Supporting paediatric and neonatal learning in hospitals

Workplace-based Learning and Assessment

Marcus Wootton and Dr Sarabibi Thuzarwin
UNICEF
UNICEF Myanmar/2020/Dr Natasha Liow
29 June 2020

Hospitals, vital for treatment and healing, are also critical places for learning, bridging the gaps between the theory taught to medical students in universities and the practice the young doctors need to deliver as a clinician at the bedside. 

UNICEF supports the Myanmar Neonatal and Emergency Paediatric Care Programme, to improve the quality of childcare delivered through regional and district hospitals in Myanmar and to standardise paediatrician practice in the country’s hospitals.

The Myanmar Paediatric Society and the Royal College of Paediatrics and Child Health have partnered with UNICEF since 2016 in this programme which builds the competencies of young doctors during their paediatric postgraduate course, at the start of their paediatric careers, setting high standards from the outset.

Throughout 2019, the Myanmar Paediatric Society led a pilot programme for Workplace-based Learning and Assessment, working with 85 second-year paediatric postgraduate master’s students and their individual learning portfolios, which set out competencies to be achieved. 

The Workplace-based Learning and Assessment tool was developed by a Myanmar-UK working group, based on international models and adapted to support the standards of the Myanmar Paediatric Society and to fit the local context. It focuses on areas of practice that form the bulk of Myanmar’s inpatient mortality and morbidity, including pneumonia, sepsis and dengue. Common clinical skills such as resuscitation (the process of correcting lack of breathing or heartbeat) and IV cannulation (a technique to insert a tube into a vein).  The competencies include clinical and non-clinical practices, such as communication, leadership and teaching.

A standard nationwide assessment criterion is applied to review the completed portfolios and checked by senior Myanmar paediatricians. 

From the very encouraging results demonstrated in the pilot, supervisors and students have reported significant improvement in student practice, confidence, structure, and quality. The new approach also allowed for targeted support of students who were not meeting the criteria, where it was needed.

This ambitious drive towards the standardisation of practice had never been attempted in this context in Myanmar before. The pilot shows that Workplace-based Learning and Assessment approaches form a viable new element to paediatric postgraduate education and wider quality assurance within the health system.

The 2020 Workplace-based Learning and Assessment cohort was scaled up to include all third-year students. 

The portfolio has now been delivered to 170 second and third-year students. The lessons and principles from this pilot are to be extended to other hospital staff members, including nurses.

The Workplace-based Learning and Assessment pilot has shown that the standardisation of practice, a foundational principle of high-quality care for children, is achievable within a Myanmar context.