Health Sciences, Lahore was established in2002, having sole jurisdiction over all medical, dental and allied health institutes in the provincewith the aim of moving medical education towards an outcome-based patient and communityoriented competency-driven system. This paper attempts to clarify how initiatives and reforms inthe evaluation process have helped the UHS realise its aims. Evaluation in all branches of highereducation has long been taken as a means to an end. The focus of UHS on teacher-training,introduction of behavioural sciences as a compulsory subject and setting up an outcome-basedevaluation process, has established a knowledge-acquisition medical education atmosphere. Thechallenges in the future relate to sustainability through capacity-building and staying abreast withthe Best Evidence Medical Education practices worldwide, implementing them to fit our localneeds and resources.Keywords: Evaluation, Examination, Education, Punjab, OSCE, OSPE

References

WHO [homepage on the internet]. Cairo; 2005-2009 [cited 2011

March 02]. Country Cooperation Strategy for WHO and

Pakistan; [About 33 screens]. URL: http://www.who.int/

countryfocus/cooperation_strategy/ccs_pak_en.pdf

Farooq U. Ministry of Finance. Economic Survey 2009-10;

Pakistan Economic Survey 2009–10, Chapter 12, pp. 145–59

[serial on the Internet]. [Cited 2011 March 04]. Available from:

http://finance.gov.pk/survey/chapter_10/ 10_Education.pdf

WHO Country profiles [homepage on the internet]. Regional

office for the Eastern Mediterranean; [cited 2011 March 03].

Available from: http://www.emro.who.int/emrinfo/

index.aspx?Ctry=pak

WHO [homepage on the internet]. Cairo; 2006 [cited 2011

March 05] Country Cooperation Strategy: at a glance, [About 2

screens], available from: http://www.who.int/countryfocus/

cooperation_strategy/ccsbrief_pak_en.pdf

Punjab Gateway; Government of the Punjab. [homepage on the

Internet]. Punjab. [cited 2011 March 03]. Available from:

http://pportal.punjab.gov.pk/portal/portal/media-type/html/user/

anon/page/default.psml/js_panename/ContentViewAdmin/portal/

/nav/right/punjabcms/servlet/PunjabCMSServlet?CMDCMS

=V_D_BROWSER&CMDDOCTYPE=1&txtDocID=7394&txt

VersionID=1.

World gazetteer; Punjab. 2010 [cited 2011 March 03]. Available

from: http://www.worldgazetteer.com/wg.php?x=&men=gpro&lng

=en&des=wg&geo=-2943&srt=pnan&col=abcdefghinoq&

msz=1500

Statistics Division, Government of Pakistan. Labour Force

Survey, 2007-2008 [homepage on Internet]. D.P. Center

Islamabad. [cited 2011 March 03]. Available form:

http://www.statpak.gov.pk/depts/fbs/publications/lfs2007_08/res

ults.pdf

Haider M. Sindh-Balochistan Lowest & most neglected

in Pakistan; IAOJ [Serial on the Internet]. 2010 October;

Available from: http://iaoj.wordpress.com/2010/06/02/sindhbalochistan-lowest-most-neglected-in-pakistan/

Unicef Pakistan Statistics [homepage on the Internet]. 2009 [cited

March 04]. available from: www.unicef.org/infobycountry/

pakistan-pakistanstatistics.html.

Afridi MK. Medical Education in Pakistan. J Med Edu

;37:962–70.

Pakistan Medical & Dental Council. About Us [homepage on the

internet]. Plexus Pvt. Available from: http://www.pmdc.org.pk/

AboutUs/tabid/72/Default.aspx

PFMSG. Recommended Teaching Hospitals [homepage on the

Internet]. Pakistan: 2008. URL: http://www.pfmsg.com/

teachinghosp.htm

University of Health Sciences, Lahore, Dental and Allied Health

Institutes[homepage on the Internet]. Available from:

http://www.uhs.edu.pk/registration/affinst.html

Kazi A. Expired Medicine: Medical Education in Pakistan

[homepage on the Internet]. Newsline ; [2004 June] Available

from: www.newslinemagazine.com/2010/06/expired-medicinemedical-education-in-pakistan/

Government of the Punjab; Law and Parliamentary Affairs

Department, Notification 2002 September, 28th (The Punjab

Gazette); Ordinance 2002, University of Health Sciences,

Lahore.

Mukhopadhyay S, Smith S. Outcomes-based education:

principles and practice, J Obstet Gynaecol 2010;30:790–4.

Frankel RM, Eddins-Folensbee F, Inui TS. Crossing the patientCentered Divide: Transforming Health Care Quality Through

Enhanced Faculty Development. Acd Med 2011;86:445–52.

Emanuel L, Walton M, Hatlie M, Lau D, Shaw T, Shalowitz J, et

al. The Patient Safety Education Project: An International

Collaboration. In: Henriksen K, Battles JB, Keyes MA, Grady

ML, editors. Advances in Patient Safety: New Directions and

Alternative Approaches (Vol. 2: Culture and Redesign).

Rockville (MD): Agency for Healthcare Research and Quality

(US); 2008.

Brennan N, Corrigan O, Allard J, Barnes R, Bleakley A, Collett

T, de-Bere SR. The transition from medical student to junior

doctor: today’s experiences of Tomorrow’s Doctors. Med Edu

;44:449–8.

Sales CS, Schlaff AL. Reforming medical education: a review

and synthesis of five critiques of medical practice. Soc Sci Med

;70:1665–8.

Abid K, Qureshi AL, Yasmin R. Continuum of medical

education: objectively in instructional method, learning and

assessment. J Pak Med Assoc 2010;60(4):262–4.

Kim KJ, Kee C. Reform of medical education in Korea. Med

Teach 2010;32(2):113–7.

Heise B, Himes D, The course council: an example of studentcentered learning. J Nurs Edu 2010;49:343–5.

Masiello I. Why simulation-based team training has not been

used effectively and what can be done about it. Adv Health Sci

Educ Theory Pract 2012;17(2):279–88. Epub 2011 Feb 11.

Hendricson WD, Rugh JD, Hatch JP, Stark DL, Deahl T,

Wallmann ER. Validation of an instrument to assess, and

confidence in the dental environment. J Dent Educ

;75(2):131–44.

Potomkova J, Mihal V, Zapletalova J, Subova D. Integration of

evidence-based practice in beside teaching paediatrics supported

by e-learning. Biomed Pap Med Fac Univ Palacky Olomouc

Czech Repub 2010;154(1):83–7.

Mcneil HP, Hughes CS, Toohey SM, & Dowton SBr. An

innovative outcomes-based medical education program built on

adult learning principles. Med Teach. 2006; 28(6): 527-534.

Sousa AC, Wagner DP, Henry RC, Mavis BE. Better data for

teachers, better data for learners, better patient care: college-wide

assessment at Michigan State University’s College of Human

Medicine. Med Edu Online [serial on Internet]. 2011 Jan 14;

[cited 2011 March 7]; 16 doi: 10.3402/meo.v16i0.5926.

Available from:

http://www.ncbi.nlm.nih.gov/pubmed/21249172

Price DW, Miller EK, Raham AK, Brace NE, Larson RS.

Assessment of barriers to changing practice as CME outcomes. J

Contin Educ Health Prof 2010;30(4):237–45.

IDEAL Consortium, Quality Enhancement Cell; University of

Health Sciences, Lahore, Pakistan. Available from:

www.uhs.edu.pk/qec/indicators.html

Linn RL, Gronlund NE. Measurement and Assessment in

Teaching, 9th ed. India: Parson Education Inc; 2005. p. 526–7.

Published

2011-03-01