Dr Jo Lander writes:
In 2010, the influential medical journal The Lancet published a commissioned report on health professional education for the 21st century. It was scathing.
Despite ‘groundbreaking reforms’ 100 years ago, which saw the integration of modern science into university health professional education, this education has not kept pace with the challenges which have arisen in the intervening years, including ‘glaring gaps and inequities in health (that) persist both within and between countries’.
To blame are irrelevant curricula and a maldistribution of health education institutions which do not align with areas of need.
The authors call for reform, recommending a more global outlook, including transformative learning to create leaders and agents of change and an interdependence of learning institutions, which enables mutual learning and collaboration.
Health professional education should transcend the confines of the classroom, instil social accountability, be systems-based (rather than science-based or problem-based), be collaborative (between institutions), inter-professional, foster cultural sensitivity and feature cross-cultural and cross-national experiential learning.
The Classroom in the Field (CIF) project was established to address many of these issues. It is a collaborative venture, led by Dr Giselle Manalo, between the School of Public Health at the University of Sydney and partners in the Philippines: Health Human Resource Development Bureau of the Department of Health, University of the Philippines Manila, Zuellig Family Foundation and United Nations Population Fund Philippines.
The aim of the program is to ‘provide students with a contextual understanding of “on the ground” approaches to international health issues and to provide insight into community-based educational programmes and community mobilization, the complexities of the Philippine health system and the implementation of health programmes at the national, regional, municipal, city and village levels’.
Now in its second year of operation, the CIF program enables students selected from the Master of International Health cohort on the basis of academic merit and an interview (of which cultural competence is an important element) to undertake a 2 month placement in the Philippines with one of the partner organisations, a placement which is integrated with relevant electives from the degree program.
In January 2015, for the first time, two Aboriginal students from the Graduate Diploma in Indigenous Health Promotion will be taking part, with a placement in an Indigenous community.
In 2013-4, students were either supported by a scholarship from the School or self-funded; for 2014-5 two of the six students will receive partial funding from the School while the remaining four students will receive partial funding from AsiaBound grants.
The placements themselves provide authentic, on-the-ground experiences of health services within communities and institutions; these are supplemented with briefings on the ‘bigger picture’ (health systems and provision in the Philippines) as well as social and cultural events.
Students are well-supported before and during their placement, with pre-departure orientations and briefings and in-country support from supervisors and mentors, the latter being MIPH alumni working for NGOs.
As with any true collaboration, the flow is not just one way and partner organisations in turn report gaining insights from the students, many of whom have years of experience and health professionals in their own countries.
At the conclusion of the placements, a presentation day in Manila sees students presenting on their placement to an audience that includes partner institutions, mentors, academics, local NGO representatives, Department of Health and local government officials.
Once back in Sydney, students are required to provide a written report for assessment and a presentation on their placement (the latter may be viewed on YouTube here and here). The subjects of the reports ranged from a “doctors to the barrios (village)” program focused on rural health care delivery; analysing current TB control measures to the impact of a conditional cash transfer program on child nutrition.
For her leadership of the Classroom in the Field program, as well as other groundbreaking initiatives and support of the student experience in the Sydney School of Public Health and Sydney Medical School, Giselle Manalo was awarded the inaugural CAPHIA Award for Excellence and Innovation in Public Health Teaching at the CAPHIA Teaching and Learning Forum in Perth in September.
CAPHIA (the Council of Academic Public Health Institutions Australia) is the peak national organisation that represents Public Health in Universities that offer undergraduate and postgraduate programs and research and community service activity in public health throughout Australia.
Its aim is to improve the public’s health by advancing public health education, research and service. The CAPHIA Awards and commendations recognise and support excellence and innovation in teaching and learning and research, including recognition of early career and PhD researcher excellence.
Although the CIF program has been successful in attracting scholarships for 2014-5, the aim is to raise donor funds to enable more students to undertake these placements and cover operational costs of the program in country as all CIF University of Sydney alumni mentors, local partners and community stakeholders participate on a voluntary basis.
For sustaining the Classroom in the Field Dream please visit https://www.alumniandfriends.usyd.edu.au/MedicalFoundation.asp for one avenue to donate.
• Jo Lander is Director, Teaching and Learning, e-Learning Director at the Sydney School of Public Health, and Associate Dean, Learning and Teaching at the Sydney Medical School, at the University of Sydney.