Dowell A, Crampton P, Parkin C
Department of General Practice, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand.
Med Educ. 2001 Mar;35(3):242-9. doi: 10.1046/j.1365-2923.2001.00772.x.
Cultural factors in health and illness, and an awareness of community health needs analysis, are important issues for medical education. Both have received relatively little recognition in the medical education literature. This paper describes the development of an educational attachment to remote predominantly Maori rural communities in New Zealand. The twin purposes of the programme were to encourage students to adopt broad public health approaches in assessing the health needs of defined communities, and to increase their awareness of the importance of cultural issues.
During a one week attachment, 51 students from the Wellington School of Medicine were hosted in six small communities in the East Cape region of New Zealand. Students gained an insight into the health needs of the communities and were encouraged to challenge their own attitudes, assumptions and thinking regarding the determinants of health and the importance of cultural factors in health and illness. The programme included both health needs assessment and cultural immersion. Students made visits with primary health care professionals and were also introduced to Maori history and cultural protocol, and participated in diverse activities ranging from the preparation of traditional medicines to performing their own songs in concert.
The students evaluated the course extremely highly. Attachments of this sort provide an opportunity for students to appreciate how cultural values have an impact on health care, and how they also make the teaching and learning of topics such as community health needs analysis an enjoyable and dynamic experience.
健康与疾病中的文化因素以及对社区健康需求分析的认识，是医学教育的重要问题。在医学教育文献中，这两方面受到的关注相对较少。本文描述了在新西兰主要为毛利人聚居的偏远农村社区开展教育实习的情况。该项目的双重目的是鼓励学生采用广泛的公共卫生方法来评估特定社区的健康需求，并提高他们对文化问题重要性的认识。
在为期一周的实习期间，惠灵顿医学院的51名学生被安排到新西兰东开普地区的6个小社区。学生们深入了解了这些社区的健康需求，并被鼓励挑战自己对健康决定因素以及文化因素在健康与疾病中重要性的态度、假设和思维方式。该项目包括健康需求评估和文化沉浸体验。学生们与初级卫生保健专业人员一同走访，还学习了毛利历史和文化礼仪，并参与了从制作传统药物到表演自己创作的歌曲等各种活动。
学生们对该课程评价极高。这类实习为学生提供了一个机会，让他们了解文化价值观如何影响医疗保健，以及如何使社区健康需求分析等主题的教学和学习成为一次愉快且充满活力的经历。
