Vidal C A, Quiñones J
Educ Med Salud. 1986;20(1):1-25.
The article broadly reviews the conceptual basis of the integration of service and education and the history of the process and of the programs in progress in the countries of the Americas. A study of the different definitions given and uses made of the concept and practice yields a definition of the integration of services and education as "a process of progressive articulation between institutions providing health services and those imparting instruction in the health field in order to improve health care and guide the generation of knowledge and the training of personnel on the basis of the epidemiological profile of a given region and population. This ongoing education process takes place in the course of work, which it is capable of changing by virtue of its own momentum." This definition embodies the features common to all those used: The process itself, articulation between teaching and service establishments, and objectives. The story of the process in the Old World is briefly reviewed; its stages in the New World are considered at greater length, and the positions taken by the Pan American Health Organization since 1963 are stated. The emphasis today is on the technical cooperation provided in the different aspects of the process: institutional and program development, program supervision, the setting of standards and priorities for research, personnel utilization, etc. The article closes with an account of the mechanisms for interaction (formal, informal, operational, and policy-making) and a discussion of the different fields, practices and coverage that have been affected by this process, and comes to the conclusion that the integration of service and education has been essential to the student's training in exposing him to the practical realities of the local and general situation of his country.
本文广泛回顾了服务与教育整合的概念基础、该进程的历史以及美洲国家正在进行的相关项目。对所给出的不同定义以及该概念和实践的应用进行研究后，得出服务与教育整合的定义为：“提供卫生服务的机构与卫生领域教学机构之间逐步衔接的过程，目的是改善医疗保健，并根据特定地区和人群的流行病学特征指导知识的生成和人员的培训。这一持续的教育过程在工作过程中进行，它自身的发展势头能够改变工作。” 该定义体现了所有已使用定义的共同特征：过程本身、教学与服务机构之间的衔接以及目标。文中简要回顾了旧世界该进程的情况；更详细地探讨了新世界的各个阶段，并阐述了泛美卫生组织自1963年以来所采取的立场。如今重点在于该进程不同方面所提供的技术合作：机构和项目发展、项目监督、研究标准和优先事项的设定、人员利用等。文章最后介绍了互动机制（正式、非正式、业务和决策方面），并讨论了受这一进程影响的不同领域、实践和覆盖范围，得出结论认为，服务与教育的整合对于学生接触本国当地和总体实际情况的培训至关重要。
