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REVIEW PROTOCOL

Recommendation 3

Does the innovative expansion of faculty affect the quantity, quality and relevance of

health professionals?

A systematic review

Review protocol

Organization, City, Country: University of the Philippines Manila , Manila , Philippines Prepared by: Date:

Venice Celis September 2011

Senior supervisor Marilyn Lorenzo Research team members Jenny dela Rosa, Grace Fernandez, Venice Celis, Janet

Clemente

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Table of Contents

A SYSTEMATIC REVIEW ........................................................................................................................... 1

1.0 Background .......................................................................................................... 3 2.0 Objective .............................................................................................................. 3 3.0 Review Question .................................................................................................. 3 4.0 Evidence gathering and study selection ............................................................... 4

5.0 Assessment of risk of bias and data extraction .................................................... 6 6.0 Data synthesis ....................................................................................................... 7 7.0 Dissemination ....................................................................................................... 7

8.0 Resource implications .......................................................................................... 7 9.0 References ............................................................................................................ 7 Appendix A: search strategy .......................................... Error! Bookmark not defined.

Appendix B: data extraction forms (see attached excel workbook) ............................. 12 Appendix C: Example of databases, websites and journals which could be searched . 12

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1.0 Background

Include definitions, answers to background questions, description of the intervention and how it might work to help better understand the question. This section is optional.

2.0 Objective

To assess the effect of streamlined educational pathways, or ladder programmes, for the advancement of practicing health professionals, in both undergraduate and postgraduate programmes, on the improvement of the quantity, quality, and relevance of health professionals.

3.0 Review Question

For the purposes of this literature review, the population, intervention, comparators and outcomes (PICO) framework to inform the review objectives are presented below:

Population Intervention Comparison Outcome Health Science

Educational Programs for: o Medical Doctors

including PH doctors o Nursing

Professionals including PH nurses

o Midwifery Professionals including PH midwives

o Dentists o Pharmacists

Health Science Students including: o Medical students o Nursing students o Premedical students o Midwifery students o Residents

Health Professionals o Doctors/physicians o Nurses/nursing staff o Midwives o Dentists/dental staff

Innovative

expansion of

faculty

No Innovative expansion of

faculty

Quantity, quality and

relevance of health

professionals

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o Pharmacists

Paramedical practitioners

4.0 Evidence gathering and study selection

3.1 Evidence gathering

The evidence gathering approach will have four components:

4.1.1 Searching databases

The databases in the table below will be searched with a pre-determined strategy as detailed in Appendix A. In cases where the search results are small in number, search terms will be reduced to maximize the search sensitivity.

Topic/Field Database

Medicine and Health Sciences

PubMed, Campbell Library, Cochrane Library, Health Systems Evidence

Education ERIC

Social Sciences Social Science databases SSRN

Regional databases

African Index Medicus, Australasian Medical Index, Index Medicus for Eastern Mediterranean Region, IndMED, KoreaMed, LILACS, IMSEAR, Panteleimon, WPRIM, British Education Index, Research and Development Resource Base (RDRB)

Grey Literature databases

OPENSIGLE, NewYork Academy of Medicine Grey Lit site, FADE Library, HMIC, Biomed, INTUTE, MedicalTeacher database, DATAD, International Journal of Pharmacy Education

Local databases HERDIN, UP Integrated Library System, UST Miguel de Bienvenides Library, De La Salle University Library, Ateneo de Manila Library, Siliman University Library, Ateneo de Zamboanga Library, Xavier University Library, San Carlos University Library,

4.1.2 Hand searching

The following journals and websites will be hand-searched for relevant articles:

Resources that will be searched by hand

WHO's Library Database (WHOLIS) HRH Global Resource Center World Federation of Medical Education World Bank Resources regarding the UP Manila School of Health Sciences

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4.1.3 Expert network consultations

A network of health professional education experts will be consulted by email to identify additional grey literature or research that has not been found through the above processes. The following experts and networks will be contacted.

Experts and networks will be contacted regarding additional articles

Consultation with relevant members of the Core Guidelines Development Group

4.1.4 Reference searches

Bibliographies of those papers that match the eligibility criteria below will be searched by hand to identify any further, relevant references, which will be subject to the same screening and selection process.

4.3.2 Eligibility criteria

After gathering the evidence, the following eligibility criteria will be applied to the results and all identified references screened independently by two reviewers (ML, VC) using a three-stage approach to reviewing the title, abstract and full text.

4.2.1 Types of studies:

All types of evaluative study designs are eligible for inclusion, including grey

literature. Studies will not be selected on methodological quality.

