A mini-lecture for small group discussions on "fieldwork" for medical students_Community Medicine RACM302

1. กลุ่มย่อยครั้งที่ 4: การทำงานภาคสนาม (Fieldwork)
อ.บวรศม ลีระพันธ์
RACM302: เวชศาสตร์ชุมชน กลุ่มกุฉินารายณ์
22 มกราคม 2557
Pix source: ecrins2010.blogspot.com

2. Outline
• วัตถุประสงค์ของการเรียน/ทำงานภาคสนาม (purposes)
• บุคคลที่เกี่ยวข้องกับการเรียน/ทำงานภาคสนาม (participants)
• หลักการเรียนรู้จากการทำงานภาคสนาม (principles)
• การวางแผนการทำงาน (practices)
Pix source: online.wsj.com

3. Chaos vs. Order
Ø 4Ps: “Chaordic Design Process”
– Purpose
– Principle
– Participant
– Practice
Source: chaordic.org

4. Purpose
• Why we have to do a fieldwork?
• Is studying in a classroom not enough?
– If so, why not?

5. Purpose: Brainstorming
• Fieldwork is an irreplaceable learning experience:
– To see the linkage between the “abstract” and the “concrete”.
– To learn not only “cognitive knowledge”, but also “attitude/Inspiration” and
“skills” (HEAD, HEART, HANDS).
– To understand “community” and learn a “context-specific” knowledge.
– To understand a “big picture” from seeing a small portion of Thailand’s health
system and health services system.
– To use both “deductive” vs. “inductive” learning skills.
– To see the “gap” of what/how people think/believe/feel vs. how health
professionals operate.
– To learn “holistic” medicine from people living in family/community

6. What Level of Our Learning?
Wisdom
• Why
Knowledge
• How
Informa8on
• What,
Who,
When,
Where
Data
• Number,
Text,
Picture,
Sound,
etc.

7. Principle
Ø “Up and down the ladder of abstraction”
นามธรรม:
•
•
•
•
แนวคิด (concepts)
ทฤษฎี (theories)
หลักการ (principles)
กลยุทธ์ (strategies)
รูปธรรม:
Source :influxentrepreneur.com/wendyelwell/
•
•
•
•
การเก็บข้อมูลและวิเคราะห์ข้อมูล (data)
กรณีศึกษา (case studies)
การทำงานภาคสนาม (fieldwork)
การนำเสนองาน (presentations)

8. Principle
Ø “Experience, not explanation.”
EXPERIENCE
Picture source: commonsenseatheism.com; variety.thaiza.com

9. Principle
1.
2.
3.
4.
5.
Climbing “the ladder of abstraction”
Learning by doing (“experience, not explanation.”)
Trying to learn as a “team” (not a group or individuals)
Creating “your own knowledge” (not just collecting “data
or information” & not just “adopting” others’ knowledge.)
Trying to learn from emerging opportunities in the field
(not just to fulfill the homework/assignment only

10. Participant
• In fieldwork, we can learn from:
– Patients, People (ชาวบ้าน), Faculty (อาจารย์), Hospital staffs,
Resource persons (วิทยากร)—via lecture, Q&A, group discussion, etc.
– Friends/colleagues—via working with each others, listening to your
friend’s different exposures AND your friend’s different thoughts/
interpretations of the same exposures.
– Yourself—via observing how each of you respond to experiences
and situations in the fieldwork, how your thoughts/beliefs have
changed, how you adapt, AND how you “grow”.

11. Practice
• Health determinants:
“Web of Causations”
Figure source: รายงานสรุปการศึกษาภาคสนาม โดยนักศึกษาแพทย์ คณะแพทยศาสตร์รพ.รามาธิบดี ชั้นปีที่ 3 กลุ่มกุฉินารายณ์ ปีการศึกษา 2555

12. Study Approaches
Positivism
Study tools
Critical Realism
Relativism/Interpretivism/
Social Constructionism
• Measurements
through survey, use
of archival and other
data records
• Statistical analysis
• Qualitative data
analysis (through
semi-structured
interview and rigid
interviewing
procedures)
• Multiple data
(review of
documents,
range of
interviewing
methods,
observation)
• Qualitative data
analysis
(through
in-depth
interviewing,
focus-group
interviewing,
documentary
review,
participant
observation,
life histories)

13. Theory U
X
Senge, P., Scharmer, C.O., Jaworski, J. & Flowers, B.S. (2004). Presence- Exploring Profound Change in People, Organizations and Society.

14. Going Deeper
• Multiple levels of how we can learn from the fieldwork:
– Downloading: To test our knowledge e.g. test hypotheses
– Observing (using “open mind”): To understand new
knowledge e.g. why and how do people think or behave in a
certain way?
– Sensing (using “open heart”): To empathize people we met
and create our own insight/knowledge
– Presencing (using “open will”)

15. Going Deeper
1. Know “what to ask & how to ask”
2. Need skills to identify “emerging opportunities to
learn” and “emerging themes”

16. Practice
• Be prepared, be prepared, be prepared.
• Even well prepared, practices in the field can always
be changed if necessary.
• However, any changes will be done according to our
agreed “proposes”, “participants”, and “principles”.