Abstract: Not available

INTRODUCTION

Rationale of quality in higher education: Dramatic changes in the education scene began taking place in the 1980s. There was a striking growth, worldwide of participation in higher education with the advent of Information age with its huge and rapid growth in knowledge. The growth of places in the universities increased at rates >10% per annum. A growing participation of non-traditional students, e.g., those aged 21 and over, also increased at a phenomenal rate. With the galloping demand, the segregation that the governments had maintained. The great ‘binary divide’ between technical institutions and higher education, came under enormous strain. Many countries caved in to the pressures and granted the same status of a university to all these institutions a unified system of higher education.

These dramatic changes in the composition of universities prompted the governments to look more closely at the issues of control and at outcomes in terms of the employability graduates. With the arrival of the knowledge based economy, universities were expected to play apart in the shaping of the new mould of education for the community (De Alva, 1999).

Total quality management in KAU college of medicine began in 2000. A committee was formed to put the rules of TQM which included faculty members from different fields (both basic science and clinical). One of the most important jobs of this committee was to assess the current state of education in KAU College of Medicine.

Disadvantages of TQM in higher education: Application of TQM in higher education is concerned, there are serious problems identified with its adoption: application of TQM in higher education is concerned, there are serious problems identified with its adoption.

In TQM the processes are supposed to be customer driven. In higher education the critical problem is identification of the customers or products to drive towards. The customers can variously be students, employers, government etc. and in the same way the products can also be education, knowledge, research etc. This creates a considerable lack of focus for the groups involved with the processes.

With its measurement and process focus, TQM makes an implicit assumption that the processes are amenable to measurement. On the other hand many processes in education are too subtle to be measured. The more important the knowledge is the less likelihood there is of ever noticing it (Bowden and Marton, 1998).

In addition, the main tenet of effective communication required within a university for TQM implementation is rarely reached. There is rarely a shared vision and the academic managers in an attempt to retain power act as communication block. The participation in decision making at all levels rarely ever takes place. Those with power continue to retain it (Bramble, 1996).

Quality assurance and continuous quality improvement: There is a notable improvement in quality inside the faculty of Medicine in the past few years. Recently a Vice Deanship for Quality and development has been established. Moreover, a detailed strategic plan with a timed operational plan has been finalized. These include 50 projects to improve the quality and develop the educational environment in the faculty of medicine. There is a desire to set a quality assurance system in the faculty. Preparation for that is going on and will take a year to complete.

The aim of the committee responsible for TQM in KAU was to assess and improve the performance in relation to generally accepted standards of good practice and identify areas for improvement.

The faculty of medicine is preparing to benchmark its performance against the standards of Liaison of Commission for Medical Education (LCME); this will be starting soon and will help the faculty to establish their own indicators. Lack of indicators that provide clear evidence of quality of performance in achieving objectives. Lack of benchmarks for comparing quality of performance. Self-assessments of quality of performance are not checked against related evidence including feedback through user surveys and opinions of stakeholders such as students and faculty, graduates and employers.

One of the most important tasks of this committee was to establish clear mission and objectives that reflect a real change in the KAU college of medicine towards application of TQM.

Faculty mission and goals
Mission: To promote knowledge of human life processes, both in health and illness in order to serve the community by teaching and training health professional in the art of prevention and treatment of diseases.

Goals:

General educational objectives:

The strategic plan in KAU College of medicine: Total Quality Management (TQM) is syntheses of well-known management practices aimed at creating an organizational culture where every one will work contribute to overall quality of the products and services. Although, Deming’s original 14 points tend to be an important guide, many Western masters, like Crosby, Peters etc. provided a substantial slant in emphases, followed by a large group of Japanese masters like Ishikawa, Shingo and Taguchi etc. Hence, TQM remains a very rich field for potential management practice.

There is a broad field for inspiration and guidance. More recently, many countries have instituted national quality awards e.g., Malcolm Baldridge Quality Award (US) which encapsulate these principles of TQM into measurement oriented frameworks of management practices which are available for any organization to seek some guidance from. Generic Elements of TQM (Harvey, 1995).

The Curriculum Development Task Group (CDTG) and the Faculty Curriculum Committee (FCC) at the FOM of King Abdul-Aziz University share in putting the strategic plan of KAU College of medicine. It described all the activities that were carried out by the CDTG over the 2 years period during which a strategic objective was formulated and stated as to develop and improve on the quality of teaching and learning environments of the FOM in relation to: curriculum reforms and development, students support, staff development, development of resources and facilities and high quality health care provision to the community. Such strategic objective was proposed to be achievable by the end of 1430 H, though 12 proposed strategies:

Strategy 1: Continuing to develop program specifications that will reflect curriculum reform in relation to:

Strategy 2: Extending structured clinical and communication skills development in medical students to increase their clinical ability and competence upon graduation.

Strategy 3: Fostering a desire for lifelong self-learning skills in medical students in relation to:

Strategy 4: Providing appropriate academic and pastoral support for medical students throughout the phases of the curriculum. To ensure attributes appropriate for future responsibilities to patients, colleagues and community in general.

Strategy 5: Refine in the management and supervisory structure that support learning and teaching, to enable the FOM to monitor goals, objectives and targets and to ensure that they are met, including using the outcomes of internal and external review procedures to enhance the quality of both learning and teaching.

Strategy 6: Ensuring continuous financial support from sources other than the University pool by supporting the expansion of:

Strategy 7: Encouraging academic staff at all levels to demonstrate excellence in learning and teaching as well as in research and to take advantage of opportunities for continuing professional development in their specialty.

