Reorientation of Medical Education for Primary Health Care Med J Malaysia Vol 42 No 1 March 1987 EDITORIAL REORIENTATION OF MEDICAL EDUCATION FOR PRIMARY HEALTH CARE INTRODUCTION There is universal co[.]
the Accreditation Council for Graduate MedicalEducation (ACGME) Systems-Based Practice and Practice-Based Learning and Improvement competencies is needed [4 – 7]. The content of these novel domains is broad and includes topics such as systems improvement, clinical informatics, high-value care, systems and human factors engineering, health policy, and population health [4, 8]. Taken together, this content has been referred to as the third science , healthcare delivery science , health systems science , and herein, the science of healthcare delivery (SHCD) . Although the terms vary, all refer to a new set of physician capabilities essential for practice that extend beyond the basic sciences and clinical skills traditionally taught in medical schools .
Results: Data analysis revealed four categories and nine subcategories. The categories emerging from individual interviews were “educational structure”, “mediating factors”, “conceptual understanding”, and “professional identity”. These categories are explained using quotes derived from the data. Conclusion: Matching the existing educational context and structure with IPE through removing barriers and planning to prepare the required resources and facilities can solve numerous problems associated with implementation and design of inter- professional training programs in Iran. In this way, promoting the development of a cooperative rather than a competitive learning and working atmosphere should be taken into account. The present findings will assist the managers and policy makers to consider IPE as a useful strategy in the integrated medicaleducation and healthcare system.
Medical literature is replete with information regarding the need for physicians to serve the underserved and provide rural healthcare services. Many institutions and educators have considered how best to recruit and retain physicians in rural areas in order to improve access to healthcare for the rural population. 1,2,3 Others have elaborated on the benefits medicaleducation can provide for rural health. 4
Results: Prehospital factors include the community; education of hospital administrators and healthcare personnel; dispatchers; the medical transport system; and preparedness and stroke education of emergency medical services (EMS). Stroke-ready hospitals and networking with other regional tertiary stroke hospitals play important roles in increasing access to stroke care. In addition, legislation at the state and federal levels is a key factor in providing high-quality, timely access to stroke care for the population in general. Strategies to facilitate access to stroke ther- apy are critical to improving mortality and functional outcome and increasing the proportion of patients treated by systemic thrombolysis and endovascular approaches.
It is not surprising that children’s mental health needs after September 11th were not met fully, given the longstanding inadequacy of resources for quality mental healthcare for children throughout the United States and the formidable barriers to access and reimbursement constructed by the managed care environment. The primary medicalcare system has become the de facto mental healthcare system in the United States. Children are most likely to receive treatment, including psychotropic drugs, from pri- mary care physicians for symptoms associated with mental disorders. Improving the skills of pediatri- cians to address the mental health needs of children and providing adequate reimbursement for these services therefore is critical not only to disaster pre- paredness, but because crisis is not uncommon in the lives of children, it is also vital to ensuring quality pediatric care even in the absence of a national crisis.
Telehealth is a technology with the potential to allow numerous improvements in healthcare; however, ethical, regulatory, and technical considerations must be evaluated and managed to address the drawbacks. A governance model that is standardized across all state and federal levels could alleviate some legal concerns, particularly regarding credentialing and licensure. Incorporating ethical and technical training around telehealth into medical and nursing education will prepare future providers for the inevitable remote healthcare to be provided through digital communication. This training should be comprehensive of not only medical expertise but also communicating with empathy. Finally, broadening the education of consumers on the potential robustness and limitations of telehealth will allow individuals to take part in a potentially lifesaving
quality of entering medical students, and quality of medicaleducation . It is for certain that at least two critical variables, both the quality of entering students and quality of medical programs, substantially varied. First, medical students admitted to the bachelor pro- gram and junior medical college program are signifi- cantly different in terms of their quality. Like many other countries, graduates from high school who attempt to receive tertiary level education need to take the national college entrance examination (NCEE); however, those scores for bachelor programs in medicine are much higher than that for junior medical colleges. For example, only students who basically rank top 40% in NCEE have admissions into medical bachelor programs for the whole country, so junior medical colleges have to recruit from students ranked below 40% in NCEE . Second, students who attend secondary vocational schools out of junior middle school have only a mini- mum 9 years of basic education, which brings about the quality problem of the entering students on the one hand; those secondary vocational schools in medicine generally offer limited and tailored courses to meet de- mands of those students on the other hand.
