The Journey from Quality to Accreditation: What is after?

EDITORIAL

The Journey fromQuality to Accreditation: What is after?              Moustafa Abdelnasser, MBBCh, Ph.D. (Microbiol), MHPE, Dip (TQM), mostafa_online1@yahoo.com                                                                                                                Director of Quality Assurance Unit of Education, Faculty of Medicine, Al-Azhar University, 

Abstract

In 1977, the Medical Education Unit (MEU) has been founded in the Faculty of Medicine, Al-Azhar University with its main goal to reform medical education. Since its foundation, several short (2-3 days) courses were held in teaching and assessment.  In 2001, the philosophy of MEU has been shifted from short courses to long training courses (2 weeks) in the field of teaching, assessment and research.  The aim and objectives were to prepare the university teacher for his new career after awarding the doctorate degree, and before assignment as a staff member. In 2005, the Educational Quality Assurance (EQAU) had been founded. Since then, several attempts were carried out to write a self study and to develop s strategic plan. In 2016, a new self study and strategic plan (July 2016-June 2021) were formulated.  The vision and mission reflected the  role of our Faculty in achieving distinction in medical education, scientific research, and community service, within a moderate Islamic culture.  The Faculty has been accredited in April 2017 by the National Authority of Quality Assurance and Accreditation of Education (NAQAAE) in Egypt.  Moreover, in July 2017, a team from the Association of African Universities and some other experts from Africa and Europe also visited our Faculty. The major standards measured were program planning and management, curriculum development, teaching and learning and assessment and program results. Rating score was 15.43/5=3.09 which meant Good Quality. The team recommended further quality improvement based on systemic and systematic approaches to strengthen the unique role in higher education and research nationally and internationally. In September 2017, Al-Azhar Faculty of Medicine adopted the idea of integrated medical education. Moreover, in October, 2017, a scientific committee was formulated from the Al-Azhar Faculties of Medicine, Dentistry and Pharmacy in order to make unified research plan for the medical sector. In conclusion, since the foundation of Al-Azhar Faculty of Medicine, it strives towards quality. More work is needed not only to keep the Faculty accredited, but also to improve and enhance quality, in addition to international accreditation and recognition.   

Introduction

In an attempt to stimulate the Egyptian Medical Schools to assure minimum quality standards for its programs, the Eastern Mediterranean Regional Office of the WHO (EMRO) has assigned a group of experts to prepare National Guidelines to ensure quality assurance,
The EMRO group of experts conducted 5 national workshops with representatives from 22 Egyptian Medical Schools and – for the first time, on the same bench – 2 private medical schools. These workshops were held at Suez Canal University in 2003, 2004; Tanta University in 2003; October 6^th , in 2003 and Ain Shams University in 2004. The workshops flourished the media for self study presentations that revealed variations as regards  strengths, weakness, threats and opportunities (SWOT) among the different medical schools.

The national guidelines acknowledged regional differences in various medical educational programs, respected the autonomy of individual medical schools as the new reform policies were generated from regional voluntary institutional self-evaluation and peer review and succeeded in eliminating the fear of ranking  among the various schools.

The National Guidelines included:

I-                    Mission, Vision and Objectives. 

II-                  Educational Programme.

III-               Educational Resources. 

IV-               Student.

V-        Students Assessment. 

V-                 Programme Evaluation.

VI-               Academic Staff  Faculty.

VII-             Governance & Administration.

VIII-           Continuous Renewal..

Role of Medical Education Unit in Educational Reform in The Faculty of Medicine,  Al-Azhar University

i-                    Teaching Courses

ii-                  Workshops for House Officers

iii-                Courses on “Methods of  Evaluation”  for senior professors were undertaken.

House officer Training Course: This course aims at providing pre-registered physician with the skills attitudes not taught during the previous 6 years education.

Methods of Evaluation: The target of this course is the senior professors including the heads of the departments. This will ensure that the policy makers are involved in educational reform. At the end of each course, a feedback is taken from the trainers and trainees. A final recommendation is formulated from this feedback, and an action plan is taken by the policy maker according the facility and feasibility.

Strategic Plan of the Faculty of Medicine, Al-Azhar University (During the period from July 2016 to June 2021):                                                              

1- Vision of Al-Azhar  Faculty of Medicine: Taking the Faculty to be the forefront both nationally and regionally through achieving distinction in medical education, scientific research, and community service, within a moderate islamic culture. "

2- Mission of Al-Azhar Faculty of Medicine : The Faculty offers the graduates the best opportunity for medical education and gaining knowledge, skills, and attitudes that in accordance with our vision fulfill the needs of the labor market. The Faculty of Medicine is committed to the following:

• Distinction in education, medical research, and training for students before and after graduation. This is to enhance their competitive skills, and ability to learn and educate, nationally and regionally all the times, with continuous improvement of syllabuses, curriculums, and medical programs especially that relate to the existing health problems nationally and regionally.
• Distinction in different fields of medical researches especially that relate to the existing health problems nationally and regionally.
• Applying the health care programs to fulfill the community needs and improve the environment.
• Commitment to the standards of health services, and work ethics through moderate Islamic culture.

