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While instructional coherence is important for student learning, structured analysis of such coherence, especially in low- and middle-income countries and at a systems level, is rare. We use an established methodology, the Surveys of Enacted Curriculum, and apply it in Tanzania and Uganda to systematically analyze and quantify the content and coherence of the primary curriculum standards, national examinations, and actual teaching delivered in the classroom. We find high levels of incoherence across all three instructional components. In Uganda, for example, only four of the fourteen topics in the English curriculum standards appear on the primary leaving exam, and two of the highest-priority topics in the standards are completely omitted from the exams. Teachers tend to cover broad swathes of content and levels of cognitive demand that are not well aligned with either the curriculum standards or exams. An exception is Uganda mathematics, for which standards, exams, and teacher instruction are all well aligned. The SEC methodology can be used as a diagnostic tool, helping education systems identify areas of instructional (in)coherence and informing efforts to improve coherence for learning. • Analyze and quantify content and alignment of curriculum standards, exams, and teacher instruction in Tanzania and Uganda • Find high levels of incoherence across all three instructional components. • In Uganda, only four of the fourteen topics in the English curriculum standards appear on the primary leaving exam. • Teachers cover broad swathes of content not well aligned with either the curriculum standards or exams. • Surveys of Enacted Curriculum methodology can diagnose instructional (in)coherence & inform improved coherence for learning. [ABSTRACT FROM AUTHOR]

Introduction: Standardized courses for the care of the burn patient have historically been developed in High Income Countries (HIC). These courses do not necessarily reflect the challenges and needs of Low Income Countries (LIC) and some components may not be relevant there (i.e. use of ventilators in a country that has no or very limited number of ventilators). We are developing a Burn Management Course for East Africa. This course was created and trialed in a LIC and subsequently a formal manual and course curriculum created. Recently the first iteration of the course was undertaken in a major regional burn centre in East Africa. We present participant feedback on the course content, and potential future directions for course development., Objective: (1) To evaluate the ability of a standardized burn course for LIC to meet the needs of the participants. (2) To explore characteristics of burn care and needs related to delivery of burn care in LIC., Methods: 21 students participated in a multidisciplinary burn management course. They were asked to complete an anonymous questionnaire at the end of the course., Results: There were 11 nurses, 6 doctors, a physiotherapist, occupational therapist, and a dietician. 15 worked in either the adult or pediatric burn units, the other six worked in emergency, ICU or the operating room. The majority of respondents (56%) had less than 3 years of experience working with burn patients. Overall agreement that the course met their objectives was rated as 4.6 out of 5. As well the students agreement that they had a better understanding of burn injury was rated as 4.8/5. 55.6% indicated that scalds were the most commonly seen injury followed by 27.8% responding that flames were the most common. Some responses to the question of top difficulties facing the caregivers were similar to HIC: staffing shortages, bed shortages, and finding useable donor site in large burns. Other responses highlighted the challenges these care givers face: poverty stricken patients, not enough appropriate food available, and deficiencies in infection control practices., Conclusion: It is possible to create a course that translates knowledge from a HIC setting to meet the needs of the end-user in a LIC setting., (Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.)

Muhimbili University of Health and Allied Sciences (MUHAS) strives to instill in its graduates skills and competencies appropriate to serving the Tanzanian population well. MUHAS leadership, working in collaboration with educators from the University of California San Francisco (UCSF), selected and trained an interdisciplinary group of faculty members to promote effective teaching. We describe the development of this group of faculty change agents - now known as the Health Professions Educators Group (HPEG). The HPEG invigorated the education environment at MUHAS by: engaging many colleagues in special training events that introduced new methods for teaching and assessment; encouraging innovation; and developing strong mentoring relationships. HPEG members piloted courses in education to prepare all postgraduate students as peer educators, teaching assistants, and as candidates for faculty future appointments. Creation of a 'teaching commons' reinforces the new focus on innovative teaching as faculty members share experiences and gain recognition for their contributions to quality education.

In 2009, the Muhimbili University of Health and Allied Sciences (MUHAS) School of Pharmacy began to revise its BPharm curriculum for students entering in 2011. Its goal was to assure these pioneer students and their successors would be prepared to lead pharmacy practice to improve patient care and health outcomes in Tanzania. Building on its own experience and recommendations from other parts of the world, MUHAS actively engaged counterparts from the University of California San Francisco School of Pharmacy. MUHAS's vision was to create a curriculum to educate students to become 'clinical pharmacists' with a more direct patient-care focus. This means a major expansion in activities undertaken by newly graduating pharmacists - beyond preparing and dispensing medications. With the transformation from a traditional curriculum (knowledge-based) and teaching (lectures), the new approach emphasizes interprofessional team care, clinical science content (treatment and prevention of diseases), and experiential learning opportunities from classrooms to patient-care settings. Assessments of strengths and weaknesses of previous graduates' performance in their early employment informed curricular revision; evaluation of the competence of students and of new graduates will guide further revisions to assure preparation of effective pharmacists to lead practice in Tanzania.

From 2008 to 2011, the School of Dentistry at Muhimbili University of Health and Allied Sciences in Tanzania revised and then initiated implementation of a curriculum to improve the educational process for, and competence of, its graduates. As an increasing body of research demonstrates the detrimental effects of oral diseases on health and the interrelationships between oral and systemic diseases (including HIV and diabetes), the importance of dentistry education grows. We describe the population oral health problems in Tanzania, the need to enhance the dental workforce, and the process of curricular reform to meet these needs. This reform included transition to a competency-based curriculum featuring teaching methods that will enhance the effectiveness of the education and performance of graduates in traditional and new roles. We conclude with lessons for Tanzania and for health professions educational institutions elsewhere, as well as for public health-care planners concerned about linking health professions education to improving population health in resource-poor countries.

Education about palliative care is crucial for oncology nurses, particularly in the developing world, where most patients present with advanced disease and heavy symptom burden. The End-of-Life Nursing Education Consortium-International training program was implemented in Tanzania to provide nurses with the knowledge, expertise, and tools to better care for the dying and to educate others. The curriculum was presented to 39 participants over three days, including didactic presentations, small group discussions, and role play. None of the participants had received previous formal palliative care training. The participants rated their impression of the course as excellent. Follow-up at eight months yielded similar findings regarding the effectiveness of the curriculum. International education regarding palliative care for those with cancer requires an understanding of different disease patterns and clinical practices, along with cultural humility and empathy. These experiences are extraordinarily enriching, giving nurses a unique perspective on palliative care that ultimately informs their own practice.