MANAGEMENT AND LEADERSHIP (ML)
Health service organisation
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome | Health Service Organisation |
| Code | ML1 |
| Description | Trainees must understand the organisation of the healthcare system, so as to appreciate the political and economic context of patient care. |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.1.2 below |
HEALTH SERVICE ORGANIsation Study Guide .
The ophthalmologist needs a good level of understanding of the way in which the Health Service is organized and managed, to include the interaction between major organizations such as the Department of ophthalmology ,Ministry of health, National council of dental and health practitioners, the various Colleges, and the primary , secondary and tertiary healthcare delivery organizations.
Think:
- Who is ultimately responsible for the running of the Health Service?
- What are the roles and responsibilities of the Department of Health/Ministry of health?
- How do Primary and Secondary Care relate to the District hospital/regional/referral hospitals and MOH, and how is health care "purchased"?
- What do I know about Ministry of health? Targets and how should I respond?
- What are the roles and responsibilities of the professional societies, ministry of health and the various Colleges?
- Which regulatory agencies are involved in the licensing and use of drugs and instruments, and what are their roles?
- How do doctors, nurses, managers and patients have an input into the running of the National Health System?
- What are the differences in health legislation between the different countries and how does that affect my patient?
- How does teaching fit into the role of the ministry of health, professional societies and what other institutions are involved?
Activity:
- Read up from the study resources below.
Resources:
- Websites of local ministries of health and other relevant organizations in various countries.
- Websites of, professional societies, teaching hospitals and colleges
Clinical Governance
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Clinical Governance |
| Code | ML2 |
| Description | Trainees must understand and play an active role in local clinical governance processes, and ensure that patient safety is paramount in all they do. |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.2.2 below |
UNDERSTANDing THE PRINCIPLES OF CLINICAL GOVERNANCE Study Guide
The ophthalmologist needs a good level of understanding of the principles of clinical governance. The ophthalmologist must have an appreciation of the application of clinical governance principles to their own practice.
Think:
- What is Clinical Governance?
- How is the quality of the delivery of clinical care assured?
- How do Clinical Governance principles respond when quality of clinical care is found to be below standard?
- What are the principles of risk assessment and risk management?
- How can patient management pathways be best organised to ensure a failsafe system?
- What is my role in ensuring that correct site procedures are performed?
- What is my responsibility regarding others in the healthcare team whom I perceive to be a cause for concern?
- In practice, what does a "no-blame culture" mean to me?
- What is the mechanism in my hospital and ministry of health for reporting of Critical Incidents and Serious Untoward Events?
- What is a never event?
- When should I "whistle blow" when I see evidence of seriously unsafe practice, and from whom should I seek advice before doing so?
Activity:
- Read up from the study resources below.
- Make sure you attend, and actively contribute to, your department's audit/clinical governance/mortality and morbidity meetings.
- Ask to be actively involved in the assessment and management of a Critical Incident or a Serious Untoward Event in your department and reflect on this in your e/hard copy-portfolio diary.
- Ensure you are a member of a medical defence society and be prepared to seek advice from them when potentially serious matters come to your attention
Resources:
- www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Clinical Governance/fs/en
- Medical Defence Union (MDU) at www.themdu.com
- Website for national Medical and dental Associations
- Medical Protection Society (MPS) at www.medicalprotection.org/uk
- General Medical Council website http://www.gmc-uk.org/guidance/good_medical_practice.asp
Cooperation with other services
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Cooperation with other services |
| Code | ML3 |
| Description | Trainees must accept the responsibilities of an ophthalmologist in relation to other tertiary, secondary and primary care services. They must develop good clinical networks with colleagues in other disciplines that will benefit patient care. |
| Assessment |
MSF, Case based discussion, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.3.2 |
CO-OPERATION WITH OTHER SERVICEs Study Guide
The ophthalmologist should understand the importance of maintaining effective professional relationships with all other health professionals where there might be shared care of a patient's clinical problem. These relationships extend to other medical, nursing and paramedical colleagues, as well as to members of lay bodies, where those bodies have a legitimate interest in a patient's medical care.
Think:
- What other medical, nursing, paramedical and lay persons/bodies have a role in the delivery of care to my patient?
- How best can I actively seek the views of other professionals?
- How should I best maintain the professional relationships between us to optimise the treatment of my patient?
- What do I do if that relationship fails or breaks down?
- Who is responsible for restoring clinical and other links between the various interested parties?
