Yongyuth Pongsupap National Health Security Office Orawan Tawaytipong Mahidol University Context Based Learning (CBL) in Thailand: a participation to the LINQED Network 19 May 2012, Quito, Ecuador

Primary Care development in the context of DHS (LHS): a specific context and limited resources Five axes Context Based Learning: CBL Competencies outcomes Individual-Team-System Identified learning activities Curriculum

For example: Curriculum for family doctor Context Based Learning: CBL Competencies outcomes Individual-Team-System Identified learning activities Curriculum For example: Curriculum for family doctor

Competencies Curriculum: FLU, CLU, DLU 1. เยี่ยมบ้าน 2. ให้บริการที่บ้าน 1. Dr-Pt-Fm-Comm. Relationships 3. ให้บริการที่ สถานบริการในชุมชน (HC) 2. Bio-Psycho-Social-Existential ‘Whole’ 4. ประชุมชาวบ้าน 3. Continuity of Care: Episodic Continuity, Personal Continuity, Continuity of all care 5. ร่วม จนท. HC ตามเยี่ยม ผป. admit รพช 4. Integrated Care (promote health): Curative, Preventive, Rehabilitative and Health Promotion 6. นิเทศเพื่อเพิ่มสมรรถนะ จนท. HC Family Identified learning activities (Integration of Routine & Learning): Curriculum: FLU, CLU, DLU 7. ให้คำปรึกษาทางไกลกับ จนท HC 5. Coordination/Advocate Community 8. อภิปรายกรณีศึกษา 6. Capacity building of HC staff District 9. ให้บริการที่ รพช. 7.Community Diagnosis: Quantitative &Qualitative 10. รับผิดชอบโครงการระดับอำเภอ 8. Community Involvement & Inter-sectoral Collaboration 11. ประสานและตามเยี่ยม ผป. ที่ได้รับการ Admit ที่ รพท/รพศ/รร.แพทย์ รวมภาคเอกชน 9. Integrated District Health Care System 12. ข้อมูลต่อเนื่องรายบุคคลและครอบครัว Individual – Team – and System Competencies 13. ข้อมูลเชิงปริมาณ และคุณภาพของ HC-Comm 14. ข้อมูลเชื่อม HC & Hosp

Individual-Team-System Competencies & Learning activities VS Preceptors: FM &DHS Competencies Individual-Team-System Learning activities Main Preceptor FLU CLU DLU 1 2 3 4 5 6 7 8 1. Dr-Pt-Fm-Comm. Relationships x FM 2. Bio-psycho-social-existential ‘whole’ 3. Continuous care: personal, episodic… 4. Integrated care: prev-prom-cur-reh… 5. Coordination/Advocate 6. Capacity building of HC staff DHS/FM 7. Community Diagnosis: quantitative DHS 8. Community Diagnosis: qualitative 9. Comm. Involve & Inter-sectoral collaboration 10. Integrated DHS Main Preceptor 1 2 3 4 5 6 x 1 2 3 4 5 6 7 8 x 1 2 3 4 x FM FM FM/DHS DHS FM DHS

Remarks (Expected Products) 1st month 2nd month 3rd month 4th month Remarks (Expected Products) 1st Trimester Individual and family continuous records of the selected families are completely installed. 2nd Trimester Community Diagnosis (quant. & qual.) has been done. Data link of HC & hosp (utilization & coverage) has been analyzed 3rd Trimester Scientific products (R to L & R): cohort studies of selected families; continuous community diagnosis; progress of integrated health system. Adapted attitude: Build on previous experience of the learner Settle learning method: Self-directed, gear to his/her own pace Assessed by learner, team, peers, and advisor Continue learning activities & routine works: Finalize scientific products Systematic academic supports Inter-vision: exchange experiences among peers in the fields Supervision: participation of advisor Academic conferences: distance learning, academic institutions, … Networking: social media, society, Community of Practice Learning in the System (in the context)

Context Based Learning: formally started in 2007 (5 districts), now a more national policy Health professionals for a new century: transforming education to strengthen health systems in an interdependent world: The Lancet 2010, J Frenk, et al.

Competency Driven Traditional model Competency-based educational model According to ability (competency) of teacher to teach A very clear curriculum CAPS: 12 domains Competency-based educational model A clearer curriculum Competencies outcomes and a context specific Identified Competencies: Individual-Team-System CAPS: 12 domains

PC development in the context of DHS (LHS) Formal curricula: -> CBL MPH: 4 Universities -> CBL Five axes District health manager Development Family doctor: IST (RCFP) -> CBL Time To Exchange and Learn more from the LINQED Thank you very much