ID-5184 Wonca Abstracts supplement L-Z 13-10-23 - Flipbook - Page 33
WONCA 2023 Supplement 2: WONCA 2023 abstracts (L–Z)
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Practical challenges in medical education reform for
capacity building of primary care doctors in Cambodia
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Dr Sengkhoun Lim, Dr Sambath Cheab
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University Of Health Sciences
Introduction
Primary care doctors are essential for the healthcare system, with better health outcomes at lower
costs and greater equity. Medical education reform as an upstream strategic intervention is needed
to improve primary healthcare capacity, especially in resource-limited contexts. Competency-based
medical education (CBME) has gained momentum as the premier curricular model to produce
competent doctors. However, moving toward a competency-based curriculum comes with challenges.
Resource constraints may exacerbate inherent challenges. Contextualisation plays a crucial role
in curricular change. Adopting the CBME model, originating from the Western world, requires the
acceptance of instructional design and social organisation. In Cambodia, CBME implementation
efforts have been ongoing for a decade now. However, significant barriers persist, and progress is
limited. This study aims to explore practical challenges of CBME implementation in a resource-limited,
non-Western context.
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Methods
Information was collected through document reviews and semistructured interviews. First, grey
literature, public documents, strategic plans, project outputs and pertinent reports were examined.
Second, three international consultants and 10 faculty members from all five medical schools in
Cambodia were interviewed. Data were analysed using inductive thematic analysis.
Results
The study identified 12 themes and numerous subthemes. Several issues were directly related to the
curriculum, including conceptual understanding, the national curriculum standard, clinical training and
assessment. Challenges in stakeholder engagement, resources, teachers and students affected the
process of implementing curricular change. Contextual factors also hampered CBME, such as policy,
culture and organisation, accreditation and leadership.
Conclusion
Study results reveal interrelated factors that may facilitate or hinder CBME implementation. Some
challenges are similar across contexts, while others are specific to Cambodia, including pragmatic
approaches to CBME adoption, conceptual misconception, the prescriptive curriculum, resource
constraints and contextual barriers. Relevant stakeholders must find collaborative strategies to
overcome these challenges, turn them into opportunities and learn from successful examples.
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