How innovative and conventional curricula prepare medical students for practice in Sub-Saharan Africa: A comparative study from Mozambique

Janneke Frambach, Beatriz Manuel, Afonso Fumo, Bernard Groosjohan, Cees van der Vleuten, Erik Dreissen

    Research output: Contribution to journalArticlepeer-review


    Background: Medical education in Sub-Saharan Africa is in need of reform to promote the number and quality of physicians trained. Curriculum change and innovation in this region, however, face a challenging context that may affect curriculum outcomes. Research on outcomes of curriculum innovation in Sub-Saharan Africa is scarce. We investigated curriculum outcomes in a Sub-Saharan African context by comparing students’ perceived preparedness for practice within three curricula in Mozambique: a conventional curriculum and two innovative curricula. Both innovative curricula used problem-based learning and community-based education. Methods: We conducted a comparative mixed methods study. We adapted a validated questionnaire on perceived professional competencies and administered it to 5th year students of the three curricula (n = 140). We conducted semi-structured interviews with 5th year students from these curricula (n = 12). Additional contextual information was collected. Statistical and thematic analyses were conducted. Results: Perceived preparedness for practice of students from the conventional curriculum was significantly lower than for students from one innovative curriculum, but significantly higher than for students from the other innovative curriculum. Major human and material resource issues and disorganization impeded the latter’s sense of preparedness. Both innovative curricula, however, stimulated a more holistic approach among students toward patients, as well an inquiring and independent attitude, which is valuable preparation for Sub-Saharan African healthcare. Discussion: In Sub-Saharan Africa, risks and benefits of curriculum innovation are high. Positive outcomes add value to local healthcare in terms of doctors’ meaningful preparedness for practice, but instead outcomes can be negative due to the implementation challenges sometimes found in Sub-Saharan African contexts. Before embarking on innovative curriculum reform, medical schools need to assess their capability and motivation for innovation.

    Original languageEnglish
    Pages (from-to)3-10
    Number of pages8
    JournalEducation For Health: Change in Learning and Practice
    Issue number1
    Publication statusPublished - 1 Jan 2017


    • Community-based education
    • Curriculum implementation
    • Curriculum innovation
    • Mixed methods
    • Preparedness for practice
    • Problem-based learning
    • Sub-Saharan Africa


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