Evidence map›Paper›PMID 34049538›Full record

ArticleBMC medical education2021

Medical education reform in Tajikistan: comparison of the conventional one-year family medicine residency program and the new two-year residency program for postgraduate medical education.

Leah F Bohle, Edgar Valencia, Greta Ross, Davlyatova Dilbar Dzhabarovna, Shakhlo N Yarbaeva, Zukhra A Kasymova, Helen Prytherch

Abstract read
In one paragraph

Article in BMC medical education, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. La Tunisie medicale · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Leah F BohleSwiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland. leah.bohle@swisstph.ch.
Edgar ValenciaPontificia Universidad Católica de Chile, Santiago de Chile, Chile.
Greta RossIndependent Health Consultant, England, Canterbury, UK.
Davlyatova Dilbar DzhabarovnaMedical Education Reform Project Tajikistan, Dushanbe, Tajikistan.
Shakhlo N YarbaevaSwiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.
Zukhra A KasymovaMedical Education Reform Project Tajikistan, Dushanbe, Tajikistan.
Helen PrytherchSwiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe last two decades have seen a shift in former Soviet countries from highly specialized to more family medicine-focused systems. Medical education has slowly adjusted to these reforms, although the region is still at risk to have a chronic shortage of family doctors. This paper presents the evaluation of a new post-graduate family medicine program in Tajikistan, focused on competency-based training. The findings are relevant for policy makers, international organizations and practitioners participating in similar medical education reform programs.

methodsWe employed a quasi-experimental control group design and compared intervention residents, control group residents with traditional training, and 1st year residents with no training in two outcomes, clinical knowledge and competencies. We employed two objective measures, a written multiple-choice question test (MCQT) and an Objective Structured Clinical Examination (OSCE), respectively. We report reliability and validity of the measures along with ANOVA, planned contrasts and effect size estimates to examine differences across groups.

resultsWe found statistically significant differences in both clinical knowledge and competencies between intervention and control groups. We also detected a large intervention effect size. Participants in the intervention outperformed control group participants in the two measures. Our analysis suggests that intervention and control group participants are comparable in terms of initial knowledge and competencies, strengthening the argument that the intervention caused the improvement in the program outcomes. DISCUSSION: Receiving tailored training and structured opportunities to practice knowledge and competencies in clinical settings have a positive effect on the education of family medicine doctors in Tajikistan. Our results support curriculum reform and investment in medical education in the form of longer and supervised on-the-job preparation designed to be more in line with international standards. We discuss suggestions for future studies and potential requirements to inform replicability in other countries.

conclusionFamily medicine is well recognized as central to health systems throughout the world, but high quality residency training lags behind in some countries. Our study showed that investing in family medicine residency programs and structured training is effective in increasing critical clinical competencies. We encourage promoting comprehensive post graduate family medicine doctor training so that the goals of a family medicine centered health system are attainable.

Indexed as

Internship and ResidencyCurriculumFamily PracticeHumansReproducibility of ResultsTajikistanEvaluationFamily medicineMedical education reformResidencySpecialty programTajikistanValidation

Identifiers

PMID34049538
PMCPMC8164299

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.