Background and Rationale
In a show of recognition of the value of education for socioeconomic development of the country, the Government of Ethiopia has opened several higher learning institutions over the last decade. Arsi University is one of newly established universities taking upon itself has a motto of “Like our star athletes excelling professionals” by putting quality and problem-solving education at the center stage. Arsi University is Located at an altitude of 2150 – 2400 meter above sea level. It is evolved from the former Adama Science and Technology University college of Health and college of agriculture Asella campuses. Arsi University is officially inaugurated in, 2007 E.C which is located 159 KM from Addis Ababa in Southern-East Ethiopia, Arsi zone, Asella Town by having the Moto of “Like our star athletes, excelling professionals”
Currently, the University has the following Schools and Colleges are active in Asella and Bokoji campuses, School of Graduate studies, School of Law College of Health Sciences College of Agriculture & Environmental Science College of Business and Economics College of Computational Sciences College of Education & Behavioral Sciences College of Natural Sciences, and College of Social Sciences and Humanity
Though it is youngest, Arsi University currently accommodates thousands of undergraduate and postgraduate students, and runs 36 undergraduate and 17 graduate programs with human resource capacity of around 2120 staffs (432 academic and 1688 supporting). From those staffs CoHS accounts around 1365 staffs
Beside this, under College of Health Sciences it has an eye ball referral Hospital, Asella Teaching and Referral Hospital, which serves all communities of Arsi Zone, West Arsi Zone, Bale, East Showa, West Harare and other neighboring zones of Oromia region. ATRH serves as catchments about 5 million people. The University has shown a series of developments and expansions in different field of studies due to the increased demand for trained man power in the region as well as in the country at large. The graduate programs (both at MSc and PhD levels) already started in some departments in Arsi University
Arsi University College of Health Sciences (ARUCHS), has more than 20 years of cumulative experience in teaching and learning processes. Health Science College has 9 undergraduate program and 5 post graduate programs 4 Major dep’t specialty program (Internal medicine, General surgery, Pediatrics &Child health and Gyn/Obs) and General MPH extension based post graduate programs and will have other PG programs near future.
Medical service available in Asella teaching & Referral hospital:
- General surgery
- Trauma & Orthopedic surgery
- Urology surgery
- Maxillo – facial surgery
- Neuro surgery
- Gynecology & Obstetrics surgery
- Fistula care
- Internal medicine
- Pediatrics and Child health
- ICU service
- Cancer treatment
- Radiology & Imaging service
- Dental medical care
- Psychiatry care
- HIV treatment
- Neonatal Intensive care Unit and so on.
- Ophthalmology surgery
There are two programms in Anesthesia department
A. undergraduate program (BSc. Anesthesia)
Mission and Objectives of the Program
To produce competent Anesthesia professionals who will provide the full scope of
Anesthesia Service, as defined by the professional scope of practice, with good knowledge, clinical skills, Attitude and critical thinking abilities.
- To equip Anesthesia professionals with solid knowledge of biomedical science, clinical and public health practice
- Prepare anesthesia students to assess and optimize patients with co morbidity for surgery and anesthesia
- Prepare Anesthesia students in providing individualized anesthesia clinical care using anesthesia management plan.
