The WHO-SEARO regional meeting to review progress in strengthening teaching of public health in medical schools, 11-13 Dec 2013, Pattaya, Thailand

1. Innovation in Public Health Education for Medical Students
at Ramathibodi, Mahidol University
Borwornsom Leerapan, MD PhD
Department of Community Medicine
Faculty of Medicine Ramathibodi Hospital, Mahidol University
WHO-SEARO Regional Meeting, Pattaya, Thailand
12 December 2013
Pix source: Pinaree Chen, 2nd World Prize (under 9 year-old), One Health Art Contest PMAC 2013

2. Our Innovations?
#1: Changes of learning objectives
– What exactly are “public health” concepts and skills that
our medical students really need nowadays?
#2: Changes of learning experiences:
– How do we deliver public health education to our
“Gen Y/Z” medical students?
#3: Changes in evaluation:
– How do we know our students “succeed or fail”?

3. What’s “public health” here?”
Pix source: online.wsj.com

4. Some Background: Thailand in 1970s
Pix Source: www.nationalguard.mil

5. Some Background: Thailand in 1970s
• In 1967, the Rockefeller Foundation assisted the Faculty of
Medicine Ramathibodi Hospital, Mahidol University to found
the Center of Community Medicine
• Dr.Aree Valyasevi, Former Dean and Chairman of Pediatrics,
Dr.Rachit Buri, Former Dean and Chairman of Medicine
Department, and Dr.Prem Buri, Former Chairman of Surgery
Department set up the teaching “Community Medicine” for
medical and nursing students at Ayudhthaya province,
especially focusing on community survey and diagnosis.

6. Public Health Challenges
• Thailand in 1970s:
– Limited resources in rural healthcare
• Thailand in 2000s:
– Issues of quality, equity, and efficiency in health systems

7. st
21
Century Medical Education
Pix source: Frenk et al. (2010)

8. Mapping Medicine & Public Health
Source: Hoffman et al. (2012). A Review of Conceptual Barriers and Opportunities Facing Health Systems Research to Inform a Strategy from WHO.

9. Academic Home
Community Medicine Center
Department of Community Medicine
(1967)
(from August 2010 on)

10. How to teach it to “Gen Y/Z”?
Pix source: online.wsj.com

11. Our Community Medicine Courses
• 3rd-Year Community Medicine (required, 5 credits): concept of health and health
determinants, health system & health service system, physician roles, health
education, health promotion, community capacity, community diagnosis,
epidemiology, biostatistics
• 4th-Year Community Medicine I (required, 5 credits): district health system,
hospital services system, health systems research, health economics
• 5th-Year Primary Care Medicine II (3rd-yr, 5 credits): evidence-based medicine,
concepts of primary care, health promotion: health policy and roles of NGOs
• 6th-Year: Family and Community Medicine (required, 4 credits): skills in
community hospitals, health systems research projects
• Health Services System in Community Hospital (elective, 2 credits): health
service system in community hospital

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

13. Fighting ADHD in Medical School
Recommended treatment:
• Ritalin
• Active engagement
Pix Source: www.thersa.org/events/rsaanimate/animate/rsa-animate-changing-paradigms

14. Active Engagement in Group Work

15. Active Engagement Outside Classroom

16. Active Engagement in the Field

17. Active Engagement in Community

18. Active Engagement in SDH

19. Active Engagement in Ambulatory Care

20. Active Engagement in Knowledge Management

21. Teaching Methods
•
•
•
•
•
•
•
•
•
Self-directed learning
Team-based learning
Problem-based learning
Task-based learning
Case conference, discussion, oral & poster presentation
Fieldwork in community settings
Working in community hospitals
Site visits: factory, clinic, NGO, etc.
Research projects: epidemiological research, health policy and
systems research, clinical tracer, routine-to-research (R2R*), etc.

22. How to “evaluate” our teaching?
Pix source: online.wsj.com

23. Evaluation Methods
• Formative evaluation;
– Feedback to student’s logbook
– Feedback of group process
– Assessment of report & presentation
– Assessment of individual behaviors in the field trip
– Assessment of individual and group performance
– Peer assessment
• Summative evaluation;
– Examination: MCQ, SAQ, short essay, individual report, oral
examination
– Assessment of research, projects, and case study

24. Using Social Media for Formative Evaluation

25. Student’s Satisfaction by Departments
Note: 5-level scale of evaluation

26. st
21
Century Medical Education
• We want to develop “change agents” who knows how to get
people in health systems involved in solving their own problems.
• Now, the question is “how” to evaluate change agents?
Pix source: Frenk et al. (2010)

27. Work in Progress
• Teachers’ Capacity Building:
– Periodic medical education workshops for the faculty
members and supporting staffs
– Monthly meetings for knowledge management, course
evaluation, and course development

28. Future Challenges
•
•
•
•
•
•
•
•
•
Change agents??
Time constraints (esp. in teaching blocks)
Longitudinal and integrated community clerkship
Shortage of qualified staffs
Urbanized settings
Global health issues
Standardization of courses among schools
Safety issues in the fieldwork
Budget issues for the fieldwork

29. Q & A
borwornsom.lee@mahidol.ac.th
rassamee.tan@mahidol.ac.th
boonmee.sat@mahidol.ac.th
Pix source: online.wsj.com
http://www.slideshare.net/borwornsom