Pre-service Education

The shortage of qualified and capable health care workers in resource-constrained settings poses a major challenge for all health care delivery. Any sustainable response to this problem must include strengthening the education of health care professionals before they begin their service. To help address this gap, I-TECH has created tools and offers expertise to educational institutions and health care settings to improve both the curricula and  leadership of pre-service institutions.

I-TECH's Pre-service Strengthening Framework

Any reform made to a pre-service curriculum—whether integrating new content into an existing curriculum or revising an entire program—requires extended time for planning, implementation, and evaluation. It also requires the involvement and consensus of multiple stakeholders. To ensure success, the process must include gaining the support and participation of relevant health and education agencies in a country, rewriting the curriculum to include new content, galvanizing faculty to embrace and learn new content and participatory teaching methods, reestablishing the course calendar to reflect any changes in timing, and purchasing learning materials.

I-TECH's Pre-service Strengthening Framework, based on experience in addressing educational reform in multiple countries as well as on the work of other leading organizations—such as Jhpiego and the World Health Organization—reflects the multifaceted, long-term, participatory nature of pre-service reform. The framework consists of five phases:

1. Plan and prepare
2. Strengthen curriculum
3. Build faculty capacity
4. Pilot, revise, and evaluate curriculum
5. Evaluate impact

In each phase, I-TECH collaborates with funders and stakeholders to establish the extent of I-TECH's support, and to clarify the roles of partners.

What I-TECH Is Doing about the Shortage of Qualified Health Care Professionals

I-TECH assists its partners to improve the quality and relevance of pre-service education for a range of health care professionals, including graduating physicians, clinical officers, nurses, social workers, psychologists, and lab technicians.

I-TECH's experience in this regard has included:

• Convening and facilitating stakeholders in strategic planning for pre-service reform.
• Assessing the skill and knowledge needs of health care professionals in their local service contexts.
• Assessing the capacity of schools to prepare students with necessary skills and knowledge.
• Assessing the clinical content and teaching methods of existing curricula.
• Writing learning objectives for curricula, and competencies for graduates.
• Mentoring and building capacity in faculty and other stakeholders in new clinical content, teaching methods, curriculum design, and monitoring and evaluation.
• Rewriting health care curricula to integrate evidence-based content.
• Developing supporting materials, including syllabi, lesson plans, and reference manuals.
• Evaluating educational outcomes.

For each pre-service initiative, I-TECH's aim is to provide the technical assistance required for health care professions schools to revise their pre-service curricula to reflect: 1) the most pressing health needs of the community served, 2) the daily responsibilities of the health care professionals, and 3) the availability of diagnostic tools, drugs, and equipment in the settings in which students will work upon graduation.