Reserapport - utresande lärare
Lärosäte: Makerere University
Utbildningsprogram: Tandläkare
Utbytesprogram: Linnaeus-Palme
Termin: Hösttermin 18/19
Antal dagar: 24
Namn: Idil Alatli BURT
E-postadress: idil.alatli.burt@ki.se

Boende

There are many airlines flying to Uganda and we flew with Ethiopian Airlines (ET) with a stopover at Addis. The main entry point for flights into the country is Entebbe International Airport (EBB) which is located near the town Entebbe and about 46 km. (about 30 min drive) from the capital, Kampala. International Program Coordinator at College of Health Sciences, MU, Ms, Susan Nassaka Byekwaso arranged our transport from the airport. The Dental Clinic is located on the Mulago Hill in the School of Dental Public Health building which is a 20 min. walk from the main campus of Makerere University. However, the lecture room is located in the main campus at the department offices, in the old IDI Project House near the eastern gate of the MU campus. There are two guest houses for accommodation as one is located in the MU main campus whereas the other one is near the clinic at Mulago Hill. We chose to stay in the university campus (Makerere University Guest House) for a price of ca. 45-50 US dollars (120 thousand Ugandan shillings) for a single room per night including breakfast. There are a number of affordable accommodations of reasonable standard for rent in the vicinity. Hotels, in contrast, are usually very expensive. Accommodation was also arranged by the International Program Coordinator Ms. Susan M.B. The traffic jam is very heavy, particularly during rush hours (i.e. mornings and evenings). Therefore, it is of advantage to stay closer to the work place.

Språk och kultur

Although, there are different ethnic groups and different dialects, the main language is English. The VISION of MU is to be the leading Institute for academic excellence and innovations in Africa. The MISSION is to provide innovative teaching, learning, research and services responsive to national and global needs. CORE VALUES: Allegiance to the institutionIntegrityCustomer responsivenessProfessionalismOpenness to diversity Uganda is a multicultural society and differences in values such as culture, religion, attitudes faded out and students/teachers from different backgrounds thrive very well together.

Fritid

Uganda is a beautiful country and there is a lot to see and to do. See the link below among different links for ideas. http://www.africa-ata.org/ug_kampala.htm We visited Bwindi Impenetrable Forest, gorilla tracking and visiting the islands in Lake Bnyunyonyi.

Övrigt

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Annan verksamhet

Comparison of Teaching/Learning activities at the Makerere University (MU) and Karolinska Institutet (KI), Departments of Dental Medicine

Theory/practice relationship: The main goal of education in health care is to understand the importance and the ultimate way of application of the in learned knowledge and the results of scientific findings into the clinical practice in delivering the best health care service to the patients. The fundamental pillars of the education involves theory, methodology, analysis and application of theory and research findings to practice as clinical work. In Makerere University, Department of Dental Medicine, in comparison with KI, the link between theory and practice was less pronounced. The opportunity of integrating the theory/research/practice for the 5th year Dental students seems to be limited. 

The teacher-student-patient relationship: There was also a difference in classroom size between MU and KI. The number of dental students at MU this year is 21 in comparison to KI where the number of students vary about 75-85 per year. The advantage of having small groups over large groups allows an improvement of teacher/student interaction at an individual level. This enhances the understanding of the weaknesses and strength of students at an individual level both in their theory and practical knowledge. However, there is a lack of academic staff at MU which limits the possibility of alteration between education (theory)/research and clinical work. The schedule at MU planned as clinical practice in the mornings and lectures in the afternoon. Each different discipline has its own specific day in the week for clinical work. The afternoon lectures divided between different disciplines with 5 weeks intervals 

Teaching approach and clinical work: Both at MU and KI, a tutor supported “peer learning and feedback” teaching method is used. The student involvement in knowledge transfer did not seem to differ between two student groups. Nevertheless, assigning each student a topic to discuss based on a material provided by the tutor at MU enhances the student involvement. The student then make a power point presentation followed by an in-depth discussion of the topic in the class. Each session is then finishes with a patient case with the application of the recently discussed topic as a real scenario example. 

Support material: Almost all students as well as general dentists who attended the CPD lecture asked for soft copies of the books in the field. The university library facilities at MU are not at KI standards. The above mentioned teaching method depends on the easy access to books and updated material. One might think that the possibility of access to internet will solve this lack of material distribution. However, this seems to jeopardize the state of art in the field due to unreliable information on the internet. Tutors need to pay attention to this aspect and must stress the importance of fundamental knowledge before heroically practicing any techniques seen on “Youtube” in their clinics.

Förberedelser

Uganda is one of the safest, stable and secure countries in Africa. According to the 2016 Poverty Assessment, the proportion of the Ugandan population living below the national poverty line declined to 19. 7% in 2016. However, the country is lagging behind in several important areas such as sanitation, access to electricity, education and child malnutrition. Only 5% of households receive support from the government instead 35% rely on savings and 25% on family. 


Immunization (vaccinationscentral): I visited an immunization center in Stockholm (Hötorget) 4 weeks before my trip to allow for the vaccines to effect in my preparation for the trip to Kampala. Vaccinations and boosters I had to take were: Hepatitis A, B, Typhoid, Yellow Fever (required for entry into Uganda) Meningococcal, Measles and Rabies. Anti-malaria drug (Malarone-atovaquone/proguanil or doxycycline) Passport and Visas: The expiration date on the passport should be at least six months after the return date of your trip. You must have a visa to enter the country. The cost of the visa at the airport was 50 US dollars.

