Purpose The aim of this scoping review is to understand the motivations for the creation of global medical curricula, summarize methods that have been used to create these curricula, and understand the perceived premises for the creation of these curricula. Method In 2018, the authors used a comprehensive search strategy to identify papers on existing efforts to create global medical curricula published from 1998 to March 29, 2018, in the following databases: MEDLINE; MEDLINE Epub Ahead of Print, In-Process, and Other Non-Indexed Citations; Embase; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; PsycINFO; CINAHL; ERIC; Scopus; African Index Medicus; and LILACS. There were no language restrictions. Two independent researchers applied the inclusion and exclusion criteria. Demographic data were abstracted from publications and summarized. The stated purposes, methods used for the development, stated motivations, and reported challenges of curricula were coded. Results Of the 18,684 publications initially identified, 137 met inclusion criteria. The most common stated purposes for creating curricula were to define speciality-specific standards (50, 30%), to harmonize training standards (38, 23%), and to improve the quality or safety of training (31, 19%). The most common challenges were intercountry variation (including differences in health care systems, the operationalization of medical training, and sociocultural differences; 27, 20%), curricular implementation (20, 15%), and the need for a multistakeholder approach (6, 4%). Most curricula were developed by a social group (e.g., committee; 30, 45%) or Delphi or modified Delphi process (22, 33%). Conclusions The challenges of intercountry variation, the need for a multistakeholder approach, and curricular implementation need to be considered if concerns about curricular relevance are to be addressed. These challenges undoubtedly impact the uptake of global medical curricula and can only be addressed by explicit efforts to make curricula applicable to the realities of diverse health care settings.

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Motivations for and Challenges in the Development of Global Medical Curricula: A Scoping Review.

Optometry students in clinical years are usually faced with the challenges of making a career choice in or outside optometry. This cross sectional study was conducted to investigate the career aspirations of optometry students in Ghana. All students in their fourth to sixth year who consented to participate in the study responded to a questionnaire which explored: demographic characteristics, career aspirations, and factors influencing their choices. Descriptive statistics was used to present data as frequencies, proportions and percentages. Chi-square test and logistic regression analysis were used to evaluate relationships between variables. Two hundred and nine students from the two optometry training institutions in Ghana; Kwame Nkrumah University of Science and Technology (49.8%) and University of Cape Coast (51.2%) responded to the questionnaire. The mean (SD) age of students was 23.6 (1.9) years (males = 65.6%). On seeking admission into the university, optometry (65.6%) and human biology/medicine (28.2%) were the leading first choice programmes among participants. Participants largely aspire to be in clinical practice (64.6%) or Academia/Research (28.2%). The major factors which influenced career choices were interest in career field (64.1%) and potential good income (38.3%). Females were twice more likely to practice optometry and pursue an interest in paediatric optometry than males. Institution of study (p = .028) and information on career opportunities (p = .018) were significant predictors of students' decision to pursue a career in academia/research. Optometry students in Ghana largely aspire to be in clinical practice, a finding which is useful for optometry training institutions and relevant stakeholders in developing the optometry programme and projecting its future in Ghana.

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Career aspirations and factors influencing career choices of optometry students in Ghana.

Profile, knowledge, and attitude of contact lens users regarding contact lens wear in Ghana.

Optometry is only provided at tertiary level in two institutions in Ghana, with an average of 50 students graduating each year for a population of approximately 24.6 million. No information on the demography of optometry students and factors that influence their choice of optometry as a career and institution of learning is available. This information is important as it will assist optometry institutions to formulate effective student recruitment strategies. To assess the demographic characteristics of Ghanaian optometry students, the factors that influence their selection of optometry as a career and institution of learning. We conducted a cross sectional study among Ghanaian optometry students using a structured questionnaire to collect data on the demographic characteristics and factors that might influence their choice of optometry as a career as well as choice of institution of learning. Two hundred and eighty students from the two optometry training institutions in Ghana; University of Cape Coast (48.2 %) and Kwame Nkrumah University of Science and Technology (51.8 %) responded to the questionnaire. Their ages ranged from 17 to 28 years with most being males (72.5 %), and the majority (79 %) being from urban areas. The main factors that influenced their career choice were job availability after graduation (90 %) and desire to help other people (89.2 %). Factors that influenced their institution choice were preference for an institution (36.8 %) and proximity to home (24.4 %). In the absence of adequate optometry jobs in the public health sector, women will remain marginalised specifically those in rural areas. This marginalisation is however, a reflection of a broader societal disadvantage for women. Greater effort needs to be made to recruit high school students from rural areas to study optometry and more institutions need to provide optometry instruction throughout the country.

Demographic characteristics of Ghanaian optometry students and factors influencing their career choice and institution of learning.

Background:  New optometry education programmes in sub-Saharan Africa share a responsibility for blindness prevention by virtue of producing the countries first practitioners. Programmes need to be relevant and of a high quality to ensure sustainability. A quality culture is not a single event involving an accreditation audit but an integrated continuous system across core academic areas and accepted by all concerned in the programme. Aim:  The aim was to determine the extent to which quality assurance is integrated into the 11 participating optometry education programmes in sub-Saharan Africa. Setting:  The study was conducted in sub-Saharan Africa. Methods:  A qualitative approach, employing a phenomenological design was used in the study. Key academics in leadership were purposively selected and then consented to participate in interviews covering the core academic areas, namely, governance, recruitment and selection, teaching and learning, curriculum design, staff development, research, community-based training and student support. Transcribed data was iteratively analysed. Results:  Only one sub-Saharan country undergoes the three levels of quality audits within a regulated optometric environment. Despite a few pockets of best practices in some core areas, there was a reported general lack of quality assurance initiatives, national guidelines and adequate leadership capacity. Conclusion:  This study highlighted the absence of regulatory authorities and mandatory quality audits, which contribute to the general lack of a quality culture in optometry programmes. Schools should aim to embed a culture of quality that produces competent, socially relevant graduates and impactful research. It is recommended that schools at national, regional and global levels collaborate towards the development of a quality assurance culture across optometry education programmes in sub-Saharan Africa.

/pdf/towards-a-culture-of-quality-assurance-in-optometric-ejqgkd4q4o.pdf

Towards a culture of quality assurance in optometric education in sub-Saharan Africa

The African continent, with a population of more than one billion and 55 recognized developing countries, is still grappling in some countries with socioeconomic and other challenges inherent in developing countries. The continent is working toward a single political entity known as the African Union, and development is taking place faster than ever in most countries. The continent is known to have high levels of health problems, including visual impairment and blindness. Most nations in the continent are making efforts to reduce the scourge of health problems including visual impairment and blindness. Visual impairment in the continent is mostly caused by refractive errors. Consequently, optometry can help reduce the prevalence of visual impairment on the continent. The educational programs currently offered by the different institutions include Diploma in Optometry (DipOptom), Bachelor of Optometry (BOptom), and Doctor of Optometry (OD). There are 17 established institutions offering optometry degree programs on the continent, of which 14 are fully accredited. Considering the optometric manpower needed in the continent, more optometry institutions need to be established. Staffing and infrastructural and training facilities are major challenges facing the majority of the existing institutions. There is also a need to place greater emphasis on postgraduate education to meet the institutional, national, and international professional training standards and to ensure sustainability of optometry education. This article addresses the historical development, educational issues, challenges, and needs, as well as recommendations, for improving the standard and sustainability of optometric education.

Optometric education in Africa: historical perspectives and challenges.

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Optometric education in Africa: historical perspectives and challenges.