283 Establishing nationwide standardised workplace-based learning for paediatric doctors in Myanmar – a pilot study

Background The Myanmar Paediatric Society and the Royal College of Paediatrics and Child Health collaborated to set up a nationwide workplace-based learning and assessment strategy for MSc postgraduate paediatric doctors in Myanmar. Objectives A Myanmar/UK joint working group created an Assessment portfolio and supported 40 supervisors and 170 students in its completion. The portfolio contained workplace-based practice learning (WPBL) approaches, including Directly Observed Procedures, Case-Based Discussions and the Handover Assessment Tool. Postgraduate students (PPS) were asked to complete their portfolios during their clinical placements (in a range of Myanmar hospitals) with support and feedback from their clinical supervisors. Methods Between August 2018 and December 2020 a two-phase pilot was undertaken; phase 1 supported all second-year postgraduate students (n=85), phase 2 continued with phase 1 year 2 group going into year 3, while also supporting the new year 2 cohort (another 85 PPS). Remote support was provided by senior Myanmar, UK paediatricians and educationalists throughout. At phase 1 and 2 completion, all portfolios were collected, anonymised and assessed by senior Myanmar paediatricians affiliated to all Myanmar Medical Universities. Using a standardised rubric, including a 1–5 Likert scale, reviewers assessed the completeness of the portfolio and the quality of the feedback from the supervisor to the student. Results Phase 1 portfolio results are presented, as at the time of submission phase 2 portfolios were being analysed, concluding in February 2021. Overall completeness and quality scores In the case of the portfolios, we found that more than.69% had at least 50% of their portfolio sections completed. When we audited the supervisor feedback quality we found that 74% of the total were scored at 3 or above, adjudged to be at least a ‘Fair attempt to comment on candidate performance and provide recommendations’. In the case of Mini-CEX - Case selection there was a relatively even distribution of patient presentations selected by the postgraduate students in Mini-Cex showing a broad range of detailed clinical knowledge, which can be built on in the workplace through practical support. Conclusions The pilot demonstrated the introduction of a standardised programme of non-didactic WBPL to support greater standardisation of practice across Myanmar. Phase 1 demonstrated the importance of linking clinical practice to academic curricula, and setting up structures to support supervisors and PPS to deliver WBPL and constructive feedback. The pilot helped to develop a cadre of supervisors able to support the enhancement of clinical learning within hospitals as sites of improved professional development. There is further scope to explore the application of the methodologies of WBPL to assess and support wider clinician skills. Improving hospital systems to develop these skills can have a positive effect on the whole hospital system. For example, encouraging better leadership, governance, communication and teaching among paediatricians, will have wider positive implications for the care of children.