In medical practice, health workers encounter patients with different conditions amongst which are high fevers, persistent coughing, or even those who can't speak about their pain. Health workers ought to have the ability to interpret and solve these problems easily, especially in emergencies. However, it starts with their training. This is why the Ministry of Education and Sports in partnership with Enabel in Uganda is rolling out the training on the SPICES model of education and training for health in the partner health training institutions of Fort Portal College of Health Sciences, Jinja School of Nursing and Midwifery and Hoima School of Nursing and Midwifery.
The Student-centered, Problem-based, Integrated, Community-based, Elective, and Systematic learning (SPICES) model was developed by Professor Harden in the 1940s. The model reshapes how health professionals are trained, replacing traditional lecture-heavy methods with a dynamic, hands-on approach that mirrors real-world scenarios as it trains students to think critically, innovate, and collaborate effectively.
Nakaggwa Mary, the Principal Health Tutor at Jinja School of Nursing and Midwifery believes that it is going to give every student a chance to participate and help tutors use diverse methods to deliver content. “We’re not just creating competent nurses for Uganda but for the world," said Mary who highlighted how the model fosters self-directed learning, ensuring that students take charge of their education while tutors guide them to refine and clarify their findings.
Mbubi Joiner Stella, a Senior Health Tutor in Midwifery, wanted to experiment with the SPICES model. She told her students to prepare a presentation within 15 minutes on a topic. By the end of the day, they had practiced ten skills. Everyone participated, and no one was left behind. This hands-on, participatory approach demands more from both students and tutors as compared to the traditional lecture method of teaching.
However, such a transformation isn’t without its challenges. Christopher Isabirye, the Principal Tutor and Head of Curriculum and Pedagogy at the Health Tutors College Mulago, a tutor trainer, pointed out that instructors are juggling packed curricula and demanding workloads. "This requires more planning and preparation. Tutors need to guide students closely, which takes time and commitment. There’s also the issue of resources, learning by doing often calls for financial investments that schools may not readily have," explained Isabirye. Despite these hurdles, the enthusiasm among tutors is evident, with many appreciating the impact that the new approach will have on student learning outcomes.
One of the unique aspects of the SPICES model is its emphasis on community-based learning. In our partner health training institutions in Hoima, Fort Portal and Jinja, students don’t just learn within hospital walls, they step into communities to address real health challenges. "We take them to rural places like Kidera, Buyende where they work on environmental sanitation, teach people how to construct tippy taps for handwashing, and even help communities improve hygiene using locally available materials," said Nakaggwa. This immersion not only benefits the students but also creates tangible change in the communities they serve.
Moreover, the model aligns perfectly with Enabel’s vision for health education. "The SPICES model ensures holistic learning, connecting community needs with real-life applications. It’s not just about knowledge but about creating professionals who can apply it effectively," said George Eyunu, a Nursing School Pedagogy Officer at Enabel.
Yasin Mukibi, Senior Health Education Training Officer at Ministry of Education and Sports sees the SPICES model as a critical step forward in health training. As the Ministry is currently reviewing and developing curricula to address the changing demands of healthcare, the SPICES model complements these efforts by producing professionals suited to the world of work. He also noted how the model’s focus on integration and systematic learning ensures that graduates are prepared for the complexities of modern healthcare.
Even as challenges like resistance to change and limited resources arise, the SPICES model continues to inspire those involved. "Medicine is a dynamic field, and so is health education," said Isabirye. "If we don’t upgrade our practices, we risk becoming irrelevant, therefore we should stay ahead, ensuring our students are ready for the future," he added.
As Uganda embraces this innovative model, Enabel’s hope is that the collective effort of Ministry of Education and Sports, tutors and students in health training institutions will foster a sense of ownership and accountability for learning and teaching, and strengthen the larger health system of Uganda.
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