- Equip anesthesia students on the management of patients with multiple Co-existing diseases using the existing scientific knowledge
- To enable anesthesia students practice in a professional manner on all level of anesthesia clinical care setting
- Train anesthesia student in developing professional communication skill in dealing with patients family and other health professionals
- Prepare the Anesthesia students participate in conducting and utilizing relevant research findings
- Train anesthesia students apply evidence based Anesthesia clinical care practice
- Train the anesthesia student in practical skills based on theoretical foundation
- Equip the anesthesia students with leadership and management skills
- Equip anesthesia students with critical thinking and decision-making skills which lead to reflective and responsible practice
- Equip with knowledge and skill in emergency and critical care which help them to handle critically ill patients
Anesthesiology as a branch of medical practice represents a unique, exciting, specialized, and challenging art and science that deals with perioperative and ICU management of a surgical and/or medical patient. Moreover, it also plays a role in promotional and curative services at community level. As a young and dynamic profession, it requires keeping abreast of evolving changes. The recent innovations in educational techniques, frequent changes and new developments in anesthesia on the wide spectrum of services require professional graduates to be more of task-oriented. Anesthesia training for non-physicians in Ethiopia started in the mid-1970s in Addis Ababa in previous Duke of Harar Memorial Hospital currently Tikur Anbessa Specialized Hospital. Since that time, anesthesia training has developed from advanced diploma level to BSc and MSc levels gradually. Initially, the BSc in Anesthesia enrolled practicing nurses and more recently, a ‘generic’ BSc in Anesthesia has been developed to train anesthesia practitioners straight from leaving school, without the requirement of previous clinical experience. This ‘generic’ BSc in Anesthesia was first started in University of Gondar in 2003 and is taught in more than a dozen of governmental Universities since 2004. Currently, in Ethiopia, anesthesia is predominantly provided by non-physician anesthetists as there is a shortage of physician anesthesiologists. As stated in HDP IV, there is a significant un-met need for qua ed anesthesia professionals, especially when considering the long lead time and limited involvement of the private sector in training these professionals. Moreover, the lack of retention mechanism for mid-level anesthesia professionals (Level V and diploma
graduates) worsened the task force crisis. Although it’s known that most institutions launch generic anesthesia training to solve these problems, All have been using nearly same curricula with different approach to award similar BSc degree. Cognizant this, the Federal Ministry of Health took the initiative to produce nationally harmonized a competency based, integrated and modular curriculum at bachelor degree level to train Anesthetists as generic anesthesia program in 2019. The whole endeavor is directed towards examining if the objectives of the program are attainable, clear and appropriate to the courses offered and are capable of producing the desired type and level of competencies. Besides, this curriculum review aimed at assuring that the anesthesia service needs of the country are satisfied through the production of qualified anesthetists who can manage all new techniques for all general and specialty surgeries encompassed under the scope of these professionals. Generic Anesthesia education has the study of general education courses from natural, social sciences as well as basic courses from the biomedical sciences and moreover will enforce to integrate major clinical courses. Anesthesia professional courses assist the attainment of knowledge and skills and the development of attitudes and values essential to competent clinical anesthesia practice and beginning professional leadership through extensive lab practice and clinical field experience as well as evidenced based theory. The goal of this particular program is to prepare a competent Anesthesia professional and to provide a foundation for under graduate education programs in generic BSc Anesthesia
1. Direct observation of Practice (DOP)
The purpose of DOPs or mini-clinical evaluation exercise3 is to assess clinical skills while a student interacts with patients in different settings. Typically it takes 15-20 minutes and the assessor follows the student with a checklist and gives feedback at the end. The DOPs offers students immediate and ongoing feedback about their observed clinical skill and performance (interviewing skills, physical examination skills, and professionalism, clinical judgment, counseling skills organization/efficiency and overall clinical competence). This method will be used in all years of the training and there will be at least two DOPs to be performed by a student in each module. This assessment method enables one to follow the progress of the student and will be used for formative assessment.
2. Objective structured examination
Objective structured clinical examination (OSCE) is a performance-based exam. During the exam, students are observed and evaluated as they go through a series of 8 or more stations. It allows assessment of multiple competencies. It is Objective, because examiners use a checklist for evaluating the trainees; structured , because every student sees the same problem and performs the same tasks in the same time frame; Clinical , because the tasks are representative of those faced in real clinical situations. These increase the reliability and validity of the assessment. OSCE1 is a standardized means to assess history taking, physical examination skill, communication skills, ability to summarize and document findings, ability to make a differential diagnosis or plan and execute different anesthesia management options/ techniques, clinical judgment based on patient ‘s note and procedural skills. OSCE may use manikins and simulators, standardized patients and real patients. Standardized patients are healthy persons trained to simulate a medical condition in a standardized way. Health science students, health facility staff and faculty may serve as standardized patients. Objective structured practical exam (OSPE) is a variant of OSCE to assess students’ knowledge and skill in a non-clinical setting. Both OSCE/OSPE will be part of the summative assessment and will be implemented from year 1-3 in the post-basic anesthesia program.
