Transcript Slide 1

Learning in family medicine
Dr. JAWAHER AL-AHMADI
MB. ABFM. SBFM,MSc
DEFINATION OF PHC
– Essential health care
– Based on practical, scientifically sound and social
acceptable methods & technology
– Accessible to individuals & families
– It is their first level of contact
– Cost that the community & country can afford
– It forms an integral part for both the country’s health
system & the overall social & economic development
ELEMENTS OF PHC
PROMPOTIVE :
• Health Education
• Food supply & proper nutrition
• Maternal & Child care
PREVENTIVE:
• Immunization
• Prevention & control of locally endemic diseases
• Adequate supply of safe water & basic sanitation
ELEMENTS OF PHC
CURATIVE:
• Treatment of common diseases & injuries
• Provision of essential drugs.
ADDITIONAL ELEMENTS:
• Dental care
• School health
• Home health care
PHC PRINCIPLLES
• Equity in distribution :
Services to all & more services to the needy
• Appropriate Technology:
That the people can use & afford.
• Multisectoral approach:
Municipalities, Ministry of agriculture,
Education
PHC PRINCIPLLES
• Community participation:
- Social awareness & community self reliance.
- The people has the right and duty to participate
in the process for the improvement and
maintenance of health.
• Support from higher levels of care :
- Hospitals has to share the social goal of making essential
health services.
- Referral
Pandleton seven tasks
To establish & maintain Dr-pt relationship
To define the real reasons for pt attendance
To consider other problems
To choose with the pt appropriate action for each
problem
To achieve a share understanding
To involve pt in the management
To use time & resources effectively
PRACTICAL
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Prior to the consultation
Relationship
Anxieties
Common language
Translation
Interaction
Converting insight into action
Agreement check, safety netting
Leave from consultation, time for reflection
Communication skills &Patient
interviewing skills
A good interview should
result in an accurate
&comprehensive history
pitfalls
Hurried manner
Interruption
Lack of eye contact
Lack of feed back
Dr – Pt Relationship
Management option (CRAPRIOP)
Clarifications
Reassurance
Advice
Prescribing
Referral
Investigation
Observations
Prevention
Course objectives
1-Define terminologies used in Family Medicine
and primary health care (PHC) and explain
principles and concepts related to them.
2-Acquire and practice skills of establishing
good relationships with patients, families and
the served community and as far as possible
meet their needs and cope with their ideas,
concerns and expectations.
3-Develop appropriate professional knowledge, skills and
attitude pertaining to the management of health
problems encountered by the Family Physician in daily
practice, adopting the bio-psychosocial model and the
WHO definition of health.
4-Acquire the essential knowledge, skills and attitudes
regarding the provision of continuing, comprehensive
care to individuals and family, including anticipatory,
common, chronic, and emergent problems care and
demonstrate appropriate problem solving and referral
decisions.
5-Conduct holistic consultations with patients in a primary
care setting, and show abilities of establishing patient’s
reason for consulting, the nature of the problem, how it
affects his lifestyle and family and to determine the
management options available.
6-Get acquainted to the different sections of a PHC
Center and other practices work dynamics and functions
including the well baby clinic, pharmacy, Lab…..etc.
7-Attain the skills and attitudes for self directed life-long
learning, critical evaluation and self assessment.
Simulated clinic
• Subjective
• Objective
• Assessment
• Plan
LIST OF CASE SCENARIOS
• 1. Breaking Bad News. Example: Malignancy, bad
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prognostic
congenital anomalies, serious hereditary
diseases…etc.
2. Health Education Skills. Example: Patients use of
peak
flow meters, inhalers, glucometers, growth
charts….etc.
3. Health Appraisal. (Verifying & Projecting the
potential health risks of an individual). Examples: Newly
diagnosed hypertensive or diabetics, close relative of
patients with colon cancer….etc.
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Health Promotion. Example: Smoking Cessation, Physical
exercise.
5. Dealing With Specific Request. Examples patient coming
insisting on specific referral, refills, MRI, CT Scans,...etc.
6. Dealing With Difficult Patients. Example: Angry Patient. The
Shopper, talkative patients, multiple complainer...etc.
7. Counseling A Patient With A Newly Discovered Chronic
Disease. Example: Diabetes, Hypertension, Bronchial asthma,
….etc.
8. Giving Dietary Advise. Example: In cases of antenatals,
Hypertension, Obesity, Diabetes, Dyspepsia…..etc.
Adult Learning
• Self-Directed Learning
• Critical Reflection
• Experiential Learning
• Learning to Learn
Self-Directed Learning
• Self-directed learning focuses on the
process by which adults take control of
their own learning,
• In particular how they set their own
learning goals, locate appropriate
resources, decide on which learning
methods to use and evaluate their
progress.
Critical Reflection
• As an idea critical reflection focuses on three interrelated
processes;
• (1) the process by which adults question and then
replace or reframe an assumption that up to that point
has been uncritically accepted as representing
commonsense wisdom,
• (2) the process through which adults take alternative
perspective on previously taken for granted ideas,
actions, forms of reasoning and ideologies,
• (3) the process by which adults come to recognize the
hegemonic aspects of dominant cultural values and to
understand how self-evident renderings of the 'natural'
state of the world actually bolster the power and selfinterest of unrepresentative minorities.
Experiential Learning
• Adult education was, therefore, “a
continuing process of evaluating
experiences”
Learning to Learn
• The ability of adults to learn how to learn
to become skilled at learning in a range of
different situations and through a range
of different styles
Emergent Trends
• Cross Cultural Adult Learning
• Practical Theorizing
• Distance Learning