看護とケアのジャーナル

Steps towards Updating the Curriculum and Teaching Methods in Obstetrics, Gynaecology and Neonatology in Mongolia

Abstract

Annette Burgess, Heather Jeffery, Shinetugs Bayanbileg, Erdenekhuu Nansalmaa and Kirsten Black

Background: Medical education in Mongolia faces many challenges in terms of staff capacity, large student numbers, and limited access to clinical experience. The Government of Mongolia has placed a high priority on reducing maternal and infant mortality, necessitating improvements to the quality of medical training, ensuring a highly skilled health workforce is produced and maintained. In 2014, a team of academic staff from Sydney Medical School were appointed by United Nations Population Fund (UNFPA) to assist in reviewing and updating the medical student curriculum in obstetrics, gynaecology and neonatology in accordance with international best practice. The first phase involved a visit from a senior delegation from Mongolia, including representatives from the Mongolian National University of Medical Sciences (MNUMS), UNFPA and the Mongolian Ministry of Health to Sydney. The week long programme was designed to demonstrate best practice in obstetrics, gynaecology and neonatology undergraduate medical education; and display modern teaching practices.

Methods: Course design included demonstration and participation in a four station Structured, Clinical, Objective, Reference, problem-oriented, Integrated, and Organised (SCORPIO); observation of a Clinical Reasoning Session (CRS); demonstration and participation in a four station OSCE, and teaching of best practice in writing single-best answer multiple choice questions. Participants also took part in a teacher training session. The programme was implemented at a large teaching hospital in Sydney, Australia. We employed mixed-methods to evaluate the programme, using pre- and post-questionnaires and a focus group.

Results: The programme increased participants’ perceived understanding and ability to apply educational principles, plan learning activities, and provide feedback. In particular, participants perceived that their understanding how to implement SCORPIO, CRS and OSCE had increased. However, participants would have liked greater opportunity to observe bedside teaching. Participants foresaw challenges to the implementation of educational changes in Mongolia, including the anticipated difficulty of engaging hospital staff in teaching; implementing a student-centred approach to teaching; and providing a large number of students with adequate clinical experience.

Conclusion: Changes in educational strategy in Mongolia may assist medical schools to produce clinically competent graduates. Our programme provided an effective means to introduce Mongolian leaders in health and education to modern student-centred medical education teaching and assessment methods; and to highlight the importance of teacher training and evaluation as a strategy to engage both university and hospital staff in medical education. Additionally, programme outcomes assisted in subsequent phases of the project, including in-country needs assessment, curriculum development and delivery.