Teaching Of Primary Health Care Research Articles

Practices in clinical teaching: sharing actions for teaching in primary health care

Enquadramento: A prática docente na atenção primária é complexa, podendo a comunidade de prática servir como espaço de formação pedagógica para os enfermeiros supervisores e enfermeiros docentes. Objetivo: Descrever as ações identificadas por enfermeiros supervisores e enfermeiros docentes em comunidade de prática docente assistencial no ensino na atenção primária em saúde. Metodologia: Pesquisa-ação, qualitativa, realizada com grupos focais com 13 enfermeiros supervisores da atenção primária e enfermeiros docentes. Utilizou-se o software de análise de dados AtlasTi 8, e análise de conteúdo de Bardin. Resultados: Obtiveram-se três categorias: Ações dos enfermeiros docentes para a qualificação da formação em enfermagem na atenção primária em saúde; Ações dos enfermeiros supervisores para a qualificação da formação em enfermagem na atenção primária em saúde; Ações das Instituições de Ensino e de Saúde para a qualificação da prática docente na atenção primária em saúde. Conclusão: Os membros constituíram-se enquanto uma comunidade de prática, pois compartilharam interesses comuns, levando ao engajamento sobre definição de ações no exercício docente com especificidade na atenção primária.

Training needs and perceptions on teaching in primary care from doctors who teach in primary care in Peru.

This article was migrated. The article was marked as recommended. Introduction Medical training should include a strong emphasis on primary health care. There is a need for primary care teaching centres and teachers who can provide excellent instruction in primary health care (PHC). Objectives This investigation explores the characteristics of the doctors who teach in PHC in Peru, their educational needs and their perceptions of their teaching. Method Using a mixed method approach we ran an online questionnaire on the educational needs and focus groups which explored the challenges, problems and skills required for teaching in PHC. Results 66 teachers from 10 regions answered the questionnaire: 59 (89.4%) were family doctors; 76,7% had a formal university contract; they dedicated an average of 12.9 hours/week to teaching and 9 (13,6%) had had some training in teaching during the last 5 years. In the focus groups they showed interest in developing their teaching skills and 4 dimensions were defined: willingness to teach; teaching family medicine; teacher-student relationships; the organization of the teaching. Conclusion The PHC teachers in Peru have great interest in teaching and a need for training in teaching skills.

The exercise of interprofessionality and intersetoriality as an art of caring: innovations and challenges

Abstract Objectives: To analyze the innovations and challenges pointed out by the coordinators of basic care for the interprofessional and intersectoral exercise, and the importance of these practices as a potentiator of Nursing care and teaching in Primary Health Care. Methods: An exploratory study with a qualitative approach was carried out in a Rio Grande do Sul Health Region. Semistructured interviews were carried out with the Basic Attention Coordination of the Cities of the empirical area, between 2014 and 2015, with thematic content analysis. Results: The primary care coordinators highlight the effectiveness of interprofessional and intersectoral actions, but claim that there are still several obstacles for these actions to become routine. These professionals seek alternatives to modify the reality found, but not all have results. Conclusion: Intersectoriality and interprofessionality make it possible to carry out holistic and integral health actions, optimizing Nursing care practices.

Problematization methodology in primary healthcare teaching.

To identify the contribution of the problematization methodology in primary healthcare teaching in a nursing undergraduate course. Documentary, descriptive and qualitative study, carried out with undergraduate students from the Ribeirão Preto College of Nursing at the University of São Paulo. Data were collected through analysis documents which consisted of 21 evaluation forms filled out by first-year undergraduate students in the 2013 school year taking the subject Comprehensive Health Care I, whose theoretical framework was focused on primary health care. It was found that the subject met the intended goals, allowed coordination between theory and practice, and enabled the contact of undergraduate students with the profession and work environment in the beginning of the course. Analysis of the evaluation forms for the subject Comprehensive Health Care I evidenced that the use of the problematization methodology favored primary healthcare teaching.