- How can I best give other professionals and lay bodies the benefit of my knowledge and expertise as a doctor?
Activity:
- Read up from the study resources below.
Resources:
- www.gmc-uk.org/guidance/good_medical_practice/index.asp#Wor king%20with%20Colleagues
- websites of the national health professional councils and associations
Role as a Leader
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Role as a Leader |
| Code | ML4 |
| Description | Trainees must be able to work as part of a multi-professional clinical team. They must accept, where appropriate, the role of the leader of the team. |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.4.2 Below |
Leader/Team working STUDY GUIDE
The ophthalmologist should understand their role as the leader of a clinical team, including nursing, paramedical and other workers involved in the clinical management of a patient under his care. He or she should acknowledge his part in multidisciplinary medical management, and be aware of and sensitive to the priorities of sometimes conflicting management strategies in the treatment of patients with multisystem disease.
Think:
- What are the responsibilities of a clinical team leader?
- What are my responsibilities as patient advocate in relation to the team?
- How do I ensure the cohesion and efficient functioning of the team?
- In particular, how can I encourage good team dynamics, especially ensuring that all members contribute, and build and maintain good relationships within the team?
- How can I demonstrate that I am ready to take on a leadership role within the team?
- As the leader, how can I ensure that I am accessible to team members?
- How do I identify and remedy breakdowns in team effectiveness sensitively and assertively? Especially in regard to unprofessional behaviour, bullying and/or harassment, and conflict management.
- Am I aware of national and local regulations and protocols that govern our action in the health service, not just as an individual but within a team?
- How can I actively promote professional activities and values?
Think:
- In what circumstances should I accept that the team has different opinions to mine and what attitude should I take on such occasions?
- How can I appropriately praise staff when they do well?
- How can I best identify when other team members are struggling or failing, or under stress (e.g. with patients receiving bad news), and how can I best support them?
- How can I encourage a whole-team approach to patient safety?
- How do I ensure that new staffs are properly inducted and that no-one practices beyond their capabilities?
Activity:
- Explore leadership styles and prejudices with colleagues and trainers in a peer-learning environment, and discuss these where relevant in CbD.
- Seek opportunities to act in a leadership role under the supervision of more senior colleagues e.g. running a theatre list, chairing a meeting, organising a teaching session
- Reviewing or introducing a change in practice in your team/unit
- Read up from the study resources below.
Resources:
- http://www.bristol-inquiry.org.uk/final_report/report/sec2chap22_10.htm
- http://www.cehjournal.org/wp-content/uploads/teamwork-for-eye-care.pdf
- http://www.hrhresourcecenter.org/HRH_Info_Teamwork
Assessment:
- Case Based Discussion
- https://www.nwpgmd.nhs.uk/medical-leadership/leadership-development-tools
Role as a community/clinical researcher
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Role as a community/clinical researcher |
| Code | ML5 |
| Description | Trainees must be able to contribute to research in medicine and appreciate the value of research in clinical care and in particular understand how to carry out a community clinical trial. |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.5.2 below |
Role as a community/clinical researcher Study Guide
The ophthalmologist should understand the importance of research in the field of ophthalmology, and seek to promote it wherever possible.
Think:
- What is research?
- Do I need to obtain some research skills in order to understand research publications?
- What sort of research can I do?
- Where do I get ideas for research from?
- What do I know about research ethics and the law in relation to research?
Activity:
- Attend a research skills course
- Contact your local research ethics committee.
- Contact your Trust/institutional R&D department
- Read published research
- Attend journal clubs
- Ask others if there are any projects you can join
- Discuss research ideas with your trainers
- Seek opportunities to contribute to clinical trials through ophthalmology Clinical research networks in various centres during your training
Resource:
- http://www.dh.gov.uk/en/Managingyourorganisation/Informationpolicy/Patientconfidentialityandcaldicottguardians/DH_4100563
- International Conference on Harmonisation - Good Clinical Practice (ICH-GCP) training, which can be done online
- Websites of National research institutes
Reflect:
- How could that published research project have been carried out differently?
- What sort of research questions have been left unanswered?
Assessment:
- Research proposal presentation and dissertation defence
Role as a Teacher
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Role as a Teacher |
| Code | ML6 |
| Description | Trainees must be able to contribute to the teaching and training of students and other healthcare colleagues |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
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Role as a teacher Study Guide
The ophthalmologist should understand the importance of teaching and be able to make a positive contribution to the undergraduate and postgraduate development of doctors, nurses and paramedical staff in the field of ophthalmology.
