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Current Perspectives on Teaching of Tropical Medicine: A View from Amsterdam
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It is argued that currently prevailing concepts of the scientific status and appropriate mode of operation of epidemiology fall short of those required for the development of effective strategies to promote health in the everyday world. The need, at present unmet, exists for an experimentally meaningful and politically aware theory and method in health research and practice.
Decision makers need the right information at the right time but in rural development much information generated is too costly and inappropriate. Rapid rural appraisal forms part of the attempt to learn about rural conditions in a cost effective way. Such appraisal involves avoiding the traps of quick and dirty or long and dirty methods and using instead methods that are more cost effective. To do this means ignoring inappropriate professional standards and instead applying a new rigour based on the two principles of optimal ignorance—knowing what it is not worth knowing—and proportionate accuracy—recognising the degree of accuracy required. The article reviews a range of approaches and techniques for rapid rural appraisal that are less rigid and exhaustive than many traditional methods and yet more rigorous in relation to cost and use. Time is emphasized as a critical factor in effective appraisal and rapid rural appraisal methods increase the chance of reducing the bias against the poorer rural people in the promotion of rural development.
This book provides a guide for educators seeking to reform programmes and methods of teaching at established medical schools. Focused on practical problems, the book describes an approach to change involving the establishment of an innovative cirricular 'track' as a curriculum distinct from, but running parallel with, the already existing curriculum. To facilitate understanding of how the strategy works in real situations, the book draws upon ideas, experiences, and discussions presented during a conference attended by educators at eight institutions that have used the track approach as an agent of change, some for as long as 15 years. Though the institutions, located in China, Mexico, the Philippines, Thailand, and the United States of America, represent widely divergent needs and circumstances, all have used the track approach to reform medical education in the direction of greater relevance to health needs or by using problem-based learning in the educational process. The book has three main parts. The first outlines 23 proven strategies for using the track approach to implement change. The strategies, which represent the distilled experience of participants at the conference, give readers concrete guidelines and practical hints for getting started, building support and overcoming resistance, evaluation, networking, and options for the future of the track. Practical experiences are again pooled in the second part, which compared the features and experiences of the innovative track schools on seven key points. These range from motivation for seeking change, through curriculum content, to policies governing admissions and the budgeting and hiring of staff. Comparative information is then summarized in an 11-page table, which serves to illustrate common trends as well as glaring differences in approaches, circumstances, or outcomes. The table also provides a convenient check-list for self-assessment at other institutions considering use of the track approach. The third part, which constitutes the core text of the book, sets out detailed case studies for each of the eight participating institutions. Presented in a spirit of frank self-analysis, these studies document the range of different problems, constraints, successes, mistakes and surprises that characterized the evolution of innovative track programmes in real situations. The reliance upon first-hand experiences, whether at the Shanghai Second Medical University or Harvard Medical School, further helps account for the sense of excitement and innovation present throughout the book.
Since 1964, Dutch and Belgian authorities have jointly organized an International Course in Health Development for doctors with managerial responsibilities in the developing countries. The objective of the course is to prepare these individuals ‘to deal with problems in the field of management and planning of health systems in the context of comprehensive development’. Due to the flexibility of course structure, it has been possible to adapt both curriculum and teaching methods and to develop a model which has been broadly speaking successful in:
(1) integrating the three basic components of the course (methodologies; specific disciplines; situation) by using a problem-solving approach.
(2) promoting the active involvement of participants by making them contribute to the whole learning and adapting process.
Meeting the need for health learning materials
- W D Clarke
The role of medicine
- Th Mckeown
School and University twenty years from now
- R S Mossell