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Teaching and learning about community orientation in family medicine/general practice

Teaching and learning about community orientation in family medicine/general practice. Dr. Yonah Yaphe Department of Family Medicine Rabin Medical Centre and Sackler Faculty of Medicine, Tel Aviv University, Israel. Objectives. At the end of this presentation the learner will:

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Teaching and learning about community orientation in family medicine/general practice

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  1. Teaching and learning about community orientation in family medicine/general practice Dr. Yonah Yaphe Department of Family Medicine Rabin Medical Centre and Sackler Faculty of Medicine, Tel Aviv University, Israel

  2. Objectives • At the end of this presentation the learner will: • Know the definition of community and community orientation • Know how the community effects medicine and vice versa • Value a community orientation in teaching and learning family medicine

  3. Community • A collection of people with common social characteristics and generally geographical proximity • The physical surroundings in which we are usually located

  4. Why is this important? • Context is everything • Engel’s bio-psycho-social model • Systems theory – interaction between higher and lower levels • Advances in health through social progress

  5. How is this done • Epidemiology – the big picture • Social medicine and public health – social engineering • Community orientation by the family doctor

  6. What do we expect from our graduates in family medicine? • Clinical knowledge • Clinical skills, communication skills, management skills • Holistic approach to the care of a wide range of problems in the context in which our patients live

  7. Ho do we teach this? • Practical experience • Direct supervision • Classroom learning • Projects • Reflection

  8. How do we assess this? • Formative and summative assessment • Written and oral knowledge tests • Demonstration of competence in OSCE’s • Direct and indirect observation of performance (video, medical records)

  9. Final examination for specialization in family medicine in Israel • After 2 years - 150 MCQ’s - knowledge • After 4 years – 4 hour oral exam • Two hours of clinical topics including standardized questions • One hour family presentation • One hour community presentation

  10. Community presentation • Age-sex distribution of practice • Chronic disease register • Physical layout of clinic • Structure of health care team • Relations with community services • Prevention and health promotion activities • Future plans for practice

  11. Examples of outputs • Age-sex distribution (graph) • Chronic diseases (list) • Practice organization and staffing (diagram) • Medical records (charts) • Sample questions to candidates (tables) (Thanks to Dr. Vered Ezra for her clinic data.)

  12. Age distribution • How does your data differ from national data? • What are the implications for practice of an older or younger population?

  13. Ethnic mix • How does the ethnic mix of your practice affect morbidity? • What do you and your staff need to know about your population?

  14. Chronic disease prevalence • Questions to the candidate: • Compare with national data • What does this mean? • Why are there more or less cases?

  15. Quality improvement • Describe a health problem in your community and the means that you used (or plan to use) to address it.

  16. Conclusions • Community orientation can be integrated into the training of future family practitioners. • The are innovative ways to teach and assess the acquisition the knowledge, skills and attitudes that make up this element of general practice. • In this course we will explore and experience this further with the aim of expanding this further in our own contexts.

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