Strategy 8: Providing generic and specific training in learning, teaching and assessment for all new teaching staff through a structured medical education program.

Strategy 9: Strengthening external review procedures to maintain consistency of the reporting process and to safeguard academic standards.

Strategy 10: Maintaining links with appropriate local, national and international bodies to enable academic staff to take advantage of specific developments in learning, teaching and assessment.

Strategy 11: Adopting a faculty-wide approach to evaluating student’s satisfaction through feedback mechanism with the learning experience at the level of curriculum and the learning environment.

Strategy 12: Continuing the development in the college of medicine to:

There is a clear focus on student experience. Transformative learning requires a transparent process, which is integrated, contributing to a rich and relevant Total Student Experience. Transparency means openness about the aims, processes and method of attainment of learning byte student. Integration means that such experiences are linked together into a cohesive whole. Learning is based on a dialogue between participant and providers. Dialogue involves the discussions between learners and teachers about the nature, scope and style of their learning. Dialogue also requires a dynamic exchange among the teachers about the teaching and learning process (Harvey and Knight, 1996).

Exploration of the current state regarding TQM in KAU Initial work planning: An announcement was made during the faculty board meeting, by the Dean, informing faculty (head of departments and vice deans) about the self-study and anticipated external review and the need to provide input especially on the standard relating to learning and teaching by all the departments.

A committee was formed to undertake the self study. Members of the committee included faculty members from different departments both clinical and basic science some of whom had occupied key administrative jobs in the college (dean, vice dean).

Letters issued by the dean were sent to all head of departments to co-operate with the committee and provide the information needed whenever approached.

Distribution of work: The process of review included examining and completing the rating scales in the Quality Standards for Post Secondary Institutions. The 11 standards were subdivided into 3 related groups and each group of standards was allocated to 3 members of the committee (sub-committees) to study and complete. Several meetings between the members of the sub-committees took place before the final conclusions were reached.

Source of information: The main source of information for the evaluation of the different standards was mere analysis and judgment of the self-study committee. These are faculty members who are or were in charge and knowledgeable in that specific aspect so it is more of an educated judgment and not just an ad hoc impression.

For standard 4 (Learning and Teaching), we made use of the questionnaires that were designed by the Learning and Teaching sub-committee of the Pilot Project for Institutional Accreditation that was conducted in November 2006.

Questionnaires inquiring about good practice in Learning and Teaching (standard 4) that were designed by the self-study piloting committee included three questionnaires. Student’s questionnaires, Faculty member questionnaires and Head of department’s questionnaires.

The final rating for standard 4 depended on questionnaire feedback, brainstorming sessions and results of group discussion of faculty members in the college.

Performance evaluation in relation to quality standards
Central activities
Mission and objectives:

Governance and administration:

Learning resources:

Facilities and equipment:

Financial planning and management:

Faculty and staff employment processes:

Research: There are adequate laboratory space and equipment, library and information systems and other necessary resources to support the core research activities of faculty. King Fahd Research Center is a good example.

Institutional relationships with the community:

Internal activities
Learning and teaching
Student learning outcomes:

Educational assistance for students:

Quality of teaching:

Supports for improvements in quality of teaching: Although, opportunities are provided for professional development of faculty in relation to teaching quality, however, there is no system to ensure that those faculty members in need for such training are attending the available workshops.

Qualifications and experience of faculty:

Program development and review processes: The curriculum of the Faculty of Medicine was a typical traditional curriculum. It was departmental based, where separate courses and modules were taught by each department.

In 2003, a new innovative curriculum was designed as a result of a structured Strategic Plan of the Faculty of Medicine. This movement was due to the intention to improve the educational environment inside the Faculty of Medicine. The new curriculum of the Faculty of Medicine was designed to emphasize the following concepts:

New program proposals or proposals for major changes are documented in program specifications and formally assessed and approved or rejected by the institution’s senior academic committee (this is true of the new integrated curriculum).

Course portfolios are well established in all departments as evidenced by the AAU visit to FOM but courses are not regularly evaluated and adjustments are not always made as required and the section on instructor reflection on the course is missing in most portfolios.

Comprehensive program self-study is not done in the FOM and this is the first planned self-study conducted in accordance with the NCAAA standards.

Field experience activities: This may be only applicable to the field studies done in the Family and Community medicine department for 4th year medical students. The department’s evaluation for this standard was 4 stars and the head of department was contacted to inquire about the quality methods used to assess this standard. The availability of documents with learning outcomes, roles of students and supervising staff and student evaluations were claimed.

Student administration and support services:

Pro and cons of the quality management of FOM of KAU: Like any other program, this one has some strengths as well as weakness.

Some strengths of the program:

Some points of weaknesses exist in the FOM of KAU:

As the researchers’ point of view, weakness may delay or obstruct the way of adequate quality management.

CONCLUSION

A quality assurance system is not in place and is a major requirement if accreditation is sought in the near future. Quality assurance processes should be designed to ensure that acceptable standards are met and that there is continuing improvement in performance. Lack of documentation is a major problem in many of the activities done in the faculty. Many of the good practices were performed but they lacked documentation, monitoring and evaluation.

Many of the good practices were also noted to be done in a sporadic fashion by certain departments (and even by some faculty members in the same department e.g., student evaluation of the quality of teaching) rather than a centralized common practice that is followed by all the departments.