Think:
- How do I learn to best effect?
- What opportunities are there for teaching others?
- How can I optimise the teaching of others in different settings?
- What is the optimum way of teaching others?
- What teaching aids do I need, and where can I source them from?
- What skills do I need to be a good trainer?
- Are there any "training the trainer" courses I could attend?
- How can I ensure that patient safety if maintained as I teach others?
- What are the forms of assessment (formative, summative) and what are their roles in medical education? (especially work-place based assessment)
- How can I contribute to the organisation of teaching and training in my unit?
- What should I do if I become aware of a trainee in difficulty?
- How should the needs of service and training be balanced?
- How can I receive feedback on my teaching and training?
Activity:
- Seek opportunities to teach junior colleagues, students and allied professionals
- Contribute to the organisation of training in your unit
- Seek opportunities to act as a mentor e.g. to medical students
- Speak to your College Tutor about taking on the role of Associate College Tutor
Resources:
- www.rcophth.ac.uk/trainingthetrainers
- Attend teaching methodology courses
Assessment:
- Direct observation form
- Students feedback forms
Role as a manager
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Role as a manager |
| Code | ML7 |
| Description | Trainees need to recognize the role of an ophthalmologist as a clinical manager who needs to be able to plan in order to achieve service goals. The trainee must understand the importance of efficient utilization of resources as self appraisal and accountability for service outcomes. The trainee must understand that, as a manager, the ophthalmologist needs to be able to provide support, direction and motivation to others involved with service delivery and the need to foster an environment of improving service delivery paying due attention to patient safety. |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.7.2 below |
Role as a manager Study Guide
The ophthalmologist should acknowledge the role of medical staff in medical management, and should be able, where necessary and where called upon, to make a positive contribution to the management of departments, Trusts and the wider community for the better delivery of ophthalmic health care.
Think:
- What are the objectives and roles of medical managers in my trust?
- Why is it important for me to be involved?
- Where can I obtain training in medical management techniques?
- What is my responsibility and role in ensuring efficient and effective use of resources?
- What role can I play in appraising other staff and ensuring they are playing their full role in meeting service objectives?
- Should I consider a higher qualification in medical management? If not, how involved should I be?
- What sort of risks does a service face on a day-to-day basis?
- What techniques can be used to assess risks associated with a proposed change in service provision and modification of clinical services?
- How can risk be reduced?
Think:
- Where can I obtain human factors or patient safety training?
- What are my responsibilities in regard to the development and maintenance of a safe environment for patients and staff?
- When should I consider involving medical regulatory bodies?
- Do I know how to report serious issues within my institution?
- What regulations cover statutory rest periods and what part can I play in ensuring they are satisfied?
- How can I ensure that there is appropriate involvement of patients and the public in the management of my department?
Activity:
- Seek opportunities to work with a manager to identify risks associated with a proposed change in service provision
- Discuss with colleagues how procedures and processes can be modified to improve patient and staff safety
- Try and attend management meetings e.g. subspecialty or unit service meetings and contribute
Resources:
- http://www.gmc-uk.org/publications/gmc_today/gmc_today_june08/management_matters.asp
- http://www.gmc-uk.org/guidance/current/library/management_for_doctors.asp
Assessment:
- Case based Discussion
Apply clinical reasoning using an evidence based approach
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Apply clinical reasoning using an evidence based approach |
| Code | ML8 |
| Description | Trainees must be able to demonstrate that they can make decisions by applying appropriate and clear clinical reasoning. They must be able to apply the principles of evidence based practice. |
| Assessment |
MSF, portfolio/logbook , case based discussion and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.8.2 below |
Clinical reasoning using an evidence based approach STUDY GUIDE
The ophthalmologist needs to make decisions by applying appropriate and clear clinical reasoning using evidence based approach
Think:
- How can I apply critique and analytical methods to published research?
- How best can I keep myself up-to-date with relevant clinical evidence?