Reflektioner

This was a very educative and informative experience for me and gave me opportunities for deep reflection on my teaching and way of treating patients. The teaching methods used can be influenced by different factors such as the course time, class size, environment and others such as logistics and access to material, clinical chairs etc. Matching the teaching methods to this environment is challenging and demands creativity and flexibility. However, it is crucial to be able to get best results in teaching/learning activity. The type of patients, the type of cases and the understanding of the importance of oral hygiene among people and the timing of patient´s treatment need and multidisciplinary approach of the professionals in the field arise a lot of issues to discuss. The underlying cause of every patient need and the limitations of the care giver are very different in Uganda comparing to Sweden and these define the treatment planning in the field of Orthodontics as well as in other disciplines of dentistry. There is an extensive need of lateral thinking and compromise which was an unpracticed issue for me in my professional life as a teacher and practitioner as well. 


Curriculum at MU, College of Health Science, Department of Dental Sciences: 


1st year: medical anatomy, histology, biochemistry, physiology, public health 

2nd year: pathology, embryology, integrated tissue biology, anatomy, physiology, pharmacology, biochemistry 

3rd year: rotation in clinical medicine and clinical surgery, 2nd term: cariology, oral biology, oral pathology, radiology, dental material 

4th year: orthodontics, forensic dentistry 

5th year: orthodontics, prosthodontics, endodontics, conservative dentistry 

6th year: INTERNSHIP: dental clinical work Assessment: written exam Clinical exam OSCE Clinical Exam after the internship and the license registration.


There is another 3-year program for dental officers at MU apart from the 5-year Dental Surgeon program (DDS).

Undervisning

This is a 5 year undergraduate dental medicine program with 1 additional year as Internship in different clinics assigned by the Makerere University, College of Health Science, Department of Dental Sciences. This Orthodontics and Paediatric Dental course is intended for undergraduate dental program at their 5th year. The Orthodontic and Paediatric Dentistry theory courses run separately as one block each for 5 weeks in the 5th academic year and combined clinics every Monday for both Orthodontic and Paediatric Dentistry. 


Course Objectives 

The specific objectives of the course were: 

To understand the Orthodontic diagnosis and the orthodontic treatment need and the meaning of Interceptive Orthodontics

To identify the treatment priority of Orthodontic problems in growing patients 

To provide "hands on" experience using peer assessment learning and feedback in the registration process of new orthodontic patients and skills needed to understand the aim of treatment and to plan an interceptive orthodontic treatment and be able to apply an appropriate appliance design to achieve the planned treatment results 

To provide familiarity with the dominant research fields and research strategies in the field of Orthodontics 

To appreciate and understand the basic ethical principles that governs the application of the treatment modalities and the boundaries for a general dentist within the field of Orthodontics

To provide an understanding and a solid foundation for critical reading and reviewing the reliability and validity of research findings and scientific literature 


Comparison of Teaching/Learning activities at the Makerere University (MU) and Karolinska Institutet (KI), Departments of Dental Medicine

Theory/practice relationship: The main goal of education in health care is to understand the importance and the ultimate way of application of the in learned knowledge and the results of scientific findings into the clinical practice in delivering the best health care service to the patients. The fundamental pillars of the education involves theory, methodology, analysis and application of theory and research findings to practice as clinical work. In Makerere University, Department of Dental Medicine, in comparison with KI, the link between theory and practice was less pronounced. The opportunity of integrating the theory/research/practice for the 5th year Dental students seems to be limited. 

The teacher-student-patient relationship: There was also a difference in classroom size between MU and KI. The number of dental students at MU this year is 21 in comparison to KI where the number of students vary about 75-85 per year. The advantage of having small groups over large groups allows an improvement of teacher/student interaction at an individual level. This enhances the understanding of the weaknesses and strength of students at an individual level both in their theory and practical knowledge. However, there is a lack of academic staff at MU which limits the possibility of alteration between education (theory)/research and clinical work. The schedule at MU planned as clinical practice in the mornings and lectures in the afternoon. Each different discipline has its own specific day in the week for clinical work. The afternoon lectures divided between different disciplines with 5 weeks intervals 

Teaching approach and clinical work: Both at MU and KI, a tutor supported “peer learning and feedback” teaching method is used. The student involvement in knowledge transfer did not seem to differ between two student groups. Nevertheless, assigning each student a topic to discuss based on a material provided by the tutor at MU enhances the student involvement. The student then make a power point presentation followed by an in-depth discussion of the topic in the class. Each session is then finishes with a patient case with the application of the recently discussed topic as a real scenario example. 

Support material: Almost all students as well as general dentists who attended the CPD lecture asked for soft copies of the books in the field. The university library facilities at MU are not at KI standards. The above mentioned teaching method depends on the easy access to books and updated material. One might think that the possibility of access to internet will solve this lack of material distribution. However, this seems to jeopardize the state of art in the field due to unreliable information on the internet. Tutors need to pay attention to this aspect and must stress the importance of fundamental knowledge before heroically practicing any techniques seen on “Youtube” in their clinics.

Undervisningstimmar

The table below shows the time spent per week on different aspects of the teacher-exchange: 

Actual tutorship: 8 - hours 25% 

Discussions/seminars: 2 hours - 5% 

Interaction with individual students in the clinic: 16 hours - 45% 

Interaction with senior faculty members: 4 hours - 10% 

Preparation of materials, lectures etc: 6 hours - 15% 

Total time on teacher exchange activities/week: 36 hours - 100%