*Dorota Cianciara1, Wojciech S. Zgliczyński2, Sylwia Piętka1, Tomasz Bereza3
Compulsory public health courses for physicians – assessment of courses by attendees in the School of Public Health in Centre of Postgraduate Medical Education
Obowiązkowe kursy specjalizacyjne w dziedzinie zdrowia publicznego dla lekarzy w ocenie słuchaczy Szkoły Zdrowia Publicznego CMKP
1Department of Epidemiology and Health Promotion, School of Public Health, Centre of Postgraduate Medical Education, Warsaw
Head of Department: Dorota Cianciara, PhD, Associate Professor
2Department of Healthcare Organizations and Medical Jurisprudence, School of Public Health, Centre of Postgraduate Medical Education, Warsaw
Head of Department: Jarosław Pinkas, MD, PhD
3Analysis, Clinical Studies and Teaching Team, Centre of Postgraduate Medical Education, Warsaw
Head of Department: prof. Ryszard Gellert, MD, PhD
Streszczenie
Wstęp. Szkolenie lekarzy w zakresie zdrowia publicznego ma zasadnicze znaczenie dla systemu zdrowia. W związku z tym poszczególne elementy tego szkolenia, w tym kursy, powinny być na bieżąco monitorowane, w czym przydatne są opinie lekarzy – uczestników tego szkolenia.
Cel pracy. Celem badania było poznanie opinii słuchaczy Szkoły Zdrowia Publicznego CMKP na temat obowiązkowych kursów specjalizacyjnych w dziedzinie zdrowia publicznego dla wszystkich lekarzy oraz obowiązkowych kursów w ramach specjalizacji zdrowie publiczne.
Materiał i metody. Materiał do analizy stanowiło 3809 ankiet wypełnionych przez lekarzy uczestniczących w 214 kursach odbywających się w latach 2010-2015.
Wyniki. Kursy w zakresie zdrowia publicznego oraz kursy w ramach specjalizacji w dziedzinie zdrowia publicznego były oceniane jako przydatne w praktyce zawodowej lekarza. Wykładowcy najwyższe oceny uzyskali za zaangażowanie, przygotowanie i punktualność.
Wnioski. Wyniki wskazują na trafność przyjętej formy organizacyjnej i dobry dobór wykładowców. Badanie oceny kursów przez uczestników jest ważnym narzędziem poprawy jakości procesu dydaktycznego.
Summary
Introduction. Training of doctors in public health is essential for the healthcare system. Therefore, the individual components of the training, including courses, should be continuously monitored, for which useful are the opinions of doctors – participants of this training.
Aim. The aim of this study was to collect the opinions of attendees of the School of Public Health in the Centre of Postgraduate Medical Education (CMKP) in Warsaw on compulsory public health courses for all physicians as well as courses provided within specialization in public health.
Material and methods. Material for analysis constituted 3809 questionnaires filled up by physicians participating in 214 courses held in years 2010-2015.
Results. Courses in the field of public health and courses provided within specialization in public health were assessed as useful in the practice of doctors. Lecturers gained highest ratings for the commitment, preparation and punctuality.
Conclusions. The results indicate the accuracy of the adopted organizational form and a good selection of lecturers. The assessment of courses by participants is an important tool for improving the quality of the educational process.
INTRODUCTION
In Poland, doctors and dentists going to obtain any medical specialty, medical and dental (except for the specialization of public health), are obliged to hold the so-called unified specialty course in the field of public health, with a final colloquium. These courses are in the process of accreditation and are run by various centers, including the School of Public Health in Centre of Postgraduate Medical Education (SZP CMKP).
Previously (until 31.03.2014) the course included: a) health promotion, b) medical law, c) bioethics, d) organization and economics of health system, and e) medical certification (1) – a total of 21 subjects (2). The course lasted 60 hours of teaching, along with a seminar and a colloquium, which meant the possibility of allocating approx. 120 minutes to discussing one group of topics.
Currently (since 1.10.2014), doctors acquiring specialization are required to hold separate uniform courses in public health and medical law with final colloquiums (3). The current course in public health includes: a) medical certification, b) promotion and prevention, c) epidemiology, d) bioethics and e) the organization and economics of health system. The course consists of two parts, i.e. public health (40 hours) and medical certification (24 hours). The part on public health includes 28 issues (4), which means that each of them can take up to approx. 85 minutes.
