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菲律宾中部具有社会责任感和社区参与式医学教育对毕业生的影响:对全球农村医疗队伍的启示。

The impact of socially-accountable, community-engaged medical education on graduates in the Central Philippines: Implications for the global rural medical workforce.

机构信息

a School of Health Sciences , University of the Philippines Manila , Palo , Leyte , Philippines.

b College of Medicine and Dentistry , James Cook University , Townsville , Australia.

出版信息

Med Teach. 2017 Oct;39(10):1084-1091. doi: 10.1080/0142159X.2017.1354126. Epub 2017 Jul 28.

Abstract

INTRODUCTION

Developing and retaining a high quality medical workforce, especially within low-resource countries has been a world-wide challenge exacerbated by a lack of medical schools, the maldistribution of doctors towards urban practice, health system inequities, and training doctors in tertiary centers rather than in rural communities.

AIM

To describe the impact of socially-accountable health professional education on graduates; specifically: their motivation towards community-based service, preparation for addressing local priority health issues, career choices, and practice location.

METHODS

Cross-sectional survey of graduates from two medical schools in the Philippines: the University of Manila-School of Health Sciences (SHS-Palo) and a medical school with a more conventional curriculum.

RESULTS

SHS-Palo graduates had significantly (p < 0.05) more positive attitudes to community service. SHS-Palo graduates were also more likely to work in rural and remote areas (p < 0.001) either at district or provincial hospitals (p = 0.032) or in rural government health services (p < 0.001) as Municipal or Public Health Officers (p < 0.001). Graduates also stayed longer in both their first medical position (p = 0.028) and their current position (p < 0.001).

CONCLUSIONS

SHS-Palo medical graduates fulfilled a key aim of their socially-accountable institution to develop a health professional workforce willing and able, and have a commitment to work in underserved rural communties.

摘要

简介

在资源匮乏的国家,培养和留住高质量的医疗人员一直是一个全球性的挑战,这一挑战因医学院数量不足、医生向城市执业的分布不均、卫生系统不公平以及在 tertiary centers 而不是农村社区培训医生等问题而加剧。

目的

描述对有社会责任感的医疗专业人员教育对毕业生的影响;具体而言:他们对基于社区的服务的动机、准备解决当地优先卫生问题、职业选择和实践地点。

方法

对菲律宾两所医学院的毕业生进行横断面调查:马尼拉大学-健康科学学院(SHS-Palo)和一所课程设置更为传统的医学院。

结果

SHS-Palo 的毕业生对社区服务的态度明显更为积极(p<0.05)。SHS-Palo 的毕业生也更有可能在农村和偏远地区工作,要么在地区或省级医院(p<0.001),要么在农村政府卫生服务部门担任市或公共卫生官员(p<0.001)。毕业生在他们的第一个医疗岗位(p=0.028)和当前岗位(p<0.001)上的工作时间也更长。

结论

SHS-Palo 的医学毕业生实现了他们有社会责任感的机构的一个关键目标,即培养一支愿意并能够为服务不足的农村社区服务的医疗专业人员队伍。

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