Patrick Walter K, Cadman Edwin C
WHO Collaborating Center for Leadership Development, International Health & Medicine.
Asia Pac J Public Health. 2002;14(1):35-9. doi: 10.1177/101053950201400108.
Globalisation of economies, diseases and disasters with poverty, emerging infectious diseases, ageing and chronic conditions, violence and terrorism has begun to change the face of public health and medical education. Escalating costs of care and increasing poverty have brought urgency to professional training to improve efficiency, cut costs and maintain gains in life expectancy and morbidity reduction. Technology, genetics research and designer drugs have dramatically changed medical practice. Creatively, educational institutions have adopted the use of: (1) New educational and communication technologies: internet and health informatics; (2) Problem based learning approaches; Integrated Practice and Theory Curricula; Research and Problem Solving methodologies and (3) Partnership and networking of institutions to synergise new trends (e.g. core competencies). Less desirably, changes are inadequate in key areas, e.g., Health Economics, Poverty and Health Development, Disaster Management & Bioterrorism and Ethics. Institutions have begun to adjust and develop new programs of study to meet challenges of emerging diseases, design methodologies to better understand complex social and economic determinants of disease, assess the effects of violence and address cost containment strategies in health. Besides redesigning instruction, professional schools need to conduct research to assess the impact of health reform. Such studies will serve as sentinels for the public's health, and provide key indicators for improvements in training, service provision and policy.
经济、疾病和灾害的全球化，连同贫困、新发传染病、老龄化和慢性病、暴力及恐怖主义，已开始改变公共卫生和医学教育的面貌。护理成本不断攀升以及贫困加剧，使得专业培训变得紧迫起来，以提高效率、削减成本，并维持预期寿命的增长和发病率的降低。技术、遗传学研究和定制药物极大地改变了医疗实践。富有创造力的是，教育机构采用了以下方法：（1）新的教育和通信技术：互联网和健康信息学；（2）基于问题的学习方法；综合实践与理论课程；研究与解决问题的方法，以及（3）机构间的伙伴关系和网络，以促成新趋势（如核心竞争力）。不太理想的是，在关键领域，如卫生经济学、贫困与健康发展、灾害管理与生物恐怖主义以及伦理学方面，变革并不充分。各机构已开始调整并制定新的学习计划，以应对新发疾病的挑战，设计方法以更好地理解疾病复杂的社会和经济决定因素，评估暴力的影响，并应对卫生领域的成本控制策略。除了重新设计教学外，专业院校还需要开展研究，以评估卫生改革的影响。此类研究将成为公众健康的哨兵，并为培训、服务提供和政策改进提供关键指标。
