Project management in health professions education

1. Project
Management
Hirotaka Onishi MD, PhD, MHPE
Dept of International Cooperation for Medical Education
International Research Center for Medical Education
Graduate School of Medicine, University of Tokyo

2. Project
 Latin verb proicere
 pro : precedence, something that comes
before something else in time
 icere : to throw, to do
 Planned set of interrelated tasks to
be executed over a fixed period and
within certain cost and other limitations.
(http://www.businessdictionary.com/)

3. Logic Model
(Logical Framework)
 Used for result-based management
 Emphasize causal relationship among
input  activity  output  outcome 
impact
 Identify important assumptions to
possibly affect the success
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4. Menu
1. Overview of Logframe
2. Logframe and planning
3. Project management
4

5. 1. OVERVIEW OF LOGFRAME
5

6. Structure of Programme
Programme
Project purpose
Output
Activity
Activity
Output
Activity
Activity
Project purpose
Output
Activity
Activity
Output
Activity
Activity
6
Impact: A Development
Issue of the Partner country
Outcome
Output

7. PCM: Project Cycle with
Logframe
Plan
Do
Check
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 Recheck plan
Logframe
 Implementation/monitoring
of input/activity
 Achievement of
items in Logframe
 Relationship
among items and
assumptions
 Develop and assess
the Logframe

8. 8

9. Project Design Matrix (PDM)
Narrative summary Objectively
verifiable indicators
Means of
verification
Important
assumptions
Overall goal
Indirect, long-term effects;
impact on the target society
Indicators and target
values to measure
Achievement toward
the overall goal
Information
sources for
the indicators
at left
Conditions required for the
project effects to be
sustainable
Project purpose
Direct effects on the target
group and Society
Indicators and target
values to measure
achievement toward
the project purpose
Information
sources for
the indicators
at Left
External factors which must
be met so that the project
can contribute to the overall
goal, but with uncertainty
Outputs
Goods and services that
are produced through
implementation of Activities
Indicators and target
values to measure
achievement toward
the outputs
Information
sources for
the indicators
at Left
External factors which must
be met so that the project
can contribute to the project
purpose, but with
uncertainty
Activities
Activities to produce the
outputs
Inputs
(by both Japan and the partner
country)
Resources required for activities
(people, money, materials, and
equipment)
External factors which must
be met so that the project
can produce the outputs, but
with uncertainty
Preconditions
Conditions that must be met
before activities begin

10. Linked Relationship
activities
outputs
project purpose (outcome)
overall goal (impact)
10

11. Causal Relationship
= “if-then” relationship
"if" the project purpose is fulfilled,
"then" it will contribute to the overall goal.
11

12. Logical Construction of Logframe
Narrative
summary
Important
assumptions
Overall goal <Sustainable
conditions>
Project purpose
and
Outputs and
Activities and
preconditions
if
then
if
then
if
then
if
then

13. 2. LOGFRAME AND PLANNING
13

14. PCM Planning Process
Stakeholder analysis
Problem analysis
Objective analysis
Alternatives review/
Project selection
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Logframe
Activity planning
Analysis Planning

15. Stakeholder Analysis
In Medical Education Area
 President
 Dean
 Senior faculty
 Young leader
 Leaders in
different
professionals
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 Community
leaders
 City mayor
 City workers
 Patients
 Students
 ・・・

16. Stakeholder Analysis
(Example of the Afghan Project)
Beneficiary Implementer Decision
maker
Sponsor
 Patients
 Students in
Kabul
Medical
University
(KMU)
 Teachers of
KMU and
teaching
hospitals
 Medical
education
development
center, KMU
 Ministry of
higher
education
(MoHE)
 Key teaching
staff
 Chancellor of
KMU
 Minister of
higher
education
 Directors of
teaching
hospitals
 JICA
 JICA
 Japanese
government
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17. Why Use?
1. Getting Your Projects Into Shape
2. Winning Resources
3. Building Understanding
4. Getting Ahead of the Game
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18. Tools for Problem Analysis
 The problem tree
 Break down many issues into manageable pieces,
causes, main problem and consequences.
 Five ‘whys’ / Root cause analysis
 Ask why each issue happens and moving up to a
root cause.
 The fishbone analysis
 Trace several factors and pursue category
causes. Other detailed causes are connected with
category causes.
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19. Phases of Problem Analysis
Problem tree Root cause analysis Fishbone analysis
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20. Problem Analysis
(Example of the Afghan Project)
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Basic information Problems Needs/Wants
 Old education
system from Soviet
Union
 Many learned in
different countries
(Pakistan, Iran, UK,
India, etc)
 Low salary from
employer (MoHE)
 Dual practice
 Insufficient skills for
teaching
 Low level patient
care
 Lack of teaching
facilities
 Cash income
 Teaching skills
 Specialty training
 Reputation
 Promotion