3. Practical Clinical Examination (PCE)
41 Practical Clinical Examinations assessment presents the student with a complete and realistic clinical challenge thereby enabling the evaluator to see the complete picture of the student’s ability in addressing the challenges. The use of multiple cases improves reliability of the examination, which is a major weakness in the traditional long case. Additional improvements to the traditional long case that would improve reliability are observing the student-patient interaction and using checklist and increasing the number of examiners.
4. Standardized oral exam
The standardized oral examination2 is a type of performance assessment using realistic patient cases for questioning the examinee. The examiner begins by presenting to the examinee a clinical problem in the form of a patient case scenario and asks the examinee to manage the case. Questions probe the reasoning for requesting clinical findings, interpretation of findings, and treatment plans. In efficiently designed exams each case scenario takes three to five minutes. One or two faculty serve as examiners and students can be tested on several different clinical cases. Oral exam will be part of the summative assessment in final year comprehensive examination.
5. Written exam
Written assessments may include different item formats such as multiple choice questions, matching, true false, essay and short answer. Written assessment methods will help to evaluate knowledge and understanding of basic, clinical, public health and psychosocial sciences and professionalism and ethics. Important point to remember is to ensure written exams assess higher order knowledge in addition to recall and comprehension. Written assessments would be parts of both as formative and summative assessment in all years of the post-basic anesthesia program.
Logbook documentation serves as evidence of scope of patient care and community experience to meet requirements or specific learning outcomes. Maintaining logbook will encourage students to make use of all possible learning opportunities for clinical/procedural skills and community skills to fulfill minimum requirement. Regular review of logbook can be used to help the student track what procedures or experiences must be sought to meet requirements. The logbook document should be counter signed by faculty. The number reported in a logbook may not necessarily indicate competence. Logbook will be part of the formative assessment throughout the post-basic anesthesia curriculum.
Portfolio1 is collection of papers and other forms of evidence that learning has taken place. It provides evidence for learning and progress towards learning objectives. Reflecting upon what has been learned is an important part of constructing portfolio. In addition to products of learning, the portfolio can include statement 42 about what has been learnt, its application, remaining learning need, how they can be met. Portfolio helps to assess learning outcomes including those that are not easy to assess with other methods like personal growth, self-directed learning, reflective ability, self-assessment of personal growth and professionalism. Portfolio allows assessment of progress towards learning outcomes by using chronological work samples collected at different points in time. Portfolio will be part of the formative assessment throughout the duration of the post-basic anesthesia training and can be used as a summative assessment during professional anesthesia practice.
8. Global Rating
Global Rating is assessment of general categories of ability (e.g. patient care skill, medical knowledge, interpersonal and communication skills, professionalism, etc.) retrospectively based on general impression over a period of time and derived from multiple source of information. The purpose is to evaluate knowledge, skill and attitude over a period of time during and at the end of specialty clinical attachment thereby helping the evaluation of the student’s effort across time. Global rating will be main part of both formative and summative assessment of students throughout the duration of the post-basic anesthesia Curriculum. Some of the simple but critical assessments will be either passed or failed, whilst the others will be marked out of 4 points. 4 is considered excellent, 3.5 good, 3.0 satisfactory, 2.0 “needs to improve” and 1.0 is poor. A grade point average of 3.0 or more in each Module is required to successfully complete the module.
Rules, Regulations and Requirements
Candidates must fulfill the following criteria:
1. Meet the criteria set by ministry of education for degree students.
2. Have a background of natural sciences.
3. Preferably those who choose to enter the profession.
4. Applicant must be physically and mentally fit.
5. Top scorer students in ministry of education entrance for degree program will be encouraged
Criteria for Promotion
§ Promotion will be conducted every time when a module is completed
§ Pass mark for any module will be at least a C grade (for Professional modules) & any grade for general/ supportive modules.
§ No “less than C grade in all major supportive modules (Medicine, surgery, pediatrics Gyn& Obs and Physical Diagnosis) professional modules refer to grading system
§ If the student fail in one core/ Professional/ module (with module ECTS less than 5), He /She can repeat the assessment while continuing the next module
§ If a student has failure in more than one module or a module of greater than 5 ECTS, remedial exams will not be allowed and the student will be required to repeat the failed module(s) in the next year.
§ Any student who fails a remedial exam will repeat the modules.
§ Any student who fails in the final comprehensive qualifying examination is required to work under supervision for 5 months duration and re-examined.
