Health Professionals for a New Century Transforming Education to Strengthen Health Systems in an Interdependent World Lincoln C. Chen Banff, Canada April 15, 2012 1
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
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
Report Covers 5
The Health Revolution of the 20 th Century 6
Life Expectancy and Income per capita, by Decade 7
Knowledge Translation and the Improvement of Health Technology Knowledge Behavior Evidence Policy 8
Medical Education Knowledge Producers Knowledge Reproducers Knowledge-Based Knowledge Brokers Researchers Scientist Faculty Students Policy-makers Professionals Clinicians-specialists Public health - popn Primary care
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
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
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
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
Emerging challenges Epidemiological and demographic transitions Technological innovation Health System Professional differentiation Population demands
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
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
Density of medical schools by region
Resized world maps
Number of countries Countries by number of medical schools 45 40 35 30 25 27 Other Sub-Saharan Africa 20 15 10 5 0 22 16 23 24 12 17 10 18 9 8 7 4 4 1 2 0 2 0 1 2 3 4 5 6-10 11-20 More Number of medical schools than 20
Number of medical schools New Medical Schools India and Brazil India Brazil
Investment in total health expenditure and health professional education
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
Institutional Instructional Three Generations of Reform 1900 Science-based Problem-based Systems-based 2000+ Scientific curriculum Problem-based learning Competency driven: local-global University based Academic centers Health and education systems
Vision Transformative Learning Interdependence in Education Equity in Health Individuals Patient-Centered Population- Based 25
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
Competency-based education Traditional model Curriculum Educational objectives Assessment Competency-based education model Health needs Health systems Competencies outcomes Curriculum Assessment
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
Levels of Learning Level Objectives Outcome Informative Formative Information Skills Socialization Values Experts Professionals Transformative Leadership attributes Change agents 16
Nigel Crisp: Biased Flows Ideas/Technical Money/Finances North South Nigel Crisp
Mutual Exchange Sharing/Learning Ideas Faculty-Training Innovation Capacity Bldg North South
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
Lancet Commission Launch: Why are they so happy!
Bangladesh, April 2011
Hanoi, April 2011
Beijing, April 2011
Tokyo, September
Tokyo Launch
San Francisco, September 2011
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