Column Editor: Helena Prior Filipe, MD, MMEd
CPD in Mexico: The journey of Tecnologico de Monterrey, School of Medicine and Health Sciences to improve faculty scholarship and performance
By Mildred Lopez, MD
Dr. Lopez is the Director of Educational Innovation Tecnologico de Monterrey, School of Medicine and Health Sciences in México. She shares her particular perspective, experiences, challenges and aspirations regarding the implementation of the CPD Office she leads.
The journey of the School of Medicine and Health Sciences in Tecnologico de Monterrey has been exciting. We are a young institution, a couple of years ago, we celebrated our 40th anniversary. The school started with only one program and 27 students. As time has gone by, it has become one of the 25 best schools in Latin America and has trained health professionals that practice worldwide.
The dream that started in 1978 now articulates the TecSalud Health System, integrated by the Academic medical centers of San José and Zambrano Hellion Hospital and the TecSalud Foundation. As years have gone by, also have our conception of the needs of the organization. There are five undergraduate programs, 16 medical residency programs, and four scientific programs (two masters and two PhD). Our faculty members and collaborators are involved in creating innovative solutions and proposals with a patient-centered focus.
This vision on transforming Mexican healthcare, and becoming leaders in the region, has guided how we define our continuous professional development (CPD) activities and assessment methods. A few years ago, we were aligned with a highly traditional CPD paradigm where the clinician’s assessment was knowledge-based. This method was limited to observing the quantity and level of academic scholarship, the prestige of the universities where faculty have completed their training, the results of their English examination, and the letters of recommendations of peers in their disciplines. As experience has shown, this evidence does not guarantee the professionals’ outcomes with learners or patients. More information was needed on their involvement with quality of care or student involvement in the hospital setting.
In 2012, we started the first version of a new faculty development program for clinical educators, which in 2018 evolved into a competency-based model for continuous performance improvement of clinical educators. The objective was to create a new paradigm whereby medical practitioners could develop the leadership and educational competencies needed in clinical settings. This model embraced six essential competencies: 1) apply basic instructional skills, 2) foster learning in the clinical setting, 3) assess and debrief performance, 4) manage healthcare educational technology, 5) educate on bioethics and citizenship, and 6) promote quality and patient safety management.
As evidence of the development of clinicians’ competence, learners design a performance improvement project to implement within their own practice environment and measure the outcomes. The projects vary in their magnitude and topics, some describe initiatives in their practice, and others involve innovative teaching methods with medical residents. These interdisciplinary projects show the participants’ commitment to scholarship, as they have presented their projects and findings at many regional and international conferences. Since its implementation, the results and successes of our faculty development program have been shared in different forums. To this date, the school has received several awards for this program: Qs Stars Award 2016, Ted Freedman Award for Innovation in Education of the Canadian Association for Health Services and Policy Research (CAHSPR) in 2016, and as a finalist project in Reimagine Education 2017.
As a consequence of this new CPD program, clinician habits have changed. We have become a community of lifelong learners eager to do more. Now, our leaders are involved in different CPD organizations and committees where they have received formal and informal training in quality and performance improvement techniques. They are now familiar with concepts and practices that before were deemed as optional. In turn, this has translated into new policies and support for greater faculty involvement in the quality and performance improvement initiatives of the institution.
One of these new initiatives is our Educational Innovation Groups, where on average, 64 clinicians participate every semester in designing educational innovation projects. These groups also foster interprofessional development where health professionals from all domains collaborate. Students from health and other disciplines help to identify the improvement issues that need to be studied. To date, 76 scholarly papers have been published by these groups. It can be seen that in the first couple of years, one or two papers were published. In 2020, these groups published 19 papers describing innovation projects focused on the professional development of health specialists.
When we witness a profound transformation and, in a short time such as this one, genuinely focused on improving the quality of medical practice, one can only look forward with hope. I hope that our journey can inspire other schools to dream of the impossible. In times such as the ones we are facing today, where hope is nowhere to be seen, a community such as the one we are helping to build is everything. There is still much to be done, but we have worked on a solid foundation to map, plan and grow together.
Helena Prior Filipe, MD, MMEd, is a consultant in the College of Ophthalmology of the Portuguese Medical Association International Council of Ophthalmology, University of Lisbon, Portugal.