Faculty Perceptions | Administrators Perception |
---|---|
Organization and Coordination | |
· Lack of coordination between the ministry, institutions, health departments and WHO (95%). | · Lack of coordination between the ministry, institutions, health departments and WHO (4/16 all principals). |
· Faculty not informed of the progress on COME (71%). | · Not sure of the time lines on implementation (9/16). |
· Faculty not informed of proposed time of implementation (68%). | · Why did the faculty not think about the evaluation issue earlier on (4/16 – administrators at provincial level). |
· Transfer of trained faculty caused delays in implementation (55%). | |
· The assessment system by the university is not congruent with the PBL and COME curricula (20%). | |
Financial support | |
Lack of financial support for photocopying, books, petrol for students’ community visit, secretarial support and faculty incentives (99%). | · The concerned Ministry was willing to provide financial support however they needed official documentation from the principal (5/16 administrators at provincial and federal level). |
Political Commitment | |
· The principals were not in favour of COME (57%). | · They felt that the principals were not complying (5/16 administrators at provincial and federal level). |
· Lack of political commitment (30%). | |
· Frequent change of administrator at all levels (35%). | · No lack of political commitment, government is fully supportive (5/16 administrators at provincial and federal level). |
· Lack of ownership by the provincial government (35%). | · Frequent change of administrator at all levels (10/16). |
Lack of directive from the federal ministry (4/16 all principals). | |
Effect on Health System of the Country | |
· No effect on health system of the country (54%). | · The health system of the country will improve with implementation (9/16). |
· The senior faculty does not have time to go the field site and are not trained to go in the field (47%). | · The senior faculty will come in contact with the service providers at the peripheral level with a hope to improve their competencies (3/16). |
· The community comes to the tertiary care teaching hospitals; hence the students are adequately trained (45%). | · The cost of in-training of medical doctors after posting to Basic Health Units will be decreased (3/16). |
· Tertiary care teaching institutions will be linked with the community health services (3/16). | |
Need and Usefulness of COME | |
· We do not need to send the students to the community because the community comes to our hospitals (74%). | · Unless the infrastructure in Community health services is organized to receive students for medical training, it will be difficult to implement COME in Pakistan (3/16). |
· Infrastructure of the community is not developed and the staff is not trained in the peripheral centers (92%). | · Presence of students will have beneficial effect on the practices of the health providers at the primary care level (3/16). |
Faculty readiness and knowledge of the program | |
· Lack of acceptance by the faculty at large for the change (12%). | · Not sure of the abbreviation and concept of COME (3/16 administrators). |
· Some faculty members did not know what the abbreviation COME stood for (8%). | · COME means taking students to the community by the department of community Medicine (6/16 administrators). |
· We are ready to take the students to the community for learning (64%). |