21. Problem Analysis
Identifying Causal Relationship
Teacher-
centeredness
No need to
change teaching
strategy
Low motivation of
students
Insufficient
interaction
between teacher
and students
Lack of clinical
experiences
Low clinical
abilities
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22. Team Approach
 Analysis by a team can involve variety
of opinions/information
 Stakeholder analysis
 Problem analysis
 Objective analysis
 Alternatives review/ Project selection
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23. Conversion from Problem
Analysis to Objective Analysis
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Student-
centeredness
Need for
facilitation
Motivation of
students
More interaction
between teacher
and students
Meaningful clinical
experiences
Higher clinical
abilities

24. Project Selection
 Construction of a new teaching hospital?
 It might be destroyed by another internal war…
 Monetary incentives for teaching?
 External motivation for teachers will be faded in a
while…
 Faculty development for student-
centeredness?
 Is internal motivation for the teachers enough to
change the behaviour?
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25. Confirmation of
“Killer Assumption”
 If an external condition is important and
the possibility to satisfy the condition is
very low, it is too difficult to achieve it
and called as “killer assumption.”
 You should select alternative project to
avoid killer assumption.
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26. How to Identify Important
Assumptions
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Is the condition important for
the project?
Is the condition controllable
from the project?
How about probability of the
condition to be fulfilled?
Is it possible to change project
content?
Change part of project content
not to be affected by the condition
Not important
assumption
Not important
assumption
Not important
assumption
Killer assumption: The
project is bound to fail
Important assumption
(to be described in the
Logframe and monitored)
no
no
yes
not likely
yes
yes
almost certain
no

27. Narrative summary Important
assumptions
Overall goal
Indirect, long-term effects;
impact on the target society
Conditions required for the
project effects to be
sustainable
Project purpose
Direct effects on the target
group and Society
External factors which must be
met so that the project can
contribute to the overall goal,
but with uncertainty
Outputs
Goods and services that are
produced through
implementation of Activities
External factors which must be
met so that the project can
contribute to the project
purpose, but with Uncertainty
Activities
Activities to produce the
outputs
External factors which must be
met so that the project can
produce the outputs, but with
Uncertainty
Preconditions
Conditions that must be met
before activities begin

28. Indicators, Means of
Verification, Input
 Set objectively measurable indicators
 Relate indicators with activities
 Select Means of Verification
 Describe Inputs from both parties
 Educational resources including human
resource, facility/equipment, personnel, etc
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29. Narrative summary Objectively
verifiable indicators
Means of
verification
Important
assumptions
Overall goal
Indirect, long-term effects;
impact on the target society
Indicators and target
values to measure
Achievement toward
the overall goal
Information
sources for
the indicators
at left
Project purpose
Direct effects on the target
group and Society
Indicators and target
values to measure
achievement toward
the project purpose
Information
sources for
the indicators
at Left
Outputs
Goods and services that are
produced through
implementation of Activities
Indicators and target
values to measure
achievement toward
the outputs
Information
sources for
the indicators
at Left
Activities
Activities to produce the
outputs
Inputs
(by both Japan and the partner
country)
Resources required for activities
(people, money, materials, and
equipment)

30. Logic Model
 Also called as logical framework, project cycle
(Kellogg Foundation, 2001)
 Purpose: To assess the causal relationships
between the elements of the program
 Evaluation for international assistance projects
are conducted by this framework
input activity output outcome impact

31. 3. PROJECT MANAGEMENT
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32. Common Framework
Improvement of
Medical Education
System
Development of new curricula
and/or improvement of existing
curricula
Improvement of educational
management including resources,
scheduling, motivation, etc.
Training of trainers (TOT) –
disseminating new educational
model to other teachers
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Project Goal Outputs

33. Organize Activity Plan Table
Objective 1
Curriculum
development
Objective 2
Teaching
management
Objective 3
TOT
Activities
Outputs
Project purposes
Schedule
In-charge
Equipment
Budget
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34. Gantt Chart
2020 2021
4 5 6 7 8 9 10 11 12 1 2 3 4 5 6
Output 1
Activity 1-1
Activity 1-2
Activity 1-3
Output 2
Activity 2-1
Activity 2-2
Output 3
Activity 3-1
Activity 3-2
Start to start
Finish to start
Finish to
finish
100% complete
70% complete
Not started yet
50% complete
33% complete

35. Regular Check for the
Progress/Management
 Person in charge of the management must
check if the progress/management is OK
between the real settings and the check
sheet regularly.
 Frequency may vary
 If the management doesn’t follow the plan,
persons in leadership position must make
decision to change the plan or to ask for
further effort
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36. Checking Points
 Is the resources/supports for each output/activity are
enough? (human resources, political supports,
counterparts’ contribution, time, safety…)
 Are outputs/activities appropriate in the settings and
schedule? (mismatch with the ability/time conflict of
the counterparts, language barrier…)
 Are facilities/equipment are sufficient to implement
the activities? (too many students in a small facility,
low quality of the printing machines…)
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