4.2.2 Types of participants:

Participants in this study are:

Health Science Educational Programs for: o Medical Doctors including PH doctors o Nursing Professionals including PH nurses o Midwifery Professionals including PH midwives o Dentists o Pharmacists

Health Science Students including: o Medical students o Nursing students o Premedical students o Midwifery students o Residents

Health Professionals o Medical Doctors - both Generalist and Specialist Practitioners, and Public Health Doctors o Nursing Professionals- both Generalist and specialist practitioners, including nurse

practitioners and Public Health Nurses o Midwifery Professionals, including Public Health Midwives o Dentists o Pharmacists

Paramedical practitioners as defined in the ISCO-08 minor group 224 and Mullan and

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Frehywot, 2007; WHO, 2010. Will also include The Mid-level Cadres like Assistant medical officers, Clinical officers, Health Assistants, Health Officers, Medical Assistants, Nurse Clinicians, Physician Assistants.

4.2.3 Types of intervention:

- Does the Does the innovative expansion of faculty affect the quantity, quality and

relevance of health professionals?

4.2.4 Types of outcome measures:

The primary outcomes of interest are the quantity, quality and relevance of practicing health professionals. These are defined by a number of measurable outcomes found in the Outcomes Framework document. Secondary outcomes include values and preferences, costs and benefits, harms and all unintended effects of the intervention are also of critical importance and will be eligible. Studies that include other outcomes should not be excluded at this stage in the evidence retrieval. Other secondary outcomes can also be defined, as needed.

4.3 Exclusion criteria

Editorials, newspaper articles and other forms of popular media will be excluded. Failure to meet any one of the above inclusion criteria will result in exclusion from the review and any apparent discrepancies during the selection process will be resolved by a third, independent reviewer. The number of excluded studies (including reasons for exclusion for those excluded following review of the full text) will be recorded at each stage.

5.0 Assessment of risk of bias and data extraction

Following final selection, reviewers will extract required data from each paper, using the predefined evidence summary templates attached in Appendix B. Data will be collected regarding the reasons for exclusion, characteristics of included studies, participants, interventions (including comparators) and outcomes. The final decision for inclusion or exclusion will be made by a team consisting of the WHO Secretariat, methodologist and researchers conducting the review. Any potential disagreement will be recorded and resolved by further discussion.

Risk of bias across studies will be assessed using the approach outlined by the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group.

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Any disagreements will be recorded and resolved by involvement of an additional reviewer.

6.0 Data synthesis

The availability of appropriate data and resources to conduct a meta-analysis will be considered, where feasible.

7.0 Dissemination

A final set of tables including a GRADE Evidence Table and Descriptive Evidence Table will be produced and submitted to the WHO Secretariat as stipulated in the Procedures for the Retrieval of Evidence and Summary of Evidence. In addition, a manuscript will be submitted to peer-reviewed journals for publication (a more specific dissemination proposal can go here as well).

8.0 Resource implications

The project lead will work closely with the WHO Secretariat to define the scope and methods of the review and facilitate access to unpublished literature, supporting translation of foreign language literature where necessary. Proposed milestones and timescales are outlined below:

MILESTONES

Evidence retrieval protocol developed

Identifying and retrieving the evidence and conduct of literature review

Conduct of hand searching and contacts with experts and networks.

Summarize the evidence Develop Descriptive Evidence Table

Develop GRADE Evidence Table

Submit Descriptive Evidence Table and GRADE Evidence Table to the WHO Secretariat Upload PDFs of articles to FTP site

9.0 References

When citing articles, please use the WHO standard citation format, called the Vancouver style. Some examples:

Article in a Journal Burt BA, Pai S. Sugar consumption and caries risk: a systematic review. Journal of Dental Education, 2001, 65:1017–1023.

Chapter in a book

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Melton L J III. Epidemiology of fractures. In: Riggs BL, Melton L J III, eds. Osteoporo¬sis: etiology, diagnosis, and management, 2nd ed. Philadelphia, PA, Lippincott-Raven, 1995:225–247.

Corporate author Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20 536 high-risk individuals: a randomised placebo-controlled trial. Lancet, 2002, 360:23–33.

WHO Publication with no named author The international pharmacopoeia, 3rd ed. Vol. 5. Tests and general requirements for dosage forms; quality specifications for pharmaceutical substances and tablets. Geneva, World Health Organization, 2003.

More on the WHO-style can be found here: http://www.nlm.nih.gov/bsd/uniform_requirements.html

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Search Concept

MeSH headings Textwords

Population Faculty[Mesh]

Nurse Clinicians[Mesh]

Faculty[tw]

teachers[tw]

teacher[tw]

mentors[tw]

mentor[tw]

preceptor[tw]

preceptors[tw]

educator[tw]

educators[tw]

teaching staff[tw]

tutor[tw]

tutors[tw]

faculty of pharmacy[tw]

clinicians[tw]

clinical instructors[tw]

clinical teachers[tw]

clinical staff[tw]

Intervention 1 adjunct faculty[tw]

part-time faculty[tw]

temporary faculty[tw]

guest lecturers[tw]

visiting lecturers[tw]

visiting professor[tw]

visiting academic[tw]

visiting scholar[tw]

School expansion[tw]

Intervention 2 joint appointment of faculty[tw]

shared appointment of faculty[tw]

dual appointment of faculty[tw]

appointment in health services and educational institutions[tw]

