The MEPI Medical Education Innovation Program (MIP)
The MEPI Medical Education Innovation Program engages students and faculty at KCMUCo to participate in MEPI’s mission to improve resources available for teaching and learning at KCMUCo. Students and faculty teams are encouraged to submit proposals that aim to enhance a specific aspect of KCMUCo’s medical education. Teams with compelling proposals are provided support, and then carry out their proposals. Below is a list of awarded proposals.
Improvements of KCMUCO Facilities
As the number of medical students at KCMUCo increased, small group instruction was becoming more difficult. During surgery rotations, too many students were forced to crowd into the theatre, where they would observe clinical and surgical procedures. Often students were not able to view the procedure because of overcrowding.
A team of KCMUCo faculty and students were awarded a grant through MIP to solve the issue of overcrowding in the theatre. They proposed to install an audiovisual (AV) system in one of the operating rooms, and a complementary AV system with a large viewing screen in a separate room dubbed the “media center.” This would allow students to observe operations from a different room in the hospital, reducing overcrowding in the theatre. A monitor was also installed in the theatre, providing a better view of the procedure in progress for students observing from the theatre. Procedures can also be recorded and made available to medical students for revision purposes and to support research activities at KCMUCo.
Improvements of Community-Based Medical Education
Vehicle for Peripheral Placements:
Third-year KCMUCO medical students participate in “peripheral placements” in which they complete rotations at hospitals located throughout the Kilimanjaro region. In the past, students have often had to rely on public transportation to get to their peripheral placements. A group at KCMUCo proposed to hire a driver and to purchase a vehicle, which has made it more convenient for students to travel to their peripheral placements.
Enhancing Research Capacity
Through MIP, a proposal was awarded to hire an information resource specialist, or e-librarian to support KCMUCo faculty and students in the use of online biomedical and life science journal databases, such as WHO’s HINARI and NIH’s PubMed. This proposal is based off of an existing project established by the University of Zimbabwe’s MEPI team.
The e-librarian offers training and support to both faculty and students, and will also work with the KCMUCo library and library consortia in Tanzania to investigate print and electronic resources for potential purchase. He or she will also coordinate electronic and print reserves so that faculty can assign readings to students. Finally, the e-librarian will support faculty efforts in conducting medical education research. The e-librarian will help to create a culture of research and evidence-based practice at KCMUCo.
Renovated Anatomy Lab:
Before this proposal was implemented, the instructor would repeat his or her lecture at each table of students during the class period. This method of teaching was quite time-consuming and exhausting for the instructor.
A team of faculty at KCMUCo was awarded a grant through MIP to renovate the anatomy lab. An audiovisual system was installed so that the instructor could stand at the front of the room and lecture all students simultaneously. A camera records the instructor’s dissection of the cadaver, which is projected on multiple monitors throughout the room. The lectures can also be recorded and saved to the Learning Management System (LMS), where students can access them for review.
Physiology Education in the Wet Lab:
KCMUCo’s wet lab was renovated in 2012, and since then, faculty have been able to use the lab to train medical students in a variety of disciplines, including hematology, parasitology, clinical chemistry, microbiology, blood transfusion, entomology and histology. The resources available in the wet lab were not, however, suitable for teaching students physiology.
A group of faculty at KCMUCo proposed to equip the wet lab with appropriate instruments so that physiology students could learn how to use and interpret these tests. Through this project, students have learned how to improve patient care in resource-limited settings by studying cardiac physiology and learning how to use an electrocardiogram (ECG) machine, through practical diagnosis and monitoring of various lung conditions and response to treatment using spirometers, by monitoring blood glucose levels to improve treatment of diabetes, and by learning about diagnosis of cardiovascular diseases including myocardial infarction and heart failure.
Rapid Diagnostic Testing:
Between 2012-2014, instruction on the use of Rapid Diagnostic Tests (RDTs) was implemented at KCMUCo in the wet laboratory. Third-year medical students reported that during clinical rotations at peripheral placements, though they were capable of administering RDTs for the purpose of clinical diagnosis, health facilities did not always make RDTs available for student use. Students were not able to apply the skills that they had gained in the wet laboratory to clinical practice.
Through MIP, a group of faculty and students proposed to package RDTs into “toolboxes” that students could bring with them to clinical rotations for educational use, starting in 2015. The toolkits would include RDTs for cardiac blood markers, HIV, ABO blood typing, and Syphicheck among other tests. It is important for students to have the opportunity to apply what they have learned in the lab to the clinical setting so that they have the skills necessary to diagnose patients without the need of a lab technician.
Venipuncture Instruction in Wet Lab:
Upon returning from peripheral placements, third-year medical students expressed a lack of confidence in performing venipuncture (the process of gaining access to a particular vein for the purpose of blood sampling or blood treatment). Through MIP, a team at KCMUCo proposed to equip the wet lab with “advanced adult and child injection arms.” These arm mannequins provide complete venous access for IV therapy and phlebotomy, and have sites for intramuscular and intradermal injections. The mannequins will allow students to become more comfortable with performing venipuncture.
Partnering with other Medical Schools/Organizations
Hubert Kairuki Memorial University (HKMU):
KCMC-MEPI has opened up MIP to other medical schools in Tanzania. Faculties from Hubert Kairuki Memorial University in Dar es Salaam have proposed to adopt some features of the MEPI program. They will provide wireless internet access on campus, and will also establish a Learning Content Management System, which will reduce the workload of staff and streamline the distribution of teaching materials and examinations to students. In order to avoid overcrowding, HKMU faculty also proposed to install an audiovisual (AV) system so that students can observe lectures from a different room.
Muhimbili University of Health and Allied Sciences (MUHAS):
In 2009-2010, faculty at Muhimbili University of Health and Allied Sciences revised traditional curricula to develop competency-based curriculum (CBC) through a partnership with University of California-San Francisco (UCSF). Many faculties have not yet implemented the revised curriculum due to lack of training. A team from MUHAS has proposed to lead a series of workshops in order to impart skills and competencies to faculty on teaching medical students using the recently revised CBC. With well-trained faculty, MUHAS will have higher capacity to prepare medical students to meet the demands that they will face in clinical practice.
Catholic University of Health and Allied Sciences (CUHAS):
Through MIP, faculty members at Catholic University of Health and Allied Sciences in Mwanza have proposed to establish a cooperative learning to teach gross anatomy. This form of cooperative learning is called Reciprocal Peer Teaching (RPT); it illustrates circumstances where students alternate roles as teacher and student. By assuming the responsibility of teaching their peers, students not only improve their understanding of course content, but also develop communication skills, teamwork, leadership, confidence and respect for peers that are vital to developing professionalism early in their medical careers. Traditionally in our Anatomy department, students dissect the entire body using a standard dissection manual. More non-traditionally, however, we have increased cooperative learning in the dissection laboratory by involving students in a series of supplementary RPT activities.
Christian Social Services Commission (CSSC):
Representatives from the Christian Social Services Commission, and organization which aims to improve health and education services to Tanzanians, have proposed to enhance continuous professional development (CPD) for health workers in universities throughout Tanzania.