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      Design and Implementation of a Distant-Learning Clinical Research Mentorship Program: The Accra-Toronto Collaboration

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          Abstract

          PURPOSE

          For many oncology training programs in low- and middle-income countries, dedicated time for research education and mentorship of trainees is limited. Here, we report a 1-year–long collaboration between a cancer center in Canada and one in Ghana with the aim of imparting clinical research skills and mentoring the research of radiation oncology residents.

          METHODS

          On the basis of a needs assessment conducted in Ghana, we designed a curriculum consisting of 13 weekly seminars delivered via videoconference, followed by a 1-year–long mentorship program to support research projects. The primary outcome was the feasibility of the program from seminars to manuscript preparation. We used multiple secondary outcomes to capture the learning experience with study-specific questionnaires. We evaluated critical thinking ability using the Berlin questionnaire. Funding was made available for research and travel to international conferences.

          RESULTS

          Five Ghanaian trainees submitted research proposals. Nine Canadian faculty members delivered the seminars and two served as methodology mentors, and two Ghanaian faculty acted as local supervisors. Feedback questionnaires from all participants showed that they agreed strongly that they would recommend the sessions to another resident (75%), that the objectives were clear (71%), and that the topics were useful for their training (73%). At the end of the program, two Ghanaian trainees finalized their manuscripts and one was published.

          CONCLUSION

          Here, we report on the implementation of a mentorship program focused on research methods and evidence-based medicine in sub-Saharan Africa. The program was successful in the drafting and publication of abstracts and manuscripts by local trainees.

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          Most cited references7

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          Health research capacity development in low and middle income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature

          Objectives Locally led health research in low and middle income countries (LMICs) is critical for overcoming global health challenges. Yet, despite over 25 years of international efforts, health research capacity in LMICs remains insufficient and development attempts continue to be fragmented. The aim of this systematic review is to identify and critically examine the main approaches and trends in health research capacity development and consolidate key thinking to identify a more coherent approach. Methods This review includes academic and grey literature published between January 2000 and July 2013. Using a predetermined search strategy, we systematically searched PubMed, hand-searched Google Scholar and checked reference lists. This process yielded 1668 papers. 240 papers were selected based on a priori criteria. A modified version of meta-narrative synthesis was used to analyse the papers. Results 3 key narratives were identified: the effect of power relations on capacity development; demand for stronger links between research, policy and practice and the importance of a systems approach. Capacity development was delivered through 4 main modalities: vertical research projects, centres of excellence, North–South partnerships and networks; all were controversial, and each had their strengths and weaknesses. A plurality of development strategies was employed to address specific barriers to health research. However, lack of empirical research and monitoring and evaluation meant that their effectiveness was unclear and learning was weak. Conclusions There has been steady progress in LMIC health research capacity, but major barriers to research persist and more empirical evidence on development strategies is required. Despite an evolution in development thinking, international actors continue to use outdated development models that are recognised as ineffective. To realise newer development thinking, research capacity outcomes need to be equally valued as research outputs. While some development actors are now adopting this dedicated capacity development approach, they are in the minority.
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            Do short courses in evidence based medicine improve knowledge and skills? Validation of Berlin questionnaire and before and after study of courses in evidence based medicine.

            To develop and validate an instrument for measuring knowledge and skills in evidence based medicine and to investigate whether short courses in evidence based medicine lead to a meaningful increase in knowledge and skills. Development and validation of an assessment instrument and before and after study. Various postgraduate short courses in evidence based medicine in Germany. The instrument was validated with experts in evidence based medicine, postgraduate doctors, and medical students. The effect of courses was assessed by postgraduate doctors from medical and surgical backgrounds. Intensive 3 day courses in evidence based medicine delivered through tutor facilitated small groups. Increase in knowledge and skills. The questionnaire distinguished reliably between groups with different expertise in evidence based medicine. Experts attained a threefold higher average score than students. Postgraduates who had not attended a course performed better than students but significantly worse than experts. Knowledge and skills in evidence based medicine increased after the course by 57% (mean score before course 6.3 (SD 2.9) v 9.9 (SD 2.8), P<0.001). No difference was found among experts or students in absence of an intervention. The instrument reliably assessed knowledge and skills in evidence based medicine. An intensive 3 day course in evidence based medicine led to a significant increase in knowledge and skills.
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              Educational needs assessment, development of learning objectives, and choosing a teaching approach.

              How physicians are evaluated throughout their careers and how training programs are accredited has shifted from demonstrating what we teach and what we are learning to demonstrating the achievement of competence. This article discusses some of the components involved with determining and providing necessary educational experiences. These steps apply to various educational needs and settings such as development of curriculum for training programs, clinical staff development, courses in continuing medical education, and identifying learning needs throughout practice. Covered in this article are three components to this process: needs assessment, development of learning objectives, and choosing a teaching approach. A needs assessment is a first step in this process and can be applied to determining revisions in curriculum, identifying needs in clinical staff development, and to self-identifying individual learner status. Once conducted, the identified curriculum needs are linked to the development of learning objectives and outcome statements that identify the knowledge, skills, and attitudes that learners are expected to demonstrate. Finally, understanding of teaching methods is essential to selecting the ones that best fit the identified needs and outcomes of the educational experience. Understanding the separate components involved with learning and curriculum development can ultimately lead to improvement and enrichment of the experiences of learners and educators.
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                Author and article information

                Journal
                JCO Glob Oncol
                JCO Glob Oncol
                go
                go
                GO
                JCO Global Oncology
                American Society of Clinical Oncology
                2687-8941
                2020
                30 June 2020
                : 6
                : JGO.19.00240
                Affiliations
                [ 1 ]Princess Margaret Cancer Centre, Toronto, Ontario, Canada
                [ 2 ]Columbia University, Department of Radiation Oncology, New York, NY
                [ 3 ]Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
                [ 4 ]National Center for Radiotherapy, Accra, Ghana
                [ 5 ]Stronach Regional Cancer Center, Newmarket, Ontario
                Author notes
                Rebecca K.S. Wong, MBChB, MSc, Princess Margaret Cancer Center, 610 University Ave, Toronto, M5G2M9 ON, Canada; Twitter: @HoriaVulpe, @RebeccaKSWong; e-mail: rebecca.wong@ 123456rmp.uhn.ca .
                Article
                1900240
                10.1200/JGO.19.00240
                7328115
                32603189
                56fa1383-5a76-499c-b333-c375736424c4
                © 2020 by American Society of Clinical Oncology

                Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: https://creativecommons.org/licenses/by-nc-nd/4.0/

                History
                : 05 May 2020
                Page count
                Figures: 5, Tables: 2, Equations: 0, References: 17, Pages: 10
                Categories
                00, Radiation Oncology
                Original Reports
                Custom metadata
                v1

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