Activity:
- Ensure you discuss evidence for your decisions informally with trainers and fellow trainees, and especially when undertaking CbD assessments
- Make use of hospital and departmental library
- Make use of e-learning resources available for you
- Arrange and participate in journal clubs
Resources:
- Textbook of Evidence based Ophthalmology- available in hardcopy, PDA and PC (PDF)
- BMJ Clinical Evidence
- Cochrane Library
- Evidence based medicine- How to Practice and Teach EBM. David L Sackett, et al
- Cogni-Q- PDA based data updated frequently www.unboundmedicine.com
Departmental audit
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Departmental audit |
| Code | ML9 |
| Description | All trainees must participate in departmental audit. They must understand how audit can contribute to improvement in clinical practice. They must be prepared to implement the changes recommended by an appropriately conducted departmental audit. |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.9.2 below |
Departmental audit Study Guide
Audit is an essential component of clinical governance. All ophthalmology departments are required to undertake a review of the clinical services they provide. The review should compare these clinical services to a defined standard. The standards used might be published by international and national bodies, commissioners, the Trust or agreed as best practice in the department.
Think:
- Which audit standards can be applied to clinical practice in your department?
- What were the results of any audits carried out in your department?
- Were the recommendations identified from the audit implemented?
- Which areas of clinical practice lend themselves to audit?
- How can I ensure that patient feedback on service provision is obtained and incorporated into departmental processes?
- What methods of data collection are available to me?
- How can audit improve practice?
- What is the "audit cycle"?
Activity:
- Approach and discuss ideas with supervising Consultant and local audit department
- Read about the principles of audit
- Identify the clinical lead for audit in your department
- Get involved in any current audits that are taking place
- Present a departmental audit to the clinical team and upload your presentation to your e-portfolio (your educational supervisor, programme director or clinical audit lead must validate this)
- Organize the introduction of recommendations from an audit
- Complete the audit loop by reviewing changes in practice that have occurred as a result of the last audit
- Submit a poster of your audit to a local or national conference e.g. the annual Congress/ COECSA CONGRESS
- Upload an audit to your e-portfolio describing your contribution to the process (no more than 3 trainees can claim a significant contribution to an audit (your educational supervisor, programme director or clinical audit lead must validate the audit document)
Resources:
- Websites for national societies
- Websites for ministries and research institutions
Personal audit
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Personal audit |
| Code | ML10 |
| Description | All trainees must participate in personal audit. They must understand how audit can contribute to improvement in their own clinical practice. They must maintain appropriate audits according to national policy |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.10.2 below |
Personal audit Study Guide
Audit of your own clinical practice is an important part of annual appraisal and will provide evidence of good medical practice for revalidation. Paragraph 14 of Good Medial Practice (2006) includes guidance on maintaining and improving performance that includes audit. You are expected to maintain a logbook of surgical practice that contains details of the results and complications of your performance with cataract surgery.
Throughout your training, you MUST perform a continuous ongoing audit of any of your cataract surgery cases in which significant complications occur. The synopsis must include details of the final outcome of these cases, including the final visual acuity and (where available) refraction, and details of any further complications which arise. All these in a log book and portfolio
Think:
- Which parts of your clinical practice would you like to review?
- Are there any standards that you can use or will you have to agree your own standards with your clinical supervisor?
- How will you plan the audit so that the results are easily obtained, reliable and relevant?
- How will you respond if the audit identifies areas of your practice that need to be improved?
- How may my own poor performance have an impact on patient care and on the service as a whole?
Activity:
- Identify an area of your clinical practice that you can review.
- Track down or agree your own standards.
- Get advice from your clinical audit department or clinical audit lead.
- Plan and write an audit protocol.
How might you be assessed on this learning outcome?
Your log book and portfolio should contain at least an audit of your cataract surgery (a minimum of 50 consecutive cases) to satisfy the mentors that you will be able perform and practice to the highest quality surgery that responds to community needs. The complication rate of ALL your cataract surgery must be documented and available for the mentor to assess throughout the training years.
The structured viva part of the part 2 COECSA examination will assess your understanding and your surgical experience of audit
Resources:
- Clinical audit support centre: http://www.clinicalauditsupport.com/
- Audit and clinical effectiveness information for ophthalmologists: http://www.rcophth.ac.uk/docs/profstands/ophthalmic-services/AuditandClinicalEffectivenessApril2008.pdf
- NICE guidance on audit:
- http://www.nice.org.uk/usingguidance/implementationtools/auditadvice/audit_advice.jsp
- Good Medical Practice: http://www.gmc-uk.org/guidance/good_medical_practice/index.asp
Assessment:
- Personal audit forms
Health economics/Managing resources
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome |
Health economics/Managing resources |
| Code | ML11 |
| Description | Trainees must understand and apply knowledge of health economics relevant to eye care. They must understand how ophthalmic services are planned and managed within the health service system and must be aware of financial regulation |
| Assessment |
MSF, portfolio/logbook, case based discussion and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.11.2 below |
Health economics/Managing resources Study Guide
The ophthalmologist should acknowledge the fact that resources for services are not always unlimited and should therefore be able, where necessary and where called upon, to make a positive contribution to the cost evaluation of services , planning and budgeting for resources in departments, Institutions and the wider community for the better delivery of ophthalmic health care.
