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Evaluation of IMNCI teaching in four medical colleges
A pilot project was undertaken
at the All India Institute of`
Medical Colleges (AIIMS) supported by the World Health Organization, India
country office to evaluate pre service IMNCI in four medical schools in India
in 2005 . The primary objective was to
evaluate the process (describe
changes made to the teaching & learning process) of introducing
IMNCI in the MBBS curriculum. Evaluation of outcome (assessment of competence
of students), effectiveness and impact of the programme
was not planned as part of this activity. The evaluation was done by taking feedback from the nodal persons, the
teaching faculty, students, interns, and administrative staff by direct
questioning and focus group discussions. The changes made to the teaching
& learning process while introducing IMNCI in the MBBS curriculum were
identified and the quality of IMNCI teaching for its context, content and the
materials and methods was assessed. The gaps between what was planned and
what was achieved were noted. Ways of extending the successes and strengths
of the IMNCI strategy and methods of addressing the limitations were
defined. An assessment was made if
there was a need for additional assistance/ resources to make the programme sustainable.
Summary of
the evaluation:
 The
programme was implemented as per plan of action
decided at the initial orientation at AIIMS with minor modifications, however
there was no formal IMNCI Working Group or
long term written plan of action in any of the four colleges.
It
has been perceived as a WHO project and none of the colleges had identified a
long term source of budget.
Overall
the programme was easy to implement within the existing
academic curriculum. There was the initial resistance to the implementation
of the programme among the teaching faculty but it
was well accepted with time.
Some
of the teaching faculty had not been trained in the 6 day facilitators’
training workshop.
The
students were being taught according to the IMNCI guidelines
The
teachers were not unduly burdened with the additional responsibility.
The
students were not burdened by this programme and
felt that it was beneficial to them. It was an additional clinical skill that
they were learning.
Initially
all batches of students and some teachers had some concerns whether it would
interfere with their standard pediatric teaching but gradually accepted it as
an additional tool to enhance their clinical skills and eventually enjoyed
the programme.
Each
batch of students taking the training at one time was small and was not more
than 30 in any college. The time spent on IMNCI was from 21-56 hours across
the four colleges in the final year of MBBS or the second Pediatric posting.
Less than half of the total time was spent on clinical practice sessions
except for one college where more than two thirds was spent on clinical
practice.
WHO
provided initial support for the clinical material which was just sufficient
for the initial two years. The departments had
continued by photocopying the material available with them. There was no
further support from WHO. The colleges would need
further financial support for clinical material if the programme
was to be continued.
The
students were assessed for their knowledge on IMNCI at the end of their IMNCI
posting. Each college had devised their own system of assessment and the
marks were included as part of the internal assessment.
IMNCI
was not being practiced by the faculty during their routine clinical care
The
colleges had taken requisite permissions to implement the programme
in their curriculum. The programme had the support
of their respective college administration but it was perceived as a project
by the administrators. The faculty and the administrators were of the opinion
that it was sustainable on a regular basis in the curriculum with the support
of the central and state governments. It was also important to involve MCI
for future sustainability.
The
colleges would be happy to participate in any long term training activity for
both pre-service and in-service programmes.
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