Dynamic transmission of Schistosoma by Biomphalaria pfeifferi in the region of Man in Côte d'Ivoire

Intestinal schistosomiasis by Schistosoma mansoni is a parasitary affection transmitted in West Africa by the mollusc Biomphalaria pfeifferi. Transmission dynamic of schistosomiasis by Biomphalaria pfeifferi has seldom been investigated in Côte d'Ivoire. In the framework of a research project on the epidemiology of schistosomiasis in the natural forest ecosystems, this study was performed longitudinally over a period of three years in Man region, in western Côte d'Ivoire. The trial set up from 1986 to 1989 and the project was funded by the World Health Organization. The general objective is to design a strategy of schistosomiasis control based on chemotherapy. The approach aims at interrupting or considerably reducing the reinfections, prolonging in that way the duration of the positive effects of the chemotherapy. The specific objectives assigned to the work consisted in studying the dynamic of the B. pfeifferi population and the infection of B. pfeifferi. To achieve our objectives, diverse methods (i: the molluscs sampling by two prospectors during 15 minutes per study site and ii: individual isolation of molluscs in test tubes with 5 or 10 mL of filtered water and exposure to light) have been used. They enabled us in the sampling of the intermediary host molluscs of Schistosoma and seek their infections. The results show that apparent high densities of B. pfeifferi can be observed at the end of the dry season and at the beginning of rainy seasons. In addition, the variation of relative abundance of intermediary host molluscs of Schistosoma is significantly influenced by rainfall and the system of water ways. The period of transmission of the infection to man is six months at Gueupleu village and ten months at Botonguiné village. In order to optimize the effect of chemotherapy in these sites of transmission characterized by a high level of endemy (68 %), an extreme mobility of human populations and a multiplicity of contamination sites, this study should not only take into account the geographic space of the illness, but also it should eventually associate with a molluscicide action and/or a sanitary education through the teaching of primary health care.

Primary health care and general practice attachment: establishing an undergraduate teaching network in rural Greek health centers

Exposure of undergraduate medical students to general practice and community healthcare services is common practice in the international medical curricula. Nevertheless, proponents of the hospital and biotechnology based paradigm, which is still dominant within the medical academic environment, question both the scope and the setting of this training procedure. Regarding the latter, the quality of teaching is often questioned in settings such as rural primary health centers, where health professionals have neither incentives nor accredited training skills. Therefore, the success of community based medical education depends substantially on the procedures implemented to involve non-academic staff as clinical teachers. This report describes the steps taken by the Aristotle University of Thessaloniki (AUTH) Medical School to establish and maintain a Rural Primary Health Care (PHC) Teaching Network in order to implement community oriented PHC and GP undergraduate medical education. A multi-professional teachers' network of healthcare staff, working in Rural Primary Health Centers, has been chosen, in order to expose students to the holistic approach of PHC. The enrollment of teachers to the Teaching Network was solely on a voluntary basis. The novelty of this procedure is that each professional is approached personally, instead through the Health Center (HC) that usually offers this service as a package in similar activities. In an attempt to attract health professionals committed to medical education, a self-selection procedure was adopted. Collaboration with the medical school was established but it was characterized by the School's inability to compensate teachers. A series of 'Training the Trainers' seminars were completed during the first implementation period in order to enhance the awareness of health professionals regarding undergraduate teaching in PHC; to present the educational needs of medical students; to expose them to the principles of medical teaching; and to strengthen their communication skills. Setting up sustainable community oriented medical education activities in a more or less unfriendly environment is a difficult task that calls for wisely selected functional steps. Pilot educational activities determine the quality of the implemented programs by evaluating difficulties and constraints. Recruiting teachers on a voluntary basis proved to be critical in enhancing the quality of this educational activity, and overcoming distance constraints. The educational activities which were offered created a homogenous group of PHC teachers with explicit educational aims and objectives.