Today’s healthcare organizations are increasingly under much pressure to control costs and constrain the outflow of dollars for worker healthcare benefits and now must utilize other ways to accomplish that. An employer-based wellness program is one option which is gaining in acceptance and popularity. Its aim is to reduce the overall cost of providing health insurance by giving HCWs incentives to follow healthy living habits and meet certain health-related goals. Wellness programs can consist of health fairs, healtheducation, medical screenings, health coaching, weight management programs, wellness newsletters, and physical fitness programs. Healthier workers can help control healthcare expenses as costly serious illness are prevented and existing ones are better managed (Prevent.org, 2008). While the true cost savings of such programs is debatable, the researchers of a 2009 meta-analysis of the literature on costs and savings associated with wellness programs concluded that medical costs fall by about $3.27 for every dollar spent and absentee day costs fall by about $2.73 for every dollar spent (Baicker, Cutler, & Song, 2009).
Increasingly, Lesbian, Gay, Bisexual, and Transgender (LGBT) healthcare is becoming an important quality assurance feature of primary, secondary and tertiary healthcare in Britain. While acknowledging these very positive developments, teaching LGBT curricula content is contingent upon having educators understand the complexity of LGBT lives. The study adopted a qualitative mixed method approach. The study investigated how and in what ways barriers and facilitators of providing LGBT medical, health and social care curricula content figure in the accreditation policies and within undergraduate and postgraduate medical and healthcare teaching. This paper illustrates opposing views about curricula inclusion. The evidence presented suggests that LGBT content teaching is often challenged at various points in its delivery. In this respect, we will focus on a number of resistances that sometimes prevents teachers from engaging with and providing the complexities of LGBT curricula content. These include the lack of collegiate, colleague and student cooperation. By investing some time on these often neglected areas of resistance, the difficulties and good practice met by educators will be explored. This focus will make visible how to support medical, health and social care students become aware and confident in tackling contemporaneous health issues for LGBT patients.
Abstract: Family medicine is a focus of healthcare in Qatar, and it has emerged as a primary care pioneer in the Arabian Gulf Region. Strong governmental financial support has underpinned family medicine development in the country, and through proactive healthcare policy, free or highly affordable healthcare is available to all citizens and expatriates in primary healthcare centers and hospitals. An Ivy League and world-class medical school, Weill Cornell Medical College in New York established a second campus in Qatar in 2001, and enrolled its first students in 2002. The inaugural class graduated in 2008, including one graduate who matched to a family medicine residency in the United States. The College has already earned a reputation for an emphasis on cultural sensitivity in the curriculum. Qatar also has a well-established family medicine residency program overseen by the Primary HealthCare Corporation. Its inaugural class of family medicine residents began training in 1995 and graduated in 1999. In contrast to a trend of fluctuating interest in family medicine training in many developed countries, the demand for residency slots in Qatar has been consistently high. Since November 2012, the Accreditation Council for Graduate MedicalEducation-International has approved all hospital-based residency positions. Formed in 2012, the Primary HealthCare Corporation is dedicated to achieving accreditation for the family medicine residency in the near future. In 2011, Qatar’s 147 family physicians comprised about 18% of the total physician workforce. Through extended hours of operation at health centers, patients have ready access for acute care and follow-up consultations. Still, Qatar faces challenges including a projected population expansion from about 1.9 million in 2013 to 2.5 million people by 2020. Qatar’s National Primary HealthCare Strategic Steering Group has recently submitted a new primary healthcare strategy to the government and identifies 12 challenges for the future of family medicine. Among these, ensuring access to clinical services that are patient and family centered, addressing the shortage of family physicians, expanding academic capacity, and increasing scholarly output are manifest.
