/ 221
THE ROLE OF FAMILY PRACTICE IN THE ROLE OF FAMILY PRACTICE IN UNDERGRADUATE MEDICAL EDUCATIONUNDERGRADUATE MEDICAL EDUCATION
Trakya University Medical Faculty,
Edirne, Turkey
Zekeriya Aktürk, MD
Nezih Dağdeviren, MD
Erkan Melih Şahin, MD
Cahit Özer, MD
Title
and
Staff
/ 222
Why Famiy Practice in Medical Education ?
• Medical education: 90 % hospital
• Turkish doctors: 60 % primary careİntroduction
Primary
Secondary
Tertiary
Education Practice
/ 223
Current Condition in Turkey
• Population: 65.000.000
• Medical faculties: 47
• Family practice departments involved in education: 7 (15 %)
• This year Family Practice Department at Trakya University has started lectures to phase I.
Current State
/ 224
Introduction to Clinical Practice (ICP)
• Phase I: 135 students
• First semester– 16 hours theory– 16 hours practice
• Second semester– 16 hours theory– 32 hours practice
ICP
/ 225
First Semester Lectures
Lecture Load• Needs assessment 1• Medicine as a profession 2• Health and Illness 1• The effect of community on health 1• Cultural factors and health 1• Quality in health services 1• Health promotion 1• Preventive health care 2• Communication skills 2• Interviewing methods 1• Patient education and counseling 1• History taking skills 1• Evaluation 1
Curriculum
/ 226
First Semester Practices
Lecture Load (h)
• National internet resources 2• IM and IV injection techniques 2• Arterial blood pressure measurement 2• Health unit observation (services) 2• Health unit observation (policlinics) 2• Approach to the trauma patient: 2• Evaluation 4
Curriculum
/ 227
Second Semester Lectures
Lecture Load (h)
• Principles of physical examination 1• Periodical health examination 1• Functional health status 2• Clinical problem solving 2• Consultations 2• First aid 4• Common diseases at primary care 2• Tobacco and other harmful substances 2
Curriculum
/ 228
Second Semester Practices
Lecture Load (h)
• Urethral catheter insertion 4• Communication (History taking) 4• Communication (Examination) 4• Communication (Drama) 4• CPR 4• Sterile dressing 2• Suture techniques 2• Evaluation and feed-back 8
Curriculum
/ 229
Staff and Setting
Staff and Setting
• Lecturers– Family medicine– Public health– Anesthesiology
• Theory: large group education
• Practice: groups of 30-35 students
/ 2210
Teaching Materials and Methods
Teaching Method
• Lectures– Lecturer– Slides– Video– Discussion
/ 2211
Teaching Materials and Methods
Teaching Method
• Practice– Communication
• Small group education: 3-4 students
– CPR, blood pressure etc• Simulators
• Health unit observation– 3-4 students for each service or policlinic– Guided by an educator
/ 2212
Student Evaluation
Evaluation
• Lectures– Two interval exams– One final exam for each semester
• Practice– OSCE
/ 2213
Curriculum Evaluation
• SETh course rating scales– Didactic– Interactive
Feed-back
/ 2214
Our Experiences
• Primary care should be involved in all phases of medical education
• The role of family practice is limited with phase I• Some of the topics shoul be tought to higher
classes• We had to prepare a curriculum to cover as
much areas as possible. • Some practices necessitate baseline medical
knowledge.
Experiences
Curriculum
/ 2215
Our Experiences
• Lecture load should be enough to cover all necessary areas
• The lecture load reserved for ICP was not enough to cover all headings of primary care.
• Some important topics like fever measurement and wound care had to be omitted.
Experiences
LectureLoad
/ 2216
Our Experiences
• Enough teaching material should be available
• Suture techniques, IV injection, urethral catheterization
• Simulators • Abdominal palpation • Heart auscultation
Experiences
Material
Quantity
/ 2217
Our Experiences
• Teaching material should be of high quality
• Firm structure of the simulators disable– abdominal palpation – urethral catheter insertion.
• Leakage from the simulator reservoirs.
Experiences
Material
Quality
/ 2218
Our Experiences
• Enough educators should be available
• Teaching staff – 5 educators for the lectures – 3 educators for the practices.
Experiences
Educators
/ 2219
Our Experiences
• Effective Feed-Back should be taken
• We obtained overall good feed-back results. • SETh
– Didactic 3,76 ± 0,73– Interactive 4.02 ± 0.66
Experiences
Feed-back
/ 2220
Our Experiences
• Accurate evaluations should be done
• Multiple choice questions as well as OSCEcould be applied successfully.
• Faculty regulations: mean score above 60 %• All students passed• Mean passing score: 62.6 ± 14.89.
Experiences
Evaluation
/ 2221
Our Experiences
• In General
• Medical students have difficulties in making a picture in their mind about what medicine is and what they will face after 6 years when theygraduate.
• ICP is a good means to make things clear and maintain the motivation of students to become a good doctor.
Experiences
General
/ 2222
Conclusion
• Implementing family medicine in medical educations is an inevitable step in order to educate doctors who are able to respond the needs of the population.
• To achieve this goal – An experienced staff
(sufficient in quality and quantity)– Lecture series continuing troughout all
phases of medical education, – Teaching material
Conclusion