Health Professionals for a New Century

Transcription

1 Health Professionals for a New Century Transforming Education to Strengthen Health Systems in an Interdependent World Lincoln C. Chen Banff, Canada April 15,

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3 The Commission Education of Health Professionals for the 21st Century Advisory Inputs Scientific advisors Youth commissioners Papers Consultations Research Commissioners (20) Global Multi-professional Evidence-based Integrative framework Instruction-institution

4 General Report Outline 1. A Century of Progress, a Time of New Challenges 2. An Integrative Framework 3. Major Findings 4. Reforms for a Second Century 5. Follow-Up 4

5 Report Covers 5

6 The Health Revolution of the 20 th Century 6

7 Life Expectancy and Income per capita, by Decade 7

8 Knowledge Translation and the Improvement of Health Technology Knowledge Behavior Evidence Policy 8

9 Medical Education Knowledge Producers Knowledge Reproducers Knowledge-Based Knowledge Brokers Researchers Scientist Faculty Students Policy-makers Professionals Clinicians-specialists Public health - popn Primary care

10 General Report Outline 1. A Century of Progress, a Time of New Challenges 2. An Integrative Framework 3. Major Findings 4. Reforms for a Second Century 5. Follow-Up 10

11 A Systems Approach Supply of health workforce Labor market for health professionals Demand for health workforce Provision Demand Education System Health System Provision Demand Needs Needs Population 11

12 Key components of the educational system Structure Institutional Design Systemic Level Stewardship and governance Financing Resource generation Service provision Organizational level Ownership Affiliation Internal structure Global level Stewardship Networks and partnerships Context Global-Local Process Instructional Design Criteria for admission Competencies Channels Career pathways Proposed Outcomes Interdependence in Education Transformative Learning

13 General Report Outline 1. A Century of Progress, a Time of New Challenges 2. An Integrative Framework 3. Major Findings 4. Reforms for a Second Century 5. Follow-Up 13

14 Emerging challenges Epidemiological and demographic transitions Technological innovation Health System Professional differentiation Population demands

15 Systemic failures Mismatch of competencies to needs Weak teamwork Gender stratification Hospital dominance over primary care Labour market imbalances Weak leadership for health system performance 15

16 Professions: Two Sides Brighter Knowledge broker Care-giver Technology Quality Team leader Darker Monopoly knowledge Financial self-interests Professional chauvinism Over-specialization Urban preference Advancing Health Inequities in health

17 Density of medical schools by region

18 Resized world maps

19 Number of countries Countries by number of medical schools Other Sub-Saharan Africa More Number of medical schools than 20

20 Number of medical schools New Medical Schools India and Brazil India Brazil

21 Investment in total health expenditure and health professional education

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23 General Report Outline 1. A Century of Progress, a Time of New Challenges 2. An Integrative Framework 3. Major Findings 4. Reforms for a Second Century 5. Follow-Up 23

24 Institutional Instructional Three Generations of Reform 1900 Science-based Problem-based Systems-based Scientific curriculum Problem-based learning Competency driven: local-global University based Academic centers Health and education systems

25 Vision Transformative Learning Interdependence in Education Equity in Health Individuals Patient-Centered Population- Based 25

26 Recommendations Reforms Enabling Actions Instructional Competency-driven Local responsiveness with global connectivity Inter- & trans-professional education IT-empowered Educational resources New professionalism Institutional Joint planning Academic systems Global networks Culture of critical inquiry Mobilize leadership Enhance investments Align accreditation Strengthen global learning Goal Transformative and interdependent professional education for equity in health

27 Competency-based education Traditional model Curriculum Educational objectives Assessment Competency-based education model Health needs Health systems Competencies outcomes Curriculum Assessment

28 Models of inter- and trans-professional education Model Pre-secondary education Post-secondary education Practice MD Dominant Common Nursing Public health Teamwork Other Interprofessional Common Core + specific competencies Systematic teamwork Teamwork Transprofessional Common Core + specific competencies Systematic teamwork Teamwork Community health workers

29 Levels of Learning Level Objectives Outcome Informative Formative Information Skills Socialization Values Experts Professionals Transformative Leadership attributes Change agents 16

30 Nigel Crisp: Biased Flows Ideas/Technical Money/Finances North South Nigel Crisp

31 Mutual Exchange Sharing/Learning Ideas Faculty-Training Innovation Capacity Bldg North South

32 General Report Outline 1. A Century of Progress, a Time of New Challenges 2. An Integrative Framework 3. Major Findings 4. Reforms for a Second Century 5. Follow-Up 32

33 Lancet Commission Launch: Why are they so happy!

34 Bangladesh, April 2011

35 Hanoi, April 2011

36 Beijing, April 2011

37 Tokyo, September

38 Tokyo Launch

39 San Francisco, September 2011

40 HealthProfessionals21 Launch Worldwide - 25 National Initiatives USA IAMP, CUGH, IOM Forum Brazil, Peru, Lebanon, Canada, UK Thailand, China, Vietnam, India, Japan Regional Networks Asia 5-C network