EVIDENCE BASEDÌýINSIGHT
Medical Education Challenges in the Globalization Era
September 21, 2020 Ä¢¹½´«Ã½¢ 7 min read
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Medical education is a crucial area of activity for Ä¢¹½´«Ã½. The Global Medical Office, working in partnership with regional education teams, is expanding and aligning a broad range of training programs for nephrologists, nurses, and other renal healthcare professionals. Increased translation capabilities, shared platforms, online courses, and locally customizable materials are strengthening the overall effectiveness of these programs while accommodating the specific needs of diverse communities around the world.
Ä¢¹½´«Ã½ is the worldÄ¢¹½´«Ã½™s largest provider of renal replacement therapy services andÌýÌýmanufacturing. Thus, the company is committed to expanding theÌýavailability of medical information and education to healthcareÌýproviders around the globe. Through collaboration with diverseÌýscientific thought leaders, Ä¢¹½´«Ã½ aims to informÌýthe internal nephrology community about clinical and therapeuticÌýgovernance and the external community about product-relatedÌýtherapy concepts.
In conjunction with the Global Medical Office, the regionalÌýmedical education teams develop programs based on corporateÌýgovernance guidelines, local regulations, applicable marketspecificÌýpractices, customs, disclosures, and best clinical practicesÌýin care delivery. State-of-the-art scientific content adheresÌýto principles of ethicalness, transparency, and accountableÌýengagement. In addition, education programs are delivered basedÌýon needs, objectives, and timeliness.1
FUTURE OF EDUCATION IN THE GLOBAL ENVIRONMENT
The establishment of the Global Medical Office in 2019 providedÌýa tremendous opportunity for renal education regional alignmentÌýand collaboration. Medical communications and education areÌýhighlighted in the Clinical and Quality Agenda 2020 as activityÌýpillars across multiple regions. This will facilitate leveragingÌýÄ¢¹½´«Ã½ global resources and add great value toÌýimproving healthcare provider training for better patient-centeredÌýcare in the value-based healthcare systems (Figure 1).
FIGURE 1Ìý|ÌýBoth medical education and medical communications are key pillars of activity in the companyÄ¢¹½´«Ã½™s Clinical and Quality Agenda
EUROPE, THE MIDDLE EAST, AND AFRICA
Ä¢¹½´«Ã½Ä¢¹½´«Ã½™s Europe, Middle East, and Africa (EMEA)Ìýregion is highly diverse, with more than two billion peopleÌýresiding in nearly 120 countries spread over three continents.ÌýEnglish, French, German, Russian, and Spanish are widely spokenÌýbut represent only five of the 2,000 languages of the region. TheÌýlinguistic diversity is an important challenge when developingÌýmedical education programs. This concept of diversity also appliesÌýto different educational systems; social, economic, and culturalÌýconditions; and variations in disease patterns, distribution ofÌýnephrologists, and approaches to supporting social responsibility.2
The EMEA medical education team serves dual platforms to addressÌýthe interests of internal and external healthcare professionals.
Serving All Healthcare Providers
To address the needs of Ä¢¹½´«Ã½ affiliated andÌýnon-affiliated healthcare providers in the region, the EMEAÌýMedical Information and Education (MIE) team is introducing theÌýAdvanced Renal Education Program (AREP) in 2020. AREP willÌýallow healthcare providers access to recent advances in end-stageÌýkidney disease (ESKD) and renal replacement therapy. AREP willÌýalso be translated into multiple languages to meet the needs of aÌýdiverse group of healthcare providers in multiple countries andÌýcultures. The AREP concept will be adjusted to meet the needs ofÌýthe nephrology community through regular surveys and feedbackÌýdriven from field visits. The EMEA MIE team is launching novel,Ìýstate-of-the art educational activities and technology solutionsÌýto increase the value of medical educational platforms andÌýtraditional classroom-based seminars.
