Opportunities and Challenges for Implementation of Harmonized Competence-Based Curricula in Medicine and Nursing Programmes in Tanzania: Experiences of Biomedical Sciences' Stakeholders

Nathanael Sirili; Doreen Mloka; Lilian Mselle; Rodrick Kisenge; Erasto Mbugi; Dennis Russa; Obadia Nyongole; Stephen E Mshana; Rose Laisser; Kien Mteta; Levina Msuya; Eligius Lyamuya; Judith Martin-Holland; Gideon Kwesigabo; Ephata Kaaya

doi:10.2147/AMEP.S381242

Opportunities and Challenges for Implementation of Harmonized Competence-Based Curricula in Medicine and Nursing Programmes in Tanzania: Experiences of Biomedical Sciences' Stakeholders

Adv Med Educ Pract. 2023 May 22:14:487-498. doi: 10.2147/AMEP.S381242. eCollection 2023.

Authors

Nathanael Sirili¹, Doreen Mloka², Lilian Mselle³, Rodrick Kisenge⁴, Erasto Mbugi⁵, Dennis Russa⁶, Obadia Nyongole⁷, Stephen E Mshana⁸, Rose Laisser⁹, Kien Mteta¹⁰, Levina Msuya¹¹, Eligius Lyamuya¹², Judith Martin-Holland¹³, Gideon Kwesigabo¹⁴, Ephata Kaaya¹⁵

Affiliations

¹ Department of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
² Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
³ Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
⁴ Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
⁵ Department of Biochemistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
⁶ Department of Anatomy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
⁷ Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
⁸ Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
⁹ Archbishop Anthony Mayalla School of Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
¹⁰ Department of Surgery, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
¹¹ Department of Paediatrics and Child Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
¹² Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
¹³ Department of Physiological Nursing, University of San Francisco California, San Francisco, CA, USA.
¹⁴ Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
¹⁵ Department of Pathology, Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Abstract

Background: In 2012, the Muhimbili University of Health and Allied Sciences (MUHAS) embarked on structured competency-based curricula (CBC) for its programmes. Other health profession training institutions continued with their traditional way of teaching and thus causing variability in the competencies of the graduates. We aimed to analyze the experiences of different stakeholders on the implementation of CBC specifically on biomedical sciences by MUHAS to inform the development of harmonized competency-based curricula in three health professional training institutions in Tanzania.

Methods: We adopted an exploratory case study to analyse the implementation of CBC in programmes of Medicine and Nursing involving MUHAS graduates, immediate supervisors at the employment sites, faculty, and continuing students at MUHAS. Kiswahili guides were used to conduct the in-depth interviews (IDIs) and focus group discussions (FGDs). Qualitative content analysis was adopted for analysis.

Results: From the 38 IDIs and 15 FGDs, four categories of human resources teaching and learning environment; curriculum content; and support systems emerged. Human resources were attributed to the shortage of an adequate number of faculty and teaching skills variation. The curriculum content category was linked to the redundancy of courses or topics, poor sequencing of some topics or courses, and limited time for teaching some essential courses or topics. Training and practice area mismatch, accommodation to students, teaching space, and library were the sub-categories linked to teaching and learning environment. Lastly, support systems related to teaching methods and opportunities for improving teaching and learning were revealed.

Conclusion: The findings of this study highlight the challenges and opportunities for the implementation of CBC. The solutions to the revealed challenges are beyond the training institutions' capacity. The latter call for multi-stakeholder engagement including those from the public and private sectors in health, higher education and finance for common and sustainable solutions.

Keywords: Tanzania; biomedical sciences; competency-based curricula; harmonized training; health training institutions; teaching pedagogy.

Grants and funding

This work was supported through the Transforming Health Professions Education in Tanzania (THET) consortium, under the Health Education Partnership Initiative (HEPI) Project, funded by the NIH through the Fogarty International Centre, Grant No. IR25TWO11227-01.