ACHEST’s DR. KIGULI-MALWADDE CALLS FOR TRANSFORMATION OF HEALTH PROFESSIONS EDUCATION

With the rise of artificial intelligence and new digital technologies, Health Professions Education(HPE) should be transformed to adapt to innovations in health care delivery.
This call was made by the ACHEST Director of Health Professions Education and Development, Dr. Elsie Kiguli-Malwadde while addressing a webinar by the Student Network Organization (SNO-Uganda) on August 11, 2021.
Dr. Kiguli-Malwadde, who is also the Secretary-General of the Network Towards Unity for Health(TUFH) noted that so many things had changed over the years, and this needs to be reflected in the education and training of future health professionals.
“Things are not static. The libraries are becoming obsolete and you can fit a small library in your hands. There is transition and we need to move with it. Some of the changes include the availability of multiple sources of data to use make a diagnosis for patients and the interface between medicine and machines at all levels of health care. For example, in Radiology, we are using so many machines ( MRI, CT scan…etc.) and all manner of ways to enhance making a diagnosis for patients. With the availability of smartphones, computers, and the internet, there is a need to change the way we are doing things in Health Professions Education (HPE), “ said Dr. Kiguli-Malwadde.
She also strongly called for interprofessional training, by explaining that the provision of health care is now driven by health care teams, not just one specialty.

“Medicine is changing. As a physician or doctor, you need a team around you to provide holistic care- nurses, physiotherapists etc..” she said, adding, “We need to develop medical scientists and innovators. We should not just be giving students the information. HPE should be encouraging people to be innovators. We should move beyond health sciences and clinical sciences and embrace interprofessional training that goes beyond disciplines.

We are working in an era where patients are managed in teams. At the same time, we need to move beyond health sciences and embrace to work with engineers if we are to innovate and embrace the use of equipment. We need to embrace the use ICT because of the Artificial Intelligence era we are going into. We need to move beyond health science and become intersectoral.”
Commenting on the use of Artificial Intelligence in medicine, Dr. Kiguli-Malwadde projected that the mimicking of human medicine by computers is going to increase. “In radiology we are seeing a lot of this, whereby diagnosis is being made by artificial intelligence. We need to practice more by doing, working in teams, considering the risks and ensuring patient safety. We should not forget compassionate care. We need to develop content that is appropriate. We must change our training methods to match the times, so that we don’t keep students in class for things they would find and read about yourselves,” she said and highlighted the need for North-South and South-South partnerships that are mutually beneficial and enhance social justice and equity.
Dr. Kiguli-Malwadde also gave the history of medical education in Africa – from the holistic traditional medicine which is still being used alongside modern medicine; to acceleration of training doctors in post-independence Africa; and the current exponential phase, where there has been a rapid increase in the number of training institutions in Africa currently.
There have been major developments in HPE: such as an increase in the number of medical schools both private and public; adaptation innovative curriculum which includes community-based education, skills labs, as well as e-learning especially during the current COVID-19 pandemic where schools have been closed and students have and to study at a distance. There has also been an increase in research and publications, and improvement in infrastructure and there is more collaboration and partnerships such as the Medical Education Partnership Initiative (MEPI) , Health Professions Education Partnership Initiative (HEPI) and African Forum for Research and Education in health (AFREhealth) which are Africa-led.
However, there have been challenges too, ranging from the wide spectrum of geography, culture and languages in Africa which make collaboration difficult, lack of standards and accreditation, recruitment challenges for faculty and students, inadequate assessment and evaluation, the failure to advance the innovations and unstable, political and economic environments.
With the current COVID-19 pandemic, HPE has been greatly affected. “In Uganda, for instance, medical schools have been closed twice and we need to see how to manage the training of health professionals in an innovative manner if we are to increase the numbers and meet the demand and supply,” said Dr. Kiguli-Malwadde.
It is estimated that there will be a shortage of 18 million health workers by 2030 globally, and the majority will be in low- and middle-income countries. At the same time, 25 % of the world’s disease burden is in Africa and we have 3% of the Health work Force (HWF). This is a big gap that needs to be closed.
Dr. Kiguli-Malwadde noted that due to challenges such as low investment, high unemployment rates, low retention, and lack of motivation, most health workers decide to migrate in the hope of better working conditions abroad. All in all, HPE has to change so as to mitigate all these challenges.
Compiled by Carol Natukunda