1. Presented by Nguyen Vu Quoc Huy, Hue University Medical College
33rd Annual Conference on Global Health • Washington D.C. • May 30 – June 2, 2006
Field Teaching: Strengthening Reproductive Health Teaching at Hue Medical University
Presented by Nguyen Vu Quoc Huy, Hue University Medical College
Truong Quang Vinh, Hue University Medical College Susan Clark, Pathfinder International/Viet Nam Ngo Van Huu, Pathfinder International/Viet Nam

2. Location of Medical Colleges in Viet Nam
Hanoi
Hai Phong
Thai Binh
Thai Nguyen
Hue
Tay Nguyen
Ho Chi Minh City
Can Tho
Location of Medical Colleges in Viet Nam

3. Rationale Current gaps in Reproductive Health (RH) teaching
Perception of RH too simple
RH teaching emphasizes knowledge more than skills and attitudes
Lack of focus on basic counseling and communication skills
RH clinical skills not standardized
Lack of quality training sites; too many students to practice at teaching hospital
Inadequate facilities at teaching hospitals
Hospital-based vs. community-oriented teaching

4. RH Medical Education Project
Started in July 2001
Implementing organization: Hue University Medical College (HMC); technical assistance from Pathfinder International, JHPIEGO, UCSF, and other consultants
Funding: Ford Foundation and anonymous donor
Goal: To improve the quality of RH care in Viet Nam through improved pre-service teaching in medical schools.
General objective:
Improve the quality of RH teaching at HMC
Improve RH teaching at all medical colleges by replicating lessons learned from the HMC project

5. Field Teaching Program at HMC
Major objectives:
To increase quality/quantity of clinical skill education (competency-based learning)
To increase community–oriented teaching for medical students.

6. Field Teaching: Program Development
Prioritization of RH KAS needed for medical education in Viet Nam
Baseline Assessment:
Facility assessment
Staff’s RH knowledge/skills
RH services, client load
Teaching aids
Sample of students’ skills

7. Program Development: Reaching Consensus
Selection of field sites:
Prioritization of RH skills/topics to be taught at each site
Defining roles and responsibilities of key stakeholders: dean, board, teachers, health services, preceptors, and students
Memorandum of understanding signed

8. RH Field Teaching Planning
Design of FT program: based on KAS, chose essential contents:
Pelvic/breast exams
Infection prevention in RH
Family planning counseling
Antenatal care
Postpartum and newborn care
Submit detailed FT plan for school leader approval
Design key interventions to prepare for FT
FT preceptor selection: criteria, procedure, etc.
Assign and define roles and responsibilities of FT coordinators

9. RH Field Teaching: Intervention (1)
Develop curriculum and materials for preceptors and students:
Develop Self-Directed Learning (SDL) materials
Develop Learning Guides for all RH clinical skills, taught at field sites

10. RH Field Teaching: Intervention (2)
Develop Orientation program: learning objectives, materials, time, where to get help, learning process, assessment, and regulation, etc.
Logbook to monitor students’ learning
Establish a skill lab with anatomic models and equipment for students to practice skills at each FT site

11. RH Field Teaching: Intervention (3)
Standardize selected skills to be taught at FT sites for HMC faculty (18) and preceptors (21, including midwives)
Train preceptors (21) on teaching methodologies, including demonstration, supervision, coaching, and student assessment
Field site improvement, renovation, including new learning/ skills labs (1 per site).
Monitor and support preceptors in their clinical practice (monthly basic)

12. Field Teaching: Implementation
FT program started in school year
Y4 OB/GYN Students - rotations at Hai Lang DHC: 270 students
IP, PP, and NB care, breast and pelvic exam, ANC
Y6 students students
Rotations at Hue City hospital: IP, ANC, breast and pelvic exam
Rotations at Hue RH center: IP, ANC, breast and pelvic exam, and FP counseling

13. Monitoring and Supervision
In the early phase, HMC supervises and supports FT preceptors teaching and helps students learn selected skills at their sites
Faculty from OB/GYN Department take turns supervising and monitoring FT at sites
Supportive feedback, coaching are provided by the end of the session
Participation of Pathfinder and other international consultants (JHPIEGO)

14. Early Results of FT Program (Based on midterm evaluation)
Students motivated to learn more; have more exposure to real clients and feel more confident working with clients
Preceptors have improved their clinical skills
Preceptors happy and willing to support student learning at their sites
Teachers have more community-oriented approaches
Teachers more motivated to work with students and preceptors
Teachers use more evidence-based materials, based on local clinical experience

15. Key Challenges Time and staffing constraints
— FT rotation is too short
— Lack of FT preceptors, workload
— HMC teachers are too busy
Motivation for preceptors, including recognition and certification
Motivation for students’ learning at FT sites

16. Strategies to Overcome Challenges
Formalization of FT Program
Intervention and support from Dean, Board, training department
Stakeholders maintain commitment
Supervision and coaching at the sites

17. Looking Forward
Standardization of assessment system and integration into rotation rating system
Expansion to other Medical Colleges