What is more, the courses at the School of Public Health in the Centre of Postgraduate Medical Education are provided in the specialty program in the field of public health. Under the old system (up to 31.03.2014) doctors could train in 40 basic specialties (including public health) and 28 detailed ones, and dentists in 9 basic ones (including public health). In the new system, public health is one of the 77 medical specialties and 9 medical-dental ones. Gaining expertise in the field of public health lasts four years and requires, among others, graduation from courses – previously 10, and now 22.
Acquiring each specialization by doctors and dentists is a kind of postgraduate education. All courses included in the programs of each specialty are assessed by the participants using a standard survey used in the evaluation of courses at the Centre of Postgraduate Medical Education .
AIM
The aim of the study was to know the opinion of the attendees of the School of Public Health, the Centre of Postgraduate Medical Education on: (a) a uniform course in public health addressed to all doctors and dentists, regardless of the acquired expertise (hereinafter referred to as KJ) and (b) the courses included in the specialty program in public health addressed to doctors and dentists enrolled for this specialty (hereinafter referred to as KS) and to compare the perception of these courses.
MATERIAL AND METHODS
The study included physicians and dentists who participated in courses conducted at the School of Public Health, the Centre of Postgraduate Medical Education in Warsaw. The material for the study included course evaluation surveys: 1325 surveys completed by doctors specializing in various medical fields, taking part in 62 KJ courses conducted in 2011-2015, and 2484 surveys completed by doctors specializing in public health participating in 152 KS courses carried out in 2010-2015. In the case of courses consisting of several parts, evaluation surveys were collected after each of them. The survey was anonymous and participation was voluntary.
We studied the perception of courses, i.e. evaluation of courses and evaluation of teachers. Rating courses (0-6 points on a scale, where 0 meant the evaluation of the minimum and maximum 6) took the domain organization of lectures in the course, the usefulness of lectures in raising the qualifications of a specialist, and medical practice (professional). Rating lecturers (scale 0-6 points) took over: the degree of preparation, presentation, use teaching aids, commitment, merit presentation and punctuality. The listeners evaluated each teacher individually, and the grade averaged. The analysis was quantitative in nature. The following hypothesis was set up: KSS courses are better seen from the courses KJ.
RESULTS
Uniform specialty course in the field of public health (KJ)
The highest score obtained the organization of courses (average of the years 2011-2015 amounted to 4.77), slightly lower usefulness of the course to professional practice (4.19). Draws attention to the lower average value of judgment in relation to the usefulness of the course in raising the qualifications of a specialist (3.90). There were no major changes in the perception of courses in different years (tab. 1).
Tab. 1. Average evaluation of KJ courses in 2011-2015
| Year | Number of courses | Number of surveys | Organization of lectures | Raising specialist qualifications | Medical practice (professional) | Overall evaluation of the course (the average of all evaluations) |
| 2011 | 4 | 90 | 4.61 | 3.90 | 4.38 | 4.30 |
| 2012 | 14 | 411 | 4.79 | 3.94 | 4.24 | 4.32 |
| 2013 | 14 | 311 | 4.82 | 3.90 | 4.12 | 4.28 |
| 2014 | 14 | 268 | 4.80 | 3.88 | 4.15 | 4.27 |
| 2015 | 16 | 245 | 4.82 | 3.90 | 4.08 | 4.27 |
| Total/average | 62 | 1325 | 4.77 | 3.90 | 4.19 | 4.29 |
In each category, the average assessment of lecturers from the years 2011-2015 exceeded 5 (tab. 2). Top marks lecturers obtained for punctuality (average 5.47), and for the preparation of (5.32), commitment (5.30), presentation (5.12) and merit classes (5.11).