Activities that are funded and conducted by commer- cial organizations can carry a high risk of being biased. 4 De ﬁ ning educational objectives in partnership with inde- pendent organizations, aligning the content with evidence- based data, obtaining endorsement from accreditation sources, and using an independent partner to co-ordinate the delivery of the program, can lead to credible industry- funded CME. 15 Expert review of content by independent organizations would ensure that CME programs are not used for commercial promotion. 38 Any organization that funds, develops, and approves the education content should adopt evidence-based, unbiased and practice-trans- forming information and techniques with equity and trans- parency. NAM also encourages collaborative partnerships, between professional and patient groups; physicians; healthcare organizations; and universities, to identify and include evidence- and best practice-based care pro- cesses when developing key preventive curricula for health risk behaviors; and the use of structures to measure and appraise any resulting improvement in healthcare. 3
Therefore, lack of financing for education in man- aged care settings is a barrier, but not an insur- mountable one. The literature indicates that residents may be able to generate sufficient revenue in ambu- latory care sites to finance a significant portion of the cost of their education. In addition, the medical pro- fession has recognized the disincentives in the cur- rent system of GME financing and are seeking changes that may increase funds available for ambu- latory careeducation. In a joint statement in 1997, the American Medical Association, the AAMC, the As- sociation of Academic Health Centers, and other pro- fessional organizations called for a national all-payer fund to support GME with the funds going to the entities that incur the costs of education whether or not hospital-based. 58 With stable funding to support
This study was conducted at the University of Port Harcourt Teaching Hospital which is located along the east-west road at Choba, Obi-Akpor Local Government Area of Port Harcourt metropolis. Port Harcourt is the capital and largest city of Rivers State, Nigeria. It is a port town lying along the Bonny River. It is located in Southern Nigeria and the traditional inhabitants are the Ikwerre people who speak the Ikwerre dialect. Some inhabitants of Port Harcourt also speak the Igbo dialect. The University of Port Harcourt Teaching Hospital (UPTH) is a tertiary- care teaching and research facility in Rivers State. It is located along the East West Road. It is affiliated with the University of Port Harcourt. It is an 800-bed multi-specialist hospital where nearly 200,000 patients are seen annually in both in-patient and out-patient settings. Alongside the provision of clinical services round the clock, UPTH also provides clinical training and education to healthcare professionals [23,24]. The descriptive, cross-sectional study design was used in carrying out this research study. The University of Port Harcourt Teaching Hospital has a number of doctors working in different medical specialties who possess graduate and postgraduate educational qualifications which enable them fit into their differing areas of specialty. A typical day at work at the University of Port Harcourt Teaching Hospital involves
Abstract: Quality assurance (QA) in higher medicaleducation involves the development, sustenance, improvement, and evaluation of the standard of training of medical professionals. In healthcare delivery, QA focuses on guaranteeing and maintaining a high standard of the service provided in different healthcare systems. When the service delivered by the care pro- vider is in accordance with what the recipients of healthcare expect, then quality in healthcare is considered to be present. There are several factors in higher medicaleducation and healthcare that are responsible for the emergence of QA. These include externally imposed obliga- tions requiring demonstration of public accountability and responsibility from educational institutions, as well as the need for activity-specific information by policy makers as an aid for important decision-making within educational institutions. In healthcare delivery on the other hand, the emergence of QA is linked to the need for containing rising healthcare costs in the face of limited resources and to guaranteeing high quality patient care in a changing healthcare environment where the power relationship between doctors and patients is shifting towards patients. Although medicaleducation can be regarded as a distinct entity in the healthcare industry, it still remains an inherent part of the healthcare delivery system. As a result, differ- ent strategies aimed at guaranteeing and assuring high standards of healthcare and education in many countries tend to overlap. This paper reflects on whether quality assurance in healthcare delivery and medicaleducation should be seen as separate entities.
Differences in education, socioeconomic status, access to and quality of care, lack of public health efforts promoting awareness and screening, general mistrust of the medical establishment, and lack of self-perception of risk contribute to the growing disparity in melanoma outcomes among minori- ties as compared to Whites. As ALMs are the most common melanoma type among AA, further larger studies evaluating the role of this melanoma subtype on cancer aggressiveness and patient overall survival are necessary.