This is the first national evaluation of Lao PDR’s OB-GYN residency programme. Although there are still certain problems to overcome, the findings show that the overall aims have been met to a considerable degree. The lecturers and residents all agree that this training programme’s major difficulty is meeting the standards.
In the content evaluation. Residents may recognise the significance of their training, highlighting the need for identifying learners’ needs and creating programme objectives and assessments early in the starting period. Similar to previous research (Al-Khathami 2012), the educational purpose provided clearly in the syllabus will help represent the students’ needs and level with the class, helping them reach curricular objectives. According to (Lee 2019), teachers’ excitement for education should be fostered in all courses, as indicated by students’ learning successes and lecturers should not overreach educational content. In fact, the faculty training programme is the greatest method to develop faculty knowledge and abilities.
In the input evaluation. We found that it was difficult to borrow or reserve a room due space shortage. If there is none available, the class will have to be extended or switched to an online teaching platform such as Google classroom or ZOOM meeting. When the coronavirus disease 2019 (COVID-19) broke out, online classes increased (Chen et al. 2022), which showed that students tend to express their thoughts during online class sessions and are more successful when the lecturer acts as a guide rather than a leader. Presently, educators might utilise ZOOM instead of a classroom; however, they could not practice essential skills. Furthermore, the college of medicine in Laos plans to create a new simulation centre and objective structured clinical examination (OSCE) room for licensing exams in the next 3 years. We agreed that this proposal is in keeping with residents’ needs and will benefit all residency programmes in the near future.
In the process evaluation. Both resident and lecturer agree that hand-on teaching is the helpful way for learning and getting a real feedback. Exploring with real patients and providing individual coaching are a well-known and successful method adopted in the Lao OB-GYN residency programme. A research in pedagogy teaching (Horsfall et al. 2016) elucidated that one of the most significant components of teaching is open communication, which begins with a full description of the lesson plan, educational objectives, procedures, assessment, criteria and attitudinal guidelines. Pre-procedure talks before beginning work enable lecturers to check students’ degree of classifier knowledge and modify learning to their necessity (Garcia-Rodriguez 2016). Recognising the roles that lecturers need to pay more attention to students, we believe that an open communication can help in gaining real feedback from lecturers and students; also, students need to prepare to enhance their professional skills and understand procedures as well as technical surgeries. Thus, the feedback is important part for inform resident progress, to see their improment and engage in appropriate learning activities (Burgess, A 2020)
As shown in the product evaluation. Generally, the new RMNCH strategy placed the OB-GYN programme outcomes-enhancing priorities on the maternal death monitoring programme by offering treatment guidelines, strategies, recommendations and training to prevent maternal foetal deaths. The lecturer believes they can help in enhancing future specialties. Hands-on practice and resident follow-up allow residents to implement what they have learned throughout the training, thereby enhancing the RMNCH strategy.
According to ‘Lack of access to learning resources’, the standard handbook did not contain Laos’ language. The course uses a Thai-English textbook. Moreover, E-learning was advised to be in line with this rapidly changing environment (Sandra Barteit et al. 2019). This will help in addressing the lack of knowledge, study tools, technology and teaching personnel. In a fast-paced world, E-learning may be advantageous if designed and incorporated into a student’s schedule efficiently (Khogali 2022). Since students can acquire online resources and E-learning via the Internet, these may help residents transition to the new method of self-learning. However, free Internet access needs to be considered in the workplace area.
Most of the residents and lecturers cited ‘The class did not conduct surveys to gather student opinions’ and over half of the lecturers had never gathered resident feedback before. Residents’ opinion is essential in improving the quality of teaching. (Lewisson et al. 2013) said that student ratings were one technique for faculty growth in teaching and learning after each semester. This includes formally classifying rotations. According to a current result, lecturers should begin gathering feedback from residents to assess their own education and build methods for continuous quality improvement in the next few years. The OB-GYN programme includes information on how to prevent these issues.
Because the number of lecturers is higher than the residents, ‘lack of staff’ was one problem in the programme. (Griesbach et al. 2021) showed how to determine the optimal number of faculty needed to compare with resident number; less than 25 trainees in a programme need one programme staff or more than 50 trainees should have three staff attending to them. Depending on the current situation, the director of the programme assigned a ‘clinical preceptor’ to assist in following and teaching the residents during their rotation. This puts a clinical preceptor as part of the educational system instead of increasing the number of staff, which is beneficial for the curriculum.
Moreover, ‘The residents wanted more lecture sessions’ without a clear explanation or approbation from the lecturers. In general, lecturers may offer a quick explanation or set them up to study in small peer-to-peer groups to improve learning and peer interaction. More weekly class time on average (Schwerdt et al. 2011) tends to enhance academic success. Flipped or small-group teachings may benefit from learner-specific themes. Giles and colleagues found that medical students remembered best between 15 and 30 min, whereas the first 15 min had the worst retention. A quick overview or a 15- to 30-min lecture would boost residents’ knowledge and joy of learning. Also, our findings concur with Giles and colleagues’ recommendation that most OB-GYN residencies need more short summaries or lectures to enhance understanding.
In conjunction with ‘the course’s outcome’, according to a resident, several of the lecture outcomes overlapped, but the lecturers had a distinct perspective. The lecturers mentioned that the topics were planned out with continuous theory lectures from the beginning of the class until the rotations. Some may appear to ‘overlap’ since each educator from four separate hospitals uses different guidelines; thus, pupils may receive diverse approaches and skills. This should be a question at faculty meetings and residency talks to emphasise the importance of their training. Furthermore, The Accreditation Council for Graduate Medical Education (ACGME) standard-setting guidelines may help resolve the overlap problem and advise residents to improve their performance and learning. One respondent advised separating each lecturer’s delivery of standard material to eliminate topic overlap.
While conducting the in-depth interview, replies with higher and lower CIPP results in each section of the question were included. Thus, to determine what is lacking in the curricula, we compared both lecturers’ and residents’ viewpoints in the survey. The short summary lists the strengths and weaknesses of the problem and suggestions regarding the current OB-GYN programme, including the reasons. The suggestions are shown in Table 5.
Table 5
A Short Summary List of Problems and Suggestions Regarding the Current OB-GYN Programme, Including Reasons.
Problem | Suggestion | What to do |
• The outcome of the class had overlapped | • Clearly separate delivery outcomes for each workplace | • Pre-meeting with rotation clerkship manager |
• Lack of staff and lecturers | • Providing clinical preceptors to guide residents in the rotation | • Setting standard roles for clinical preceptors |
• Insufficient classroom and skills lab | • Online learning | • Faculty development about online learning and plan for a future classroom and skills lab |
• Lack of collecting resident’s opinion | • Provide information regardin g the benefits of student feedback | • Regular survey for quality teaching improvement |
• Resident’s English skills are insufficient | • Increase English class | • Make quarter for English class |
• Lack of funding or budget | • Contact NGO or government support | • Making future plans and meetings with stakesholders |
Consequently, this was the first evaluation of the Lao PDR’s OB-GYN programme at the UHS and the response rate of the participants in the survey was 97.5% (n = 120). Also, the interviewee had a comparative perspective between the two groups: lecturers and residents, which made our findings valuable. Even if there are still certain challenges to be overcome, the data suggest that the programme’s main goal has been achieved to a significant degree.
This study has a few limitations as there was no face-to-face interview conducted due to the COVID-19 pandemic. Moreover, the number of interview groups was small, with only six people and we could not get the opinion of all stakeholders including all staff and co-workers who participated in the educational system.