3-Goals

•  Faculty development, support and administrative body. 
• Development of competitive role of the  educational institution at the regional level.
• Development and student support and guidance to follow graduates
• Development of scientific research in order to achieve state strategies for health services.
• Enhancing community participation. 
• Developing own  resources.

In March 2017, a an external reviewer visited the Faculty  to review its adherence to quality standards.  Accreditation was given in June 2017.

Hallmarks of the Faculty:                                                                                                       The Faculty's hallmarks are evident through environmental analysis and analysis of documents (self study for  Faculty, the Faculty's annual reports, reports of peer reviewers), which can be summarized in the following points:

1. The existence of strong social capital among Faculty graduates represented distinct and businessmen in areas of activity and jobs that incumbents, whether inside or outside Egypt.
2. This balance has provided many opportunities to develop all aspects of the activity, as well as providing funding for infrastructure development for the Faculty and its Hospitals.
3. The establishment of modern library and information center at the latest, and the development of University and its main hospitals, i.e. Al-Hussein, Bab Al-Sha'aria.
4. Many contributions also represent Faculty Alumni and professors to create and furnish new classrooms and the purchase of equipment for diagnosis and treatment a good reflection of the great social balance available for the Faculty.
5. Academic and scientific cooperations are numerous through bilateral agreements and projects between Faculty and scientific and research institutions.

African Quality Rating Mechanism

In July 2017, a team from the international experts consisted of Dr Violet Makuku, The Association of African Universities Quality Assurance Specialist and Harmonization of African Higher Education Quality Assurance and Accreditation (HAQAA) Initiative Project Officer, Accra, Ghana, Prof Hortense Atta Diallo, Vice-President University Nangui Abrogoua, Cote d’Ivoire, and Prof Tatjana Volkova, Head of Licensing and Accreditation Commission, Latvia. A summary and recommendations were extracted from the Evaluation Report (Table1).                                                                                                                                             

Table (1): Rating summary at Program level

Rating Summary at Institutional level: Al-Azhar University, Cairo (Egypt), based on the African Quality Rating Mechanism approach is rated as GOOD QUALITY. and demonstrating high level commitment for quality enhancement. Al-Azhar University has to be praised for the achievements made up today and visionary leadership leading University to the next level of development. The team believes that University has necessary resources both material and non material, support from internal and external stake holders to continue its efforts in ensuring quality improvement.

Recommendations: There is a room for further quality improvement based on systemic and systematic approach thus strengthening its unique role in higher education and research nationally and internationally.

 National Academic Reference Standards (NARS- Medicine, 2017)

In April 2017, a workshop was carried out  by the National Authority for  Quality Assurance and Accreditation  of Education (NAQAAE) in Egypt  to introduce the idea of competency based education (CBME). In this regard, the National Academic Reference Standards (NARS- Medicine) competency framework were emerged out of need to focus on medical education on patient/patient related outcomes, and to emphasize learners’ abilities and foster the good practice of integrated learning.  These include:

I-   The graduate as a health care provider.
II-  The graduate as a health promoter.
III- The graduate as a professional.
IV- The graduate as a scholar and scientist.
V-  The graduate as a member of the health team and a part of the healthcare system.
VI-  The graduate as a lifelong learner and researcher.

In September 2017, Al-Azhar Faculty of Medicine, adopted the idea of integrated medical education. Several lectures, seminars and workshops were done even before that date to understand how to implement and to be familiarized with experience of others.  Merits and demerits of this system were discussed.  There were more resistance and query marks towards integration which was lessened by time. 

In October, 2017, a scientific committee formulated from the four Faculties of Medicine and the three faculties of Dentistry and the Faculties of Pharmacy in order to make unified research plan. All departments were asked to design their own research plans according to the instructions and templet prepared by the University team. A collective research plan for the medical sector (Medicine, Dentistry and Pharmacy) is now ready.

Re- accreditation is due by 2021 and d ifferent teams were formulated through fostering strengths and improving weakness in Self Study carried out in 2016 and on the light of the African Rating Report in 2017. In January 2018, Al-Azhar Faculty of  Medicine  has adopted the application of Integrated Medical Undergraduate Program. This newly developed program aimed to integrate basic and clinical sciences from the early beginning of medical study.

In Conclusion: Since its foundation, Al-Azhar Faculty of Medicine strives towards quality. More work is needed for regional and international accreditation.