Transformative Education
for Health Professionals

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Key Policy Issue #2: How to conduct monitoring and evaluation and who should be responsible?

Effective monitoring requires information systems that produce relevant and reliable data in a timely and easily accessible manner (Dal Poz, 2012). In most countries, basic health workforce data, including those relating to the process of being educated, are deficient. Typically, data are dispersed among numerous organizations that collect information on different parameters, and use different definitions and timeframes, with the result that data quality varies in terms of consistency, validity, reliability, comprehensiveness and comparability over time. In general, data on health professionals employed in public services are more complete than on those in the private sector. Few countries produce data on multiple employment, productivity, or on the mobility of health workers. The introduction of transformative changes in education is an opportunity to review the strengths and weaknesses of current information systems, and to build systems that will make it possible to monitor and assess the effects of changes on the quantity, quality and relevance of new health professionals. In order to interpret data and to evaluate policy implications, explicit criteria and targets for these expected results are needed.

Data collection is best carried out by organizations closely involved with health eduction, e.g. training institutions (for quantity), professional regulatory bodies such as accreditation agencies and professional councils (for quality and relevance), and employers (for quantity, quality, and relevance). A high level of collaboration between key stakeholders is needed to reach agreement on the data to be collected, the definition of indicators, and on the sharing of the results. Some sort of clearinghouse that gathers data from different sources is needed. It can take different forms, such as an independent public institute (Canadian Institute for Health Information, the UK Centre for Workforce Intelligence), or a health workforce observatory (Brazil’s network), for example. Whatever the type of organization, its goal should be to ensure the quality and relevance of data, which should allow tracking graduates, in particular their professional options, such as their field and location of practice. This may be best done centrally rather than at an institutional level, by an accrediting body or a relevant government agency.