THE ROLE OF FAMILY PRACTICE IN UNDERGRADUATE MEDICAL EDUCATION

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THE ROLE OF FAMILY PRACTICE IN UNDERGRADUATE
MEDICAL EDUCATION
Title and Staff

• Trakya University Medical Faculty,
• Edirne, Turkey

Zekeriya Aktürk, MD Nezih Dagdeviren, MD Erkan
Melih Sahin, MD Cahit Özer, MD
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Why Famiy Practice in Medical Education ?

• Medical education 90 hospital
• Turkish doctors 60 primary care

Introduction
Primary
Secondary
Tertiary
Education
Practice
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Current Condition in Turkey

• Population 65.000.000
• Medical faculties 47
• Family practice departments involved in
  education 7 (15 )
• This year Family Practice Department at Trakya
  University has started lectures to phase I.

Current State
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Introduction to Clinical Practice (ICP)

• Phase I 135 students
• First semester
• 16 hours theory
• 16 hours practice
• Second semester
• 16 hours theory
• 32 hours practice

ICP
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First Semester Lectures

• Lecture Load
• Needs assessment 1
• Medicine as a profession 2
• Health and Illness 1
• The effect of community on health 1
• Cultural factors and health 1
• Quality in health services 1
• Health promotion 1
• Preventive health care 2
• Communication skills 2
• Interviewing methods 1
• Patient education and counseling 1
• History taking skills 1
• Evaluation 1

Curriculum
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First Semester Practices

• Lecture Load (h)
• National internet resources 2
• IM and IV injection techniques 2
• Arterial blood pressure measurement 2
• Health unit observation (services) 2
• Health unit observation (policlinics) 2
• Approach to the trauma patient 2
• Evaluation 4

Curriculum
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Second Semester Lectures

• Lecture Load (h)
• Principles of physical examination 1
• Periodical health examination 1
• Functional health status 2
• Clinical problem solving 2
• Consultations 2
• First aid 4
• Common diseases at primary care 2
• Tobacco and other harmful substances 2

Curriculum
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Second Semester Practices

• Lecture Load (h)
• Urethral catheter insertion 4
• Communication (History taking) 4
• Communication (Examination) 4
• Communication (Drama) 4
• CPR 4
• Sterile dressing 2
• Suture techniques 2
• Evaluation and feed-back 8

Curriculum
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Staff and Setting

• Lecturers
• Family medicine
• Public health
• Anesthesiology
• Theory large group education
• Practice groups of 30-35 students

Staff and Setting
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Teaching Materials and Methods

• Lectures
• Lecturer
• Slides
• Video
• Discussion

Teaching Method
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Teaching Materials and Methods

• Practice
• Communication
• Small group education 3-4 students
• CPR, blood pressure etc
• Simulators
• Health unit observation
• 3-4 students for each service or policlinic
• Guided by an educator

Teaching Method
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Student Evaluation

• Lectures
• Two interval exams
• One final exam for each semester
• Practice
• OSCE

Evaluation
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Curriculum Evaluation

• SETh course rating scales
• Didactic
• Interactive

Feed-back
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Our Experiences

• Primary care should be involved in all phases of
  medical education
• The role of family practice is limited with phase
  I
• Some of the topics shoul be tought to higher
  classes
• We had to prepare a curriculum to cover as much
  areas as possible.
• Some practices necessitate baseline medical
  knowledge.

Experiences Curriculum
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Our Experiences

• Lecture load should be enough to cover all
  necessary areas
• The lecture load reserved for ICP was not enough
  to cover all headings of primary care.
• Some important topics like fever measurement and
  wound care had to be omitted.

Experiences LectureLoad
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Our Experiences

• Enough teaching material should be available
• Suture techniques, IV injection, urethral
  catheterization
• Simulators
• Abdominal palpation
• Heart auscultation

Experiences Material Quantity
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Our Experiences

• Teaching material should be of high quality
• Firm structure of the simulators disable
• abdominal palpation
• urethral catheter insertion.
• Leakage from the simulator reservoirs.

Experiences Material Quality
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Our Experiences

• Enough educators should be available
• Teaching staff
• 5 educators for the lectures
• 3 educators for the practices.

Experiences Educators
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Our Experiences

• Effective Feed-Back should be taken
• We obtained overall good feed-back results.
• SETh
• Didactic 3,76 0,73
• Interactive 4.02 0.66

Experiences Feed-back
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Our Experiences

• Accurate evaluations should be done
• Multiple choice questions as well as OSCEcould
  be applied successfully.
• Faculty regulations mean score above 60
• All students passed
• Mean passing score 62.6 14.89.

Experiences Evaluation
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Our Experiences

• In General
• Medical students have difficulties in making a
  picture in their mind about what medicine is and
  what they will face after 6 years when
  theygraduate.
• ICP is a good means to make things clear and
  maintain the motivation of students to become a
  good doctor.

Experiences General
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Conclusion

• Implementing family medicine in medical
  educations is an inevitable step in order to
  educate doctors who are able to respond the
  needs of the population.
• To achieve this goal
• An experienced staff (sufficient in quality and
  quantity)
• Lecture series continuing troughout all phases
  of medical education,
• Teaching material

Conclusion