Programatic-Strengthening Medical Education for Improved Health Outcomes in Kenya

说明（由申请人提供）：内罗毕大学（内罗毕大学）与其两个长期培训伙伴华盛顿大学（UW）和马里兰大学巴尔的摩分校（UMB）合作，建立了创新医学教育伙伴关系。该方案的主要目标是加强和建设联合国大学医学院在艾滋病毒和与艾滋病毒有关的疾病方面的临床和研究能力。由于每年有一半以上的肯尼亚医生进入工作队伍，因此，提高医学教育质量（目标1）、扩大内罗毕以外的医疗培训范围（目标2）和增加联合国医务人员留用率（目标3）的方案有可能对提高肯尼亚长期保健和保健成果方面的人力资源能力产生重大影响。为了提高联合国大学医学教育的质量，我们提出了一系列战略，包括使用创新的“技能实验室”，使学生能够利用专家病人和模拟模型获得实际临床经验。此外，教职员工将接受以艾滋病病毒为平台的临床教学培训，并将严格评估新的教育方法，以便在全校范围内推广最有效的方法。为了扩大上述临床培训的范围，PRIME将制定和实施一个分散的、以社区为基础的项目，优化围绕艾滋病毒/艾滋病的初级保健和预防医学培训。为此，将在内罗毕以外的12家地区医院培训和认证当地医生和专家，这些医院将成为医科学生、实习生和研究生的轮岗地点。还将在这些分散的地点为培训和护理引入远程学习和移动电话应用程序，以确保培训的可持续性。第三个目标是，PRIME将通过为联合国大学研究生和教师提供从事临床或应用研究的机会来促进教师发展。这将通过三种不同的机制来实现：1)实施科学领域为期一年的指导奖学金，2)临床研究领域的职业发展奖，以及3)种子资助计划。这些策略将共同创造一个有利的学术环境，鼓励本地驱动的研究，并可持续地增加招聘和保留学术教师。

DESCRIPTION (provided by applicant): The University of Nairobi (UON) has formed the Partnership for Innovative Medical Education (PRIME) in collaboration with two of its longstanding training partners, the University of Washington (UW) and the University of Maryland Baltimore (UMB). The primary goal of the PRIME application is to strengthen and build clinical and research capacity in the UON School of Medicine for HIV and HIV-related conditions. Because the UON trains more than half of all Kenyan doctors entering the workforce each year, a program improving the quality of medical education (Aim 1), extending the reach of medical training outside Nairobi (Aim 2), and increasing retention of UON faculty (Aim 3) has potential to have a major impact on improving human resource capacity for health and health outcomes long-term in Kenya. To improve the quality of medical education at UON, we propose a combination of strategies, including the use of an innovative "skills lab" that will allow students to have hands-on clinical experiences using expert patients and simulation models. In addition, faculty will be trained in clinical teaching using HIV as a platform, and new educational approaches will be rigorously evaluated to allow promotion of the most effective methods university-wide. To extend the reach of the clinical training described above, PRIME will develop and implement a decentralized, community-based program that optimizes training in primary care and preventive medicine around HIV/AIDS. This will be done by training and accrediting local medical doctors and specialists at 12 district hospitals outside Nairobi which will become rotation sites for medical students, interns, and postgraduates. Distance learning and mobile phone applications will also be introduced for training and care at these decentralized sites to ensure sustainability of training over time. In the third aim, PRIME will promote faculty development by providing opportunities for UON postgraduates and faculty to pursue clinical or applied research. This will be accomplished through three different mechanisms: 1) a one-year mentored fellowship in implementation science, 2) a career development award in clinical research, and 3) a seed grant program. Together, these strategies will result in creation of an enabling academic environment which will encourage locally driven research and a sustainable increase in the recruitment and retention of academic faculty. PUBLIC HEALTH RELEVANCE: This application builds on the strengths of three partnering universities (UON, UW and UMB) to address the current medical education challenges faced by UON, with the ultimate goal of improving healthcare delivery across Kenya. As UON is the largest medical school in Kenya and one of the largest in East Africa, improving quality of training around HIV and related conditions at the institutional level and extending this into communities could have a profound effect on HIV-specific and overall health outcomes.