Think:
- What is health economics and what is the value of eye health?
- What is the demand of eye health and what is the supply of eye health?
- Am I in a position to cost the ophthalmic services offered in my unit?
- Am I in a position to adequately plan and budget for the resources and services in my unit?
- Can I do a cost analysis (cost effectiveness, cost benefit and cost utility)?
Activity:
- Consider taking basic health economics course
- Seek opportunities to work with a manager to see how the ophthalmic services are costed
- Try and attend planning and budgeting meetings
Resources:
- Culyer, Anthony J., and Adam Wagstaff. "Equity and equality in health and health care." Journal of health economics 12.4 (1993): 431-457.
- Rawlins, Michael D., and Anthony J. Culyer. "National Institute for Clinical Excellence and its value judgments." BMJ: British Medical Journal 329.7459 (2004): 224.
- Alastair M. Gray, Philip M. Clarke, Jane Wolstenholme, Sarah Wordsworth (2010) Applied Methods of Cost-effectiveness Analysis in Healthcare, Oxford University Press. Preview ISBN 0-19-922728-4
- Arrow, K. (December 1963), "Uncertainty and the welfare economics of medical care" , American Economic Review 53 (5): 941–973
- Drummond, Michael F. (2005) Methods for the Economic Evaluation of Health Care Programmes, Oxford University Press. Preview. ISBN 0-19-852945-7
- Whittington, Ruth (2008). Introduction to Health Economics: A Beginners Guide Preview. ISBN 978-0-9545494-5-9.
- A.J. Culyer and J.P. Newhouse, ed. (2000). Handbook of Health Economics, Elsevier. 1A.Description. Elsevier.
Prepare monitoring and evaluation tools of projects
Learning Outcome Overview
| MANAGEMENT AND LEADERSHIP (ML) | |
| Learning Outcome | Prepare monitoring and evaluation tools of projects |
| Code | ML12 |
| Description | Trainees must be actively involved in preparing monitoring and evaluation tools. They must understand the principles of and participate actively with the monitoring and evaluation of projects. |
| Assessment |
MSF, portfolio/logbook and end of year 2-3/4 review/COECSA exam |
| Target Year of Achievement | Year 2 with annual reviews |
| Related Learning Outcomes | ML1 – ML12 |
| Other Links | Study Guide 3.10.12.2 below |
Prepare monitoring and evaluation tools of projects STUDY GUIDE
Government officials, development managers and civil society are increasingly getting aware of the value of monitoring and evaluation (M&E) of development activities. M&E provides a better means of learning from past experience, improving service delivery, planning and allocating resources, and demonstrating results as part of accountability to key stakeholders. It is therefore important for the ophthalmologist to get familiar with the concepts of monitoring and evaluation, the tools used and how to prepare such tools for projects
Think:
- What is the difference between monitoring and evaluation?
- What is the importance of monitoring and evaluation?
- What are the different tools used in monitoring and evaluation and when are they used?
- Who does monitoring and evaluation?
- Do I clearly understand the terms used in M&E and the logical framework?
- For me to prepare the M&E tools, am I in position to identify the key performance indicators to be evaluated.
Activity:
- Consider attending a short course in monitoring and evaluation
- Try and identify M&E personnel to get acquainted with how M&E is conducted particularly taking note of the types of tools used and how they were prepared.
Resources:
- Handbook on Monitoring and Evaluating for Results, Evaluation Office, UNDP, 2002
- Advancing Results-Based Programming and Simplification of Programme Procedures UNDP/PROG/01/02 16 November 2001
- Louisa Goslin and Mike Edwards (2007); A practical Guide to Planning, Monitoring, Evaluation and Impact Assessment, Save the Children
- New Country Programme Format, Review and Approval Process UNDP/PROG/01/03. 28 November 2001
- Capacity Assessment and Development In a Systems and Strategic Management Context Guidelines, MDGD/January1998
- Civicus; Monitoring and Evaluation Toolkit; www.civicus.org
Assessment:
· Case based discussions