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      Transforming medical education in Liberia through an international community of inquiry

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          Abstract

          A critical component of building capacity in Liberia’s physician workforce involves strengthening the country’s only medical school, A.M. Dogliotti School of Medicine. Beginning in 2015, senior health sector stakeholders in Liberia invited faculty and staff from U.S. academic institutions and non-governmental organizations to partner with them on improving undergraduate medical education in Liberia. Over the subsequent six years, the members of this partnership came together through an iterative, mutual-learning process and created what William Torbert et al describe as a “community of inquiry,” in which practitioners and researchers pair action and inquiry toward evidence-informed practice and organizational transformation. Incorporating faculty, practitioners, and students from Liberia and the U.S., the community of inquiry consistently focused on following the vision, goals, and priorities of leadership in Liberia, irrespective of funding source or institutional affiliation. The work of the community of inquiry has incorporated multiple mixed methods assessments, stakeholder discussions, strategic planning, and collaborative self-reflection, resulting in transformation of medical education in Liberia. We suggest that the community of inquiry approach reported here can serve as a model for others seeking to form sustainable global health partnerships focused on organizational transformation.

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          Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

          Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.
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            The REDCap consortium: Building an international community of software platform partners

            The Research Electronic Data Capture (REDCap) data management platform was developed in 2004 to address an institutional need at Vanderbilt University, then shared with a limited number of adopting sites beginning in 2006. Given bi-directional benefit in early sharing experiments, we created a broader consortium sharing and support model for any academic, non-profit, or government partner wishing to adopt the software. Our sharing framework and consortium-based support model have evolved over time along with the size of the consortium (currently more than 3200 REDCap partners across 128 countries). While the "REDCap Consortium" model represents only one example of how to build and disseminate a software platform, lessons learned from our approach may assist other research institutions seeking to build and disseminate innovative technologies.
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              Thematic analysis of qualitative data: AMEE Guide No. 131

              Thematic analysis is a widely used, yet often misunderstood, method of qualitative data analysis. It is a useful and accessible tool for qualitative researchers, but confusion regarding the method's philosophical underpinnings and imprecision in how it has been described have complicated its use and acceptance among researchers. In this Guide, we outline what thematic analysis is, positioning it in relation to other methods of qualitative analysis, and describe when it is appropriate to use the method under a variety of epistemological frameworks. We also provide a detailed definition of a theme, as this term is often misapplied. Next, we describe the most commonly used six-step framework for conducting thematic analysis, illustrating each step using examples from our own research. Finally, we discuss advantages and disadvantages of this method and alert researchers to pitfalls to avoid when using thematic analysis. We aim to highlight thematic analysis as a powerful and flexible method of qualitative analysis and to empower researchers at all levels of experience to conduct thematic analysis in rigorous and thoughtful way.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Project administrationRole: ResourcesRole: SupervisionRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Project administrationRole: ResourcesRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Project administrationRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLOS Glob Public Health
                PLOS Glob Public Health
                plos
                PLOS Global Public Health
                Public Library of Science (San Francisco, CA USA )
                2767-3375
                8 March 2023
                2023
                : 3
                : 3
                : e0001610
                Affiliations
                [1 ] Department of Medicine, Yale University, New Haven, Connecticut, United States of America
                [2 ] Republic of Liberia Ministry of Health, Monrovia, Liberia
                [3 ] Liberian College of Physicians and Surgeons, Monrovia, Liberia
                [4 ] Department of Health Policy, Vanderbilt University, Nashville, Tennessee, United States of America
                [5 ] Clinton Health Access Initiative, Boston, Massachusetts, United States of America
                [6 ] University of Liberia College of Health Sciences, Monrovia, Liberia
                [7 ] Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
                [8 ] A.M. Dogliotti School of Medicine, University of Liberia College of Health Sciences, Monrovia, Liberia
                Institute of Public Health Bengaluru, INDIA
                Author notes

                The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-5708-1222
                https://orcid.org/0000-0002-4547-4715
                https://orcid.org/0000-0003-0827-6442
                https://orcid.org/0000-0003-0709-3011
                https://orcid.org/0000-0003-0260-8266
                https://orcid.org/0000-0001-7342-2608
                https://orcid.org/0000-0002-9994-1366
                Article
                PGPH-D-22-01334
                10.1371/journal.pgph.0001610
                10021565
                36963025
                af7556ee-523c-4095-ac9d-b54ecc9f6459
                © 2023 Talbert-Slagle et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 15 August 2022
                : 26 January 2023
                Page count
                Figures: 7, Tables: 7, Pages: 23
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100009054, U.S. President’s Emergency Plan for AIDS Relief;
                Award ID: UH630738
                Award Recipient :
                Funded by: USAID PEER/Liberia
                Award Recipient :
                Funded by: World Bank
                Award ID: D00080
                Award Recipient :
                Funded by: Jackson Institute for Global Affairs
                Award Recipient :
                Funded by: USAID BRIDGE-U: Liberia
                Award ID: 7200AA21CA00010
                Award Recipient :
                Sponsor: Yale Jackson Institute for Global Affairs Specific grant/funding information: Student travel support and faculty effort support provided by Jackson Institute (no grant number available) URL to Sponsor’s website: https://jackson.yale.edu/ Authors funded by this sponsor: SL, JF, DA, MR, KTS Sponsor: PEPFAR/HRSA Specific grant/funding information: Title: “Resilient and Responsive Health Systems in Liberia” (award numbers 4 UH6HA30738-05-12 and 5 UH6HA30728-05-00) URL to Sponsor’s websites: PEPFAR: https://www.state.gov/pepfar/ and HRSA https://www.hrsa.gov/. Authors funded by this sponsor: KTS, NA, AY, CP, OO, RM, AR, LS, ZA, AB, BD Sponsor: World Bank Specific grant/funding information: “Ebola Emergency Response Project: Grant #.D00080 Contract No. PIU/EERP:24/2017.TA” URL to Sponsor’s website: https://www.worldbank.org/en/home. Authors funded by this sponsor: KTS, OI, NA, MMiller, AR, OO Sponsor: USAID/National Academy of Sciences Specific grant/funding information: PEER/Liberia (subaward number 2000009598) URL to Sponsor’s website: https://sites.nationalacademies.org/PGA/PEERLiberia/index.htm. Authors funded by this sponsor: MMartin, OO Sponsor: USAID Specific grant/funding information: Title: “BRIDGE-U: Applying Research for a Healthy Liberia” (award number 7200AA21CA00010) URL to Sponsor’s website: https://www.usaid.gov/. Authors funded by this sponsor: KTS, NA, MMartin, CP, OK, JS, BD None of the funders who supported this work played any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Custom metadata
                Data from the 2016 survey can be accessed at: https://doi.org/10.5061/dryad.573n5tbb2 Data from the 2017 needs assessment can be accessed at: https://doi.org/10.5061/dryad.j0zpc86jm Data from the 2018 needs assessment can be accessed at: https://doi.org/10.5061/dryad.j3tx95xj6.

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