Serving NephroCare Physicians
Ìýprovides renal care at dialysis centers in EMEA,ÌýLatin America, and Asia Pacific. In the EMEA region alone, aroundÌý69,000 ESKD patients are treated by approximately 2,100 employedÌýphysicians in 780 clinics.Ìý
Continuing medical education (CME) is essential for a physicianÌýto maintain clinical competencies and gain new knowledgeÌýas well as to maintain licensure and credentials. In 2016, theÌýEMEA Clinical and Therapeutical Governance team initiatedÌýthe medical education program designed to communicate theÌýlatest NephroCare standards of care and provide updates onÌýinternational best practices guidelines for improving clinicalÌýoutcomes and patient care. Any information presented toÌýNephroCare physicians is scientific in nature and does not includeÌýÄ¢¹½´«Ã½ product information.
NephroCare Academy is the educational platform for NephroCareÌýstaff, offering a large variety of e-learning topics related toÌýhemodialysis treatment, complications, comorbidities, patientÌýsafety, and chronic kidney disease (CKD) management.
A key focus of the EMEA medical education program is to expandÌýthe number of e-learning modules and video-based segments thatÌýare accredited by the European Accreditation Council for ContinuingÌýMedical Education (EACCME) institution of the European UnionÌýof Medical Specialists (UEMS) and endorsed by the EuropeanÌýRenal Association-European Dialysis and Transplant Association.Ìý
In addition, the 2018 and 2019 annual EMEA country medicalÌýdirector meetings received UEMS accreditation. By offeringÌýaccredited medical training, Ä¢¹½´«Ã½ supportsÌýphysicians in fulfilling CME credit requirements.Ìý
In late 2020, educational materials will be published on the globalÌýAREP website to increase reachability.
Medical Information Inquiry System
Channels designed to address medical inquiries in a timelyÌýmanner with the most relevant and up-to-date medicalÌýinformation are crucial. Thus, a top regional priority is to developÌýa structured medical information inquiry system. The EMEA MIEÌýwill collaborate with relevant internal departments to provideÌýand to help ensure the most appropriate and precise responsesÌýto inquiries. With this initiative, MIE aims to reach all healthcareÌýproviders living and practicing across the EMEA region toÌýenhance its commitment to provider empowerment (Figure 2).
FIGURE 2Ìý|ÌýMedical information inquiry system
EDUCATION IN ASIA PACIFIC
Ä¢¹½´«Ã½Ä¢¹½´«Ã½™s Asia Pacific (AP) region encompassesÌýapproximately 4.3 billion people, or 60 percent of the worldÄ¢¹½´«Ã½™sÌýpopulation.3ÌýDiversity in culture, beliefs, education levels,Ìýeconomic status, and languages and dialects extends across the 13ÌýAP service countries. Providing the right education to the rightÌýhealthcare providers introduces an interesting conundrum.
Serving Diversity through Collaboration
Healthcare expenditure is typically indicative of a countryÄ¢¹½´«Ã½™sÌýeconomic health, and in the Asia Pacific region, the investment ofÌýpublic funds ranges from $4,491 USD per individual in Australia toÌý$88 USD per individual in Bangladesh. This heterogeneity providesÌýa challenge in education programming because each programÌýrequires localized adaptation and adjustment prior to publication;Ìýthe same one cannot be implemented across the entire region.ÌýLanguage is a major hurdle because the regionÄ¢¹½´«Ã½™s lead educatorsÌýare not multilingual. Having no formal interpreter serviceÌýavailable, education program designers rely on local teams in eachÌýcountry to provide translated versions of the materials. RegionalÌýAP educators collaborate with country-specific professionalÌýorganizations, nephrology practices, and related clinical societiesÌýto deliver materials in the local native language.
Accessible Programming
Rather than relying on traditional didactic classroom-basedÌýteaching, the AP region embraces a blended learning, e-learning,Ìýand digital media structure to deliver education to frontlineÌýhealthcare providers. Internet-based programs offer flexibilityÌýfor participants because the materials can be accessed anytime,Ìýanywhere, with translation capabilities. As a result, participantsÌýhave reported improved comprehension of the material.ÌýIn 2019, the Asia Pacific Education Center (APEC) opened inÌýManila, the Philippines, hosting up to 20 nephrology-relatedÌýeducation programs for Ä¢¹½´«Ã½ team membersÌýthroughout the region. The facility includes lecture rooms, a fullyÌýoperational water treatment facility, and a clinical skills lab withÌýdevices for hemodialysis, peritoneal dialysis (PD), and critical careÌýwith integrated Therapy Data Management System and EuCliDÌýaccess. The lectures are designed to provide classroom teachingÌýcombined with on-site skills assessment and support.ÌýThe AP regionÄ¢¹½´«Ã½™s flagship course is the Renal Nurse EducationÌýProgram, a one-year course initially accredited by the EuropeanÌýDialysis and Transplant Nurses Association in 2014.4ÌýThe programÌýhas been conducted in China, Singapore, and Malaysia; it isÌýplanned for India in 2020.