Evaluation of undergraduate medical education in Finnish community-oriented and traditional medical faculties: a 10-year follow-up

Objectives This study focused on Finnish physicians’ views of their undergraduate medical education. Differences between traditional and community-oriented medical faculties were examined and changes which had taken place during a 10-year follow-up period were also assessed. Methods The study was based on data retrieved from a postal survey made among Finnish physicians in 1998. The study population consisted of all doctors who graduated between 1987 and 1996 (n=4926); those born on odd-numbered days were selected for this study (n=2492). A postal questionnaire and two reminders were sent to those selected, and 1822 questionnaires were returned, giving a response rate of 73·1%. Results Physicians who graduated from the community-oriented faculties were more satisfied with their undergraduate medical education when compared with their colleagues graduating from traditional faculties. There were some differences between the universities with respect to education for hospital work. The teaching of primary health care, however, was clearly more effective in community-oriented faculties. The proportion of graduates who were satisfied with their primary care education was over 70% in community-oriented faculties, whereas in the traditional faculties it was only 35–45%. Conclusions According to graduates, the community-oriented medical school curriculum better meets the needs of practising physicians than that in traditional faculties. In curriculum reforms, more emphasis should be placed on comprehensive medical education, which includes both primary and secondary health care.

Evaluation of undergraduate medical education in Finnish community-oriented and traditional medical faculties: a 10-year follow-up.

This study focused on Finnish physicians' views of their undergraduate medical education. Differences between traditional and community-oriented medical faculties were examined and changes which had taken place during a 10-year follow-up period were also assessed. The study was based on data retrieved from a postal survey made among Finnish physicians in 1998. The study population consisted of all doctors who graduated between 1987 and 1996 (n=4926); those born on odd-numbered days were selected for this study (n=2492). A postal questionnaire and two reminders were sent to those selected, and 1822 questionnaires were returned, giving a response rate of 73.1%. Physicians who graduated from the community-oriented faculties were more satisfied with their undergraduate medical education when compared with their colleagues graduating from traditional faculties. There were some differences between the universities with respect to education for hospital work. The teaching of primary health care, however, was clearly more effective in community-oriented faculties. The proportion of graduates who were satisfied with their primary care education was over 70% in community-oriented faculties, whereas in the traditional faculties it was only 35-45%. According to graduates, the community-oriented medical school curriculum better meets the needs of practising physicians than that in traditional faculties. In curriculum reforms, more emphasis should be placed on comprehensive medical education, which includes both primary and secondary health care.

Teaching of primary health care in practice: a model using local health centres in undergraduate medical education.

In Finland primary health care has a long historical background. The local communities, the state and the church have at various times and places been responsible for primary health care during the last few centuries. In 1972, a major reform took place when a new Primary Health Care Act came into force. In the same year two new medical faculties, at Kuopio and Tampere Universities, began to educate undergraduate medical students. In both of these new medical schools special attention was focused on the teaching of primary health care. Today practical teaching, which takes place at a primary health care centre, forms an important part of medical education at Kuopio University. This teaching of undergraduate students is part of the regular duties of general practitioners and public health nurses in the primary health care centres of eastern Finland that have agreed to collaborate in the teaching programme. The main principles are presented for the teaching programme in primary health care at the University of Kuopio.

The place of primary health care in medical education in the United Kingdom: a survey.

Primary health care has been held to be the foundation of any rational health system. The principle was fully endorsed by the Alma-Ata Conference in 1978, and has become the main policy of the World Health Organization. Important implications are involved for the education and training of doctors and other health care professions. An enquiry was conducted by personal interviews of those most responsible for the teaching of primary health care in the United Kingdom, to enquire about the status of primary health care in the curricula of U.K. medical schools, and about the standing of general practice. The enquiry also explored the degree of awareness among medical educators about the Alma-Ata Declaration. The leading representatives of primary health care in the medical schools made it clear that the teaching of primary health care varied greatly in the importance accorded to it and the resources made available for it by medical schools. Almost half the respondents were unaware of the support for greater emphasis on primary health care that had been specified in the Alma-Ata Declaration.

The Problem-Oriented Record in a Family Health Service

The problem-oriented record, introduced at our Family Health Service in 1971, is used by all professions in all contacts with patients, including clinic visits, telephone calls, home visits, and hospitalizations. In our primary health care teaching service, nurses, physicians, and social workers collaborate to provide total health and illness care to families. Students in all disciplines receive educational experiences in clinical practice and interdisciplinary teamwork. Regular audit of the records increases the learning of staff and students. We share our experiences here to stimulate an exchange of ideas about adapting the problem-oriented record in various settings. Our discussion emphasizes the pediatric segment of this facility, in which we have been most extensively involved. The problem-oriented record was introduced by Weed as a logical means to organize the data in med-