§ Presnt complete , signed and approved Assessement tools (CBD,DOP,PCE,Continous assessment) at the end of each Module.
Graduation requirement will be according to each university rule and regulation. Thus, a student enrolled in the Post Basic BSc anesthesia program is eligible for graduation if and only if he/she has taken all the required Modules for the program and obtained a minimum CGPA of 2. Student should be able to pass comprehensive exam of the school, both in theory and practice before graduation.
Has not scored ‘F’ grade in any module, and should not score ‘D’ grade in any professional (core) module.
- Has carried out a student research project on a selected and agreed topic of research problem and scored a minimum of ‘C’ grade in his/her thesis report.
- Present approved and signed log/performance book with a minimum of 250 cases of which the graduate:
- Performs pre-anesthetic assessment for 250 clients
- Performs 200 endotracheal intubations
- Performs of 20 LMA insertions
- Performs of 200 endotracheal and/or LMA extubation
- Performs 50 intravenous cannulation
- Major General Anesthesia for 200 cases
- Attended 15 pediatrics &/ or Neonatal Anesthesia
- Delivers Anesthesia for 50 Obstetrics clients
- Handles 30 emergency cases requiring Anesthesia
- Provided sedation (analgesia) without intubation for 20 cases
- Performs minimum of 50 regional blocks (caudal, spinal, abdominal field blocks and peripheral nerve blocks etc.)
- Produce thesis
- Student must pass Final Year Comprehensive Exam
Internal exam 40% (written -10%, Oral (10%), OSCE (10% ) & Progressive ass’t – 10% and External examination 60% (practical & oral); this is non- credited but is Passed or failed.
If a student can’t pass the exam he /she will be delayed for 5 months and re-examined. Examined by group senior Anesthesia professionals from different universities
Upon completion of the Four and half years program, the graduate will be awarded the degree of ‘Bachelor of Science in Anesthesia’ and in Amharic ‘የሳይንስ ባችለር ዲግሪ በአንስቴዝያ’
Duration and total load of the study: The program will be completed in four and half academic years for regular program Quality Improvement, Monitoring and Evaluation
Higher institutions delivering this program will establish a health sciences education development center (HSEDC) to lead and coordinate quality assurance and program monitoring and evaluation. Quality assurance will be guided by Anesthesia program level educational standards defined by the Higher Education Relevance and Quality Agency.
The ongoing quality of the Post Basic Anesthesia education will be monitored and ensured through: Establishment of a curriculum committee under the HSEDC to oversee the implementation of the curriculum, develop standard guidelines for teaching and assessment and make necessary adjustments along the way. Self-review of the educational inputs, processes and outputs (including human resources physical infrastructure, teaching/learning in classroom, skills lab, clinical and community settings, student assessment, management and governance and student performance results) semi-annually and taking action. This will be
coordinated by the quality assurance committee or team.
Organizing regular faculty development and support programs on instructional methods, technical updates, research, leadership, etc. This will be coordinated by the faculty development committee or team.
Establishment of an assessment committee or team under the HSEDC to develop and maintain exam banks and coordinate, review and administer student assessment practices
Evaluation of teaching effectiveness by systematic collection of feedback from students and at the end of each module or attachment and use it for program improvement Peer and module/rotation evaluation by instructors at the end of module delivery
Annual assessment of the program by the teaching staff
Exit interviews at graduation and for all those who drop out for any reason
Monitoring students’ pass rate in national qualification (pre-licensure) exam and comparing it with other Anesthesia schools
Establishing alumni of graduates as a mechanism to assess their career choice and development Evaluation of graduates performance including obtaining feedback from employers and society and use the information for program improvement
Review of curriculum every Four years to be led by the curriculum committee under the HSEDC
Anesthesia department started in 2007 E.C by Enrolling 13 Student. The dept has successfully graduates 3 batch students F=26 M= 24. Total of 50 students are graduated. Currently the department 53 students are attending their education now. The department has 13 staffs with different academic rank. Department of Anesthesia as part of the institution keeps sensing the ever-growing demand of the community for better health care and quality of education. With this understanding, the department has developed the curriculum of MSc degree in Advanced Clinical Anesthesia Specialty.