Lab 5 Case Study On Issues Related To Sharing

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  • A community of practice (CoP) provides a means of gathering and sharing information. Popular in business, a CoP is an informal, self-selected group of people who share expertise and who are brought together to solve problems and share knowledge [1]. Evaluators of CoPs have noted that discussion within a CoP tends to be less constrained than discussions generated by more conventional methods, allowing for creative and novel solutions to old problems [1]. However, shared information within a CoP is frequently experiential, which may limit the validity of the evidence being shared [2].

    The Capacity Project was a USAID-funded global initiative with multiple activities focused on strengthening human resources for health. The Project was led by IntraHealth International in collaboration with partners IMA World Health, Jhpiego, Liverpool Associates in Tropical Health (LATH), Management Sciences for Health (MSH), PATH and Training Resources Group, Inc. (TRG). In the pre-service education (PSE) arena, the Project has focused on strengthening key areas, such as family planning (FP) and HIV/AIDS, especially to address issues of poorly developed clinical competencies. This has included facilitating systems for developing and implementing competency-based curricula and harmonization of FP and HIV/AIDS content for pre-service and in-service training, especially of nurses and midwives [3].

    The Capacity Project established the Global Alliance for Pre-Service Education (GAPS) project to provide a forum for the discussion of issues related to teaching and acquiring competence in FP. GAPS functioned as an electronic community of practice (CoP) housed within the World Health Organization (WHO)/Implementing Best Practices (IBP) Knowledge Gateway. The moderators of GAPS were inspired by the success of the GANM. The GANM CoP, moderated by the Johns Hopkins School of Nursing and hosted by the IBP Knowledge Gateway, exemplified the potential of this medium. Lathlean et al. [4] commented that CoPs provide the opportunity to reach practitioners and educators who traditionally might not have professional access to one another.

    The GAPS CoP facilitated a virtual collaboration among educators from around the world to share relevant issues and explore common challenges associated with identifying and teaching FP core competencies. This method of sharing and eliciting information was based on the growing interest to understand how new information and communication technology may be used to support efforts to scale up and improve PSE in low-income countries [5].

    GAPS was intended to build a community of stakeholders in PSE. The intended goal of the group of PSE stakeholders was to discuss how competencies in FP were locally defined and taught and eventually identify and share best practices and strategies. The leaders of GAPS hoped that this discussion would provide a critical understanding leading to a globally acceptable set of FP PSE core competencies.

    This case study describes the process and outcome of GAPS and discusses the major issues that the CoP identified in teaching and learning FP competencies in low-resource settings.

    Defining competence

    Competence can be defined as an "ability to do something well, measured against a standard, especially ability acquired through experience or training" [6]. This ability translates into performance and may be measured if standards are clear and well-established.

    Competency as a health care provider requires knowledge acquisition in the classroom, practice in the skills lab and application of knowledge, skills and professional behaviour in the clinical practice setting. Producing competent health providers requires a competency-based curriculum and competency-focused assessment techniques.

    The curricula of health worker education programs are often knowledge-focused and rely on resources that are out of sync with current evidence. Education programs tend to include material (based on Western medical text books and curricula) that is not directly applicable or relevant to prevalent health concerns in developing countries. As a result, curricula are long and may fail to address the key health issues [5]. Programs also lack competency-based clinical skills labs and often rely on clinical supervision by overburdened clinicians working in tertiary hospitals. These factors result in insufficient emphasis on competencies needed at the primary health care level [7].

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