In 2019, AP region educators partnered with a Malaysian universityÌýto jointly deliver an advanced diploma renal nurse course, a firstÌýin Ä¢¹½´«Ã½. This one-year course is designed toÌýincrease the number of certified renal nurses in Malaysia.
EDUCATION IN NORTH AMERICA
Providing a state-of-the-art medical education program to clinics,Ìýrenal healthcare professionals, and the dialysis communityÄ¢¹½´«Ã½”whichÌýensures best medical practices and best possible outcomes forÌýpatientsÄ¢¹½´«Ã½”has always been a strong focus of Fresenius MedicalÌýCare North America (FMCNA). AREP was established by FMCNAÌýto support the renal community in 1996. It has evolved into aÌýkey educational platform for healthcare professionals, providingÌýaccess to up-to-date, evidence-based best practices to improve theÌýcare and outcomes of CKD and ESKD patients. The program isÌýcomplemented by a large variety of services, including the success@Ìýhome program, dedicated medical information and clinical resourceÌýcall lines, and face-to-face support by field-based medical scienceÌýliaisons and medical support specialists (MSS) (Figure 3).
FIGURE 3Ìý|ÌýFMCNA Advanced Renal Education Program and medical information services
Continued support from Ä¢¹½´«Ã½ leadership,Ìýa network of internationally recognized distinguished faculty,Ìýand partnerships with various nephrology organizations haveÌýcontributed to the exponential growth and success of the program.ÌýAs an integral part of the global community supporting initiativesÌýon home dialysis, AREP is endorsed by the InternationalÌýSociety for Peritoneal Dialysis and the International Society forÌýHemodialysis. It delivers best-in-class live symposia as well asÌýonline e-learning.
The AREP digital platform has grown from a few hundred toÌýover 40,000 active registered online participants, averagingÌýover 6,000 e-learning sessions monthly and more than 700,000Ìýwebsite page views annually. The live symposia and webinar seriesÌýtypically reach over 7,000 healthcare providers annually. In surveyÌýfeedback, participants reported a positive impact on their clinicalÌýpractice and an increased confidence level.
The AREP website utilizes multimedia format to create engagingÌýcontent for adult learning. These include gamification, bite-sizeÌýlearning modules, short animated videos, self-paced learningÌýcourses, and review articles. Innovative clinical tools are availableÌýon the website, including the newly launched online PD CalculatorÌýthat assists prescribers with modeling a PD prescription. The PDÌýCalculator averages over 50,000 modeled prescriptions monthly.ÌýThis tool is highly rated for user-friendliness and helpfulness.
Medical office teams in North America, EMEA, Asia Pacific,Ìýand Latin America are collaborating to create a multiregional,Ìýmultilingual AREP platform to serve a wider audience. RegionalÌýteams will be able to customize content and manage localÌýeducational activities. Cross-pollination of innovative ideas willÌýcarry AREP into its next chapter in the globalized environment.
Meet The Experts
References
- Allen T, Donde N, Hofstädter-Thalmann E, et al. Framework for industry engagement and quality principles for industry-provided medical education in Europe. JÌýEurÌýCMEÌý2017;6(1):1348876. doi: 10.1080/21614083.2017.1348876.
- Sharif MU, Elsayed ME, Stack AG. The global nephrology workforce: emerging threats and potential solutions!ÌýClin Kidney JÌý2016 Feb;9(1):11-22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720191/.
- UNFPA Asia and the Pacific. Population trends. https://asiapacific.unfpa.org/en/node/15207. Accessed June 9, 2020.
- European Dialysis and Transplant Nurse Association/European Renal Care Association (EDTNA/ERCA). The EDTNA/ERCA has given the course its Approved with High Commendation Accreditation of # AP17031-1.