innovation in public health education at ramathibodi medical school 2013.12.12
DESCRIPTION
The WHO-SEARO regional meeting to review progress in strengthening teaching of public health in medical schools, 11-13 Dec 2013, Pattaya, ThailandTRANSCRIPT
Innovation in Public Health Education for Medical Students at Ramathibodi, Mahidol University
Borwornsom Leerapan, MD PhD Department of Community Medicine
Faculty of Medicine Ramathibodi Hospital, Mahidol University WHO-SEARO Regional Meeting, Pattaya, Thailand
12 December 2013 Pix source: Pinaree Chen, 2nd World Prize (under 9 year-old), One Health Art Contest PMAC 2013
#1: Changes of learning objectives
– What exactly are “public health” concepts and skills that our medical students really need nowadays?
#2: Changes of learning experiences:
– How do we deliver public health education to our
“Gen Y/Z” medical students?
#3: Changes in evaluation:
– How do we know our students “succeed or fail”?
Our Innovations?
What’s “public health” here?”
Pix source: online.wsj.com
Some Background: Thailand in 1970s
Pix Source: www.nationalguard.mil
Some Background: Thailand in 1970s
• In 1967, the Rockefeller Foundation assisted the Faculty of Medicine Ramathibodi Hospital, Mahidol University to found the Center of Community Medicine
• Dr.Aree Valyasevi, Former Dean and Chairman of Pediatrics, Dr.Rachit Buri, Former Dean and Chairman of Medicine Department, and Dr.Prem Buri, Former Chairman of Surgery Department set up the teaching “Community Medicine” for medical and nursing students at Ayudhthaya province, especially focusing on community survey and diagnosis.
Public Health Challenges
• Thailand in 1970s:
– Limited resources in rural healthcare
• Thailand in 2000s:
– Issues of quality, equity, and efficiency in health systems
21st Century Medical Education
Pix source: Frenk et al. (2010)
Mapping Medicine & Public Health
Source: Hoffman et al. (2012). A Review of Conceptual Barriers and Opportunities Facing Health Systems Research to Inform a Strategy from WHO.
Community Medicine Center (1967)
Academic Home
Department of Community Medicine (from August 2010 on)
How to teach it to “Gen Y/Z”?
Pix source: online.wsj.com
Our Community Medicine Courses
• 3rd-Year Community Medicine (required, 5 credits): concept of health and health determinants, health system & health service system, physician roles, health education, health promotion, community capacity, community diagnosis, epidemiology, biostatistics
• 4th-Year Community Medicine I (required, 5 credits): district health system, hospital services system, health systems research, health economics
• 5th-Year Primary Care Medicine II (3rd-yr, 5 credits): evidence-based medicine,
concepts of primary care, health promotion: health policy and roles of NGOs
• 6th-Year: Family and Community Medicine (required, 4 credits): skills in
community hospitals, health systems research projects
• Health Services System in Community Hospital (elective, 2 credits): health service system in community hospital
What Level of Our Teaching?
• Why Wisdom
• How Knowledge
• What, Who, When, Where Informa8on
• Number, Text, Picture, Sound, etc. Data
Fighting ADHD in Medical School
Pix Source: www.thersa.org/events/rsaanimate/animate/rsa-animate-changing-paradigms
Recommended treatment: • Ritalin
• Active engagement
Active Engagement in Group Work
Active Engagement Outside Classroom
Active Engagement in the Field
Active Engagement in Community
Active Engagement in SDH
Active Engagement in Ambulatory Care
Active Engagement in Knowledge Management
Teaching Methods
• Self-directed learning
• Team-based learning
• Problem-based learning
• Task-based learning
• Case conference, discussion, oral & poster presentation
• Fieldwork in community settings
• Working in community hospitals
• Site visits: factory, clinic, NGO, etc.
• Research projects: epidemiological research, health policy and systems research, clinical tracer, routine-to-research (R2R*), etc.
How to “evaluate” our teaching?
Pix source: online.wsj.com
Evaluation Methods
• Formative evaluation; – Feedback to student’s logbook
– Feedback of group process
– Assessment of report & presentation
– Assessment of individual behaviors in the field trip
– Assessment of individual and group performance
– Peer assessment
• Summative evaluation; – Examination: MCQ, SAQ, short essay, individual report, oral
examination
– Assessment of research, projects, and case study
Using Social Media for Formative Evaluation
Note: 5-level scale of evaluation
Student’s Satisfaction by Departments
21st Century Medical Education
Pix source: Frenk et al. (2010)
• We want to develop “change agents” who knows how to get people in health systems involved in solving their own problems.
• Now, the question is “how” to evaluate change agents?
Work in Progress
• Teachers’ Capacity Building:
– Periodic medical education workshops for the faculty members and supporting staffs
– Monthly meetings for knowledge management, course evaluation, and course development
Future Challenges
• Change agents??
• Time constraints (esp. in teaching blocks)
• Longitudinal and integrated community clerkship
• Shortage of qualified staffs
• Urbanized settings
• Global health issues
• Standardization of courses among schools
• Safety issues in the fieldwork
• Budget issues for the fieldwork
