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Total quality management and
accreditation in Iraq
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Dr Thamer Kadum Yousif Al Hilfy
MBChB/DCM/FICMS JMHPE/MsC/Member/medical education
Director Health For All Center (NGO), Baghdad,
Iraq
Assistant Professor, Alkindy College of Medicine,
Baghdad, Iraq
Address correspondence to:
Dr Thamer Kadum Yousif Al Hilfy
Tel: +96417721963, +9647703459903, Mobile. +9647901734108
E-mail: thamer_sindibaad@yahoo.com,
thamer_center2005@yahoo.com
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Total
quality management (TQM) is defined as controlling
every thing about what is actually done to create
a product (e.g. better quality of education and
better quality of graduates related to one of
Iraqi colleges (Tikrit College of medicine/university
tikrit/Iraq). The issue of education, research
and development, developing the role of the health
services in education, research and development
in partnership with other organizations and agencies
focusing on health services research, are among
many concerns and responsibilities of this college.
The MOHE
in Iraq recently (2 months prior to writing this
paper) held a conference about the concept of
total quality management and quality approach.
The attendants were teachers and medical staff
of all Iraqi universities and medical staff of
both the MOHE and MOH. The intention of this conference
was to review the recent quality revolution and
reasons behind the need for increase in quality
consciousness of our universities as well as to
highlight the dimensions of quality in relation
to structure, process and outcome (Donabedian).
The conference highlighted to the attendees approaches
to managing quality, and the difference between
traditional, problem solving and total quality
approach.
The college,
teachers and staff members were involved in this
conference in the hope of applying these new concepts
(as far as our Iraqi colleges are concerned) to
achieve better quality by following the true total
quality processes with its 3 fundamental bases
(Student and community focus, continuous improvement
and employee involvement).
Unfortunately
this conference and the associated recommendations
that were followed did not find a basis for a
starting point due to the current situation of
the country and the instability regarding security
conditions.
What
was interesting mainly in this conference and
the further meetings that followed, is the confusion
that involved most of the participants in the
way of differentiation between concepts related
to TQM and quality assurance, appraisal and accreditation,
evaluation and monitoring.
We do
believe that a lot of work is needed in this field
regarding proper application of TQM in Iraqi universities
related to education, research and development.
Unfortunately
this conference was not followed by any further
steps of a practical nature.
Attempts
to apply total quality management principles in
Iraq:
The 1st
scientific attempt in Iraq was started by the
implementation of the National system of accreditation
in 1993. Tikrit College of medicine was part of
this attempt.
Three
components did comprise this implementation:
The systematic questionnaire
component: This was conducted centrally by a special
unit in the MOHE and scientific research called,
performance evaluation unit. This component comprises
comprehensive and detailed check lists which involve
seven domains. These cover the following topics
: goal, objectives, departmental structure - which
includes all data available on departments of
our college, the scientific units connected with
our college, the number and qualifications and
experience of available human resources including
adminstrators, technicians, workers and faculty
staff members and relevant information concerning
their academic qualifications and titles, resources
(human, financial and physical) including services
and equipment that are already available in the
college for students and staff, like transportation,
library and technology services, information .Professional
and social services, number of students (Iraqi
and non Iraqi at that time) including success
and attrition rates, research and dissertations.
Teaching staff including academic
ranked differences, qualifications and teaching
experience and load if any. Curriculum and methodologies
being the only college in Iraq that follows the
PBL approach and strategies that should be defended
to face the classical colleges accusations, exploring
teaching and learning strategies and approaches,
educational training opportunities, resources
available for teaching regarding classrooms, halls,
datashow, overhead slide projectors, etc. scientific
activities, research, cultural exchange and external
cooperation.
Published research and
books are evaluated also according to impact and
usability of services. In addition to the number
of conferences and symposiums held by the college.
This system is supposed to
be designed to cover and fulfill agreed standards;
feedback mechanism is supposed to be provided
regarding the input data, processes and outcomes.
The unit of performance is
responsible for analyzing these almost quantitative
data to end with an evaluation of and feedback
on, quantitative and qualitative bases together.
To comment on this component
and in spite of the fact that this activity does
not exist for the time being, and that there is
no clear picture whether this unit will be activated
or replaced by a further unit like implementing
TQM approach in a more scientific way. One point
that characterizes this
unit is that it did follow the traditional quality
approach regarding managing quality. It emphasizes
quality assurance, quality control to some extent
and to lesser extents, statistical quality techniques
based on random sampling from data related to
our college.
No
team problem solving in its technique were available
to induct remedies. On the contrary it seems that
the evaluation was done on a traditional approach
and prescriptions provided in the same manner.
The
goal was somehow, to preventing failure rather
than to improve it continuously.
The second comment on this evaluation is that
it takes the number of activities, rather than
the content of such activities, which makes the
activities more likel slogans or banners, rather
than a scientific approach, and this includes
also the type of research and other activities.
The second component: is to
evaluate the outcome of learning processes in
the form of the central student examination (CSE):
Written multiple choice question examinations
are conducted by central national boards and randomly
selected (1-2) papers in each year will account
for 50% of the total mark, in the selected topic.
We faced many problems regarding this issue as
the main concentration and balance was on the
knowledge domain focusing more on that issue,
and neglecting the practical skills as another
major domain which should be taken into consideration.
Being a PBL College, thisadded more obstacles
in relation to successful quality improvement
in the education process.
The third component deals with
what is called Annual performance evaluation of
the teaching staff, following several domains
and scoring systems. One important issue regarding
this component is that this evaluation is directly
linked to promotion and increments of faculty
staff. It is supposed that direct and face to
face feedback is conducted with those to achieve
highest marks and those who fail to achieve the
minimum marks.
·
The main comment on this component is really related
to absence of scientific standards (related to
quality management), absence of certain specifications,
and categories lead the component to more subjective
outcomes than objectiveoutcomes.
On the ground there is no face to face evaluation
and the process is subjected to many interferences
from the Dean and other power units in the college.
Vital attempts and great efforts
were spent toward achieving the goal of total
quality management and better quality of graduates.
On the other hand, absence of constancy for improving
the educational services, no clear philosophy
attempted regarding quality and accreditation,
dependence on some aspects of inspection, deficiency
in training on the job programs, lack of trust
between staff members and higher authorities regarding
evaluation were revealed.
Confusion related to topics
like total quality approach, Quality control and
assurance, also lack of distinction between appraisal
and accreditation, and lastly evaluation and monitoring.
All these topics need to be
addressed thoroughly for the sake of better quality
education and better quality of graduates.
Iraqi Medical School
(Systematic Accreditation)
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- Al Dabbagh S,Accreditation
in Iraqi medical schools/national conference
of MOHE,1999:presentation:2-18
- Jacqueline S, Quality management
in education: building excellence and equity
in student performance,2002,9,4:22-44
- JMHPE,Racing toward inducing
quality, toward quality and accreditation in
health profession education,www.medfomscu.org,E-
reader for unit 7,2006:2-48
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