scholarly journals Developing primary health care and public health competencies in undergraduate medical students

2017 ◽  
Vol 59 (3) ◽  
pp. 103-109 ◽  
Author(s):  
Stephen E Knight ◽  
Andrew J Ross ◽  
Ozayr Mahomed
2017 ◽  
Vol 59 (3) ◽  
pp. 54
Author(s):  
Stephen E Knight ◽  
Andrew J Ross ◽  
Ozayr Mahomed

Background: The Selective Programme (Selectives) at the University of KwaZulu-Natal (UKZN) is a three-year longitudinal, community-based programme within the undergraduate medical curriculum, which aims to develop primary health care (PHC) and public health competencies in students using the community-oriented primary care (COPC) approach. Aim: The aim of this research was to evaluate the Selectives against the Health Professions Council of South Africa (HPCSA) ‘core’ graduate competencies. Setting: This study was carried out among medical students concluding Selectives at UKZN in 2015. Methods: A cohort of 183 students concluded Selectives in 2015, and thereafter 70 (38%) completed a routine online evaluation of the programme based on the core graduate competencies. Results: Students reported substantial improvements in PHC clinical knowledge, improved understanding of a population perspective on health, and having gained public health knowledge and skills. Conclusion: Selectives is an effective way to use a decentralised PHC learning platform to enable medical students to address some of the HPCSA graduate competencies required for health care professionals and not necessarily covered by other medical disciplines. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272229


2021 ◽  
Vol 14 (1) ◽  
pp. 555-570
Author(s):  
Langalibalele Honey Mabuza ◽  
Gabriel Gyang Darong ◽  
Sbongile Joyce Makhudu ◽  
Roisin E. Drysdale ◽  
Mosa Moshabela

Background: Undergraduate medical students are trained to acquire a general medical practice overview on qualifying. This training forms a foundation for primary health care service or further training towards a specialty of choice. Objective: The aim of the study was to determine the scope of published scientific literature on the training of undergraduate medical students in “general medical practice” and “primary health care,” exploring how these two concepts are understood, the pedagogical approaches employed by the trainers, the training platforms and the challenges encountered during the training. Methods: The review followed the five steps recommended by Arksey and O’Malley. Using the specified eligibility criteria, the research team systematically screened titles, abstracts, and full articles. Data were entered into Google Forms spreadsheets, which was followed by inductive data analysis of key themes. Results: 130 articles were eligible for inclusion in the study. Thematic analysis yielded eight themes: definition of “general medical practice” and “PHC”, pedagogical approaches (conventional, PBL, teams and CBME), training platforms (tertiary and rural), medical students’ trainers (faculty, GPs and patients), training content, trainers’ and trainees’ perceptions, and challenges encountered. Conclusion: This scoping review has revealed that general medical practice and primary health care are approaches to holistic patient care taught at undergraduate medical training. Primary health care and general medical training are mainly undertaken in GP practices and rural settings. Competency-based medical education is emerging as an appropriate pedagogical method towards ‘fit-for-purpose’ training. The inclusion of patients as trainers in general medical practice and primary health care is yielding positive results.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Zhang ◽  
Xingrong Shen ◽  
Rong Liu ◽  
Linhai Zhao ◽  
Debin Wang ◽  
...  

Abstract Background In China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China. Methods Qualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically. Results PHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged. Conclusions The COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.


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