Intervention 3 Research Support as Topic[Mesh]

improve research facility[tw]

improve research facilities[tw]

improve research infrastructure[tw]

improve research infrastructures[tw]

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increase research funding[tw]

increase research resources[tw]

expand research network[tw]

expand research networks[tw]

expand research linkage[tw]

expand research linkages[tw]

training of faculty in research[tw]

PubMed Search Output

Search Most Recent Queries Time Result

#12 Search Faculty[Mesh] OR Nurse Clinicians[Mesh] OR Faculty[tw] OR teachers[tw] OR teacher[tw] OR mentors[tw] OR mentor[tw] OR preceptor[tw] OR preceptors[tw] OR educator[tw] OR educators[tw] OR teaching staff[tw] OR tutor[tw] OR tutors[tw] OR faculty of pharmacy[tw] OR clinicians[tw] OR clinical instructors[tw] OR clinical teachers[tw] OR clinical staff[tw]

20:21:14 157,223

#13 Search adjunct faculty[tw] OR part-time faculty[tw] OR temporary faculty[tw] OR guest lecturers[tw] OR visiting lecturers[tw] OR visiting professor[tw] OR visiting academic[tw] OR visiting scholar[tw] OR school expansion[tw]

20:22:16 224

#14 Search joint appointment of faculty[tw] OR shared appointment of faculty[tw] OR dual appointment of faculty[tw] OR appointment in health services and educational institutions[tw]

20:22:56 0

#15 Search Research Support as Topic[Mesh] OR improve research facility[tw] OR improve research facilities[tw] OR improve research infrastructure[tw] OR improve research infrastructures[tw] OR increase research funding[tw] OR increase research resources[tw] OR expand research network[tw] OR expand research networks[tw] OR expand research linkage[tw] OR expand research linkages[tw] OR training of faculty in research[tw]

20:26:47 18,792

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#16 Search (#12) AND #13 20:29:39 152

#17 Search (#12) AND #14 20:31:56 0

#18 Search (#12) AND #15 20:32:18 954

#19 Search ((#16) OR #17) OR #18 20:32:51 1,104

#20 Search #19 Limits: English 20:33:29 1,068

#21 Search #19 Limits: English, Publication Date from 1995 to 2011

20:34:18 757

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Appendix B: data extraction forms (see attached excel workbook)

1) GRADE Evidence Table Template.xls 2) Descriptive Evidence Table.xls

Appendix C: Example of databases, websites and journals which could be searched

Databases

Databases for biomedicine and health sciences:

Pubmed/MEDLINE

CINAHL

Cochrane Library (CDSR)

Health Systems Evidence (PPD/CCNC)

UK Pubmed Central

Global Health Library (Global Index Medicus)

UK Pubmed Central Databases for social sciences:

ISI Web of knowledge

Campbell Library

Social Science Research Network

Databases for education:

ERIC

BEME database

Regional databases for biomedicine and health sciences:

African Index Medicus (www.indexmedicus.afro.who.int)

Australasian Medical Index (www.nla.gov.au/ami)

Index Medicus for Eastern Mediterranean Region (www.emro.who.int/his/vhsl)

Chinese Biomedical Literature Database (CBM) (www.imicams.ac.cn/cbm/index.asp)

IndMED (www.indmed.nic.in)

KoreaMed (www.koreamed.org/searchbasic.php)

LILACS (www.bases.bireme.br/cgi-bin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&base=LILACS&lang=i)

Index Medicus for the South-East Asia Region (IMSEAR)

(www.library.searo.who.int/modules.php?op=modload&name=websis&file=imsear) Panteleimon for Russia and Ukraine (www.panteleimon.org/maine.php3)

Western Pacific Region Index Medicus (WPRIM) (wprim.wpro.who.int/SearchBasic.php)

PASCAL (www.international.inist.fr/article21.html)

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General databases:

Google Scholar

4.1.2 Hand searching

The following journals and websites will be hand-searched for relevant articles:

Resources that will be searched by hand, for peer-reviewed articles and grey literature

Assessment & Evaluation in Higher Education

American Journal of Health Studies

Teaching and Teacher Education

Academic Medicine

Journal of Interprofessional Care

Academic Medicine

Medical Teacher

International Journal for Academic Development

WHO's Library Database (WHOLIS)

SAMMS

HRH Global Resource Center

World Federation of Medical Education

International Council of Nurses

Association of American Medical Colleges

Council on Graduate Medical Education

American Academy of Family Physicians

American College of Physicians

World Bank

HMIC database

Grey Literature Network Service http://www.greynet.org

OPENSIGLE System for Information on Grey Literature in Europe http://opensigle.inist.fr/

NewYork Academy of Medicine Grey Literature site http://www.nyam.org/library/online-resources/grey-literature-report/

FADE Library http://www.fade.nhs.uk/

HMIC: Health Management Information Consortium http://library.nhs.uk/help/resource/hmic

Biomed http://www.biomedcentral.com/

INTUTE http://www.intute.ac.uk/