Teaching and learning about community orientation in family medicine general practice
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Teaching and learning about community orientation in family medicine/general practice. Dr. Yonah Yaphe Department of Family Medicine Rabin Medical Centre and Sackler Faculty of Medicine, Tel Aviv University, Israel. Objectives. At the end of this presentation the learner will:

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Teaching and learning about community orientation in family medicine general practice

Teaching and learning about community orientation in family medicine/general practice

Dr. Yonah Yaphe

Department of Family Medicine

Rabin Medical Centre and

Sackler Faculty of Medicine,

Tel Aviv University, Israel


Objectives
Objectives medicine/general practice

  • At the end of this presentation the learner will:

  • Know the definition of community and community orientation

  • Know how the community effects medicine and vice versa

  • Value a community orientation in teaching and learning family medicine


Community
Community medicine/general practice

  • A collection of people with common social characteristics and generally geographical proximity

  • The physical surroundings in which we are usually located


Why is this important
Why is this important? medicine/general practice

  • Context is everything

  • Engel’s bio-psycho-social model

  • Systems theory – interaction between higher and lower levels

  • Advances in health through social progress


How is this done
How is this done medicine/general practice

  • Epidemiology – the big picture

  • Social medicine and public health – social engineering

  • Community orientation by the family doctor


What do we expect from our graduates in family medicine
What do we expect from our graduates in family medicine? medicine/general practice

  • Clinical knowledge

  • Clinical skills, communication skills, management skills

  • Holistic approach to the care of a wide range of problems in the context in which our patients live


Ho do we teach this
Ho do we teach this? medicine/general practice

  • Practical experience

  • Direct supervision

  • Classroom learning

  • Projects

  • Reflection


How do we assess this
How do we assess this? medicine/general practice

  • Formative and summative assessment

  • Written and oral knowledge tests

  • Demonstration of competence in OSCE’s

  • Direct and indirect observation of performance (video, medical records)


Final examination for specialization in family medicine in israel
Final examination for specialization in family medicine in Israel

  • After 2 years - 150 MCQ’s - knowledge

  • After 4 years – 4 hour oral exam

    • Two hours of clinical topics including standardized questions

    • One hour family presentation

    • One hour community presentation


Community presentation
Community presentation Israel

  • Age-sex distribution of practice

  • Chronic disease register

  • Physical layout of clinic

  • Structure of health care team

  • Relations with community services

  • Prevention and health promotion activities

  • Future plans for practice


Examples of outputs
Examples of outputs Israel

  • Age-sex distribution (graph)

  • Chronic diseases (list)

  • Practice organization and staffing (diagram)

  • Medical records (charts)

  • Sample questions to candidates (tables)

    (Thanks to Dr. Vered Ezra for her clinic data.)


Age distribution
Age distribution Israel

  • How does your data differ from national data?

  • What are the implications for practice of an older or younger population?


Ethnic mix
Ethnic mix Israel

  • How does the ethnic mix of your practice affect morbidity?

  • What do you and your staff need to know about your population?


Chronic disease prevalence
Chronic disease prevalence Israel

  • Questions to the candidate:

    • Compare with national data

    • What does this mean?

    • Why are there more or less cases?


Quality improvement
Quality improvement Israel

  • Describe a health problem in your community and the means that you used (or plan to use) to address it.


Conclusions
Conclusions Israel

  • Community orientation can be integrated into the training of future family practitioners.

  • The are innovative ways to teach and assess the acquisition the knowledge, skills and attitudes that make up this element of general practice.

  • In this course we will explore and experience this further with the aim of expanding this further in our own contexts.