Tab. 2. Average evaluation of KJ courses’ lecturers in 2011-2015
| Year | Degree of preparation | Presentation manner | Applied teaching aids | Involvement | Substantive presentation value | Punctuality | Average evaluation |
| 2011 | 5.21 | 5.00 | 4.95 | 5.21 | 4.94 | 5.40 | 5.12 |
| 2012 | 5.34 | 5.18 | 5.15 | 5.31 | 5.17 | 5.50 | 5.28 |
| 2013 | 5.29 | 5.12 | 5.08 | 5.28 | 5.12 | 5.46 | 5.23 |
| 2014 | 5.34 | 5.06 | 4.95 | 5.28 | 5.09 | 5.48 | 5.20 |
| 2015 | 5.42 | 5.23 | 5.16 | 5.40 | 5.23 | 5.53 | 5.33 |
| Average | 5.32 | 5.12 | 5.06 | 5.30 | 5.11 | 5.47 | 5.23 |
Courses included in the program specialization in the field of public health (KS)
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Piśmiennictwo
Rozporządzenie Ministra Zdrowia z dnia 20 października 2005 r. w sprawie specjalizacji lekarzy i lekarzy dentystów. Dz. U. 2005 nr 213 poz. 1779.
Centrum Medyczne Kształcenia Podyplomowego. Program specjalizacji w chorobach wewnętrznych. Program podstawowy dla lekarzy po stażu podyplomowym (bez żadnej specjalizacji). Aktualizacja 2005. Warszawa 2005.
Rozporządzenie Ministra Zdrowia z dnia 2 stycznia 2013 r. w sprawie specjalizacji lekarzy i lekarzy dentystów. Dz. U. 2013 poz. 26.
Centrum Medyczne Kształcenia Podyplomowego. Program specjalizacji w dziedzinie chorób wewnętrznych (moduł podstawowy i moduł specjalistyczny) dla lekarzy nieposiadających odpowiedniej specjalizacji I lub II stopnia lub tytułu specjalisty w odpowiedniej dziedzinie medycyny. Warszawa 2014.
Opolski J, Zgliczyński WS, Ruiz M et al.: Jednolity, obowiązkowy dla wszystkich lekarzy kurs specjalizacyjny w dziedzinie zdrowia publicznego – w ocenie słuchaczy Szkoły Zdrowia Publicznego CMKP. Postępy Nauk Medycznych 2009; 4: 277-281.
Tyler IV, Hau M, Buxton JA et al.: Canadian medical students’ perceptions of public health education in the undergraduate medical curriculum. Academic Medicine 2009; 84(9): 1307-1312.
WHO Polska: Raport dot. oceny podejmowanych w Polsce niezbędnych działań z zakresu zdrowia publicznego (EPHOs). 2015. Materiał roboczy.
Faerstein E, Winkelstein W: William Gorgas: Yellow Fever Meets Its Nemesis. Epidemiology 2011; 22(6): 872.
Welch WH, Rose W: Institute of Hygiene: a report to the General Education Board of Rockefeller Foundation. New York: The Rockefeller Foundation submitted in 1915.
Rosenstock L, Helsing K, Rimer BK: Public Health Education in the United States: Then and Now. Public Health Reviews 2011; 33(1): 39-65.
Starr P: Professionalization and Public Health: Historical Legacies, Continuing Dilemmas. J Public Health Management Practice 2009 Nov., suppl.: S26-S30.
Fee E, Acheson RM (eds.): A history of education in public health: health that mocks the doctors’ rules. Oxford University Press, Oxford 1991.
Fee E, Bu L: Models of public health education: choices for the future? Bulletin of the World Health Organization 2007; 85(12): 977-979.
The Rockefeller Foundation. Our History; https://www.rockefellerfoundation.org/about-us/our-history/.
Ádany R, Villerusa A, Bislimovska J, Kulzhanov M: Public Health Education in Central and Eastern Europe, and Central Asia. Public Health Reviews 2011; 33(1): 105-133.
Ruis AR, Golden RN: The schism between medical and public health education: a historical perspective. Acad Med 2008 Dec; 83(12): 1153-1157.
American Academy of Family Physicians. Integration of Primary Care and Public Health (Position Paper). December 2014; http://www.aafp.org/about/policies/all/integprimarycareandpublichealth.html.
Rosenberg SN, Schorow M, Haynes ML: Bridging the gap between clinical medicine and public health: an experimental course for medical students. Public Health Reports 1978 Nov-Dec; 93(6): 673-677.
Stephen Gillam S, Maudsley G: Public health education for medical students: rising to the professional challenge. Journal of Public Health 2010; 32(1): 125-131.
Fineberg HV: Public health and medicine: where the twain shall meet. American Journal of Preventive Medicine 2011; 41(4 S3): S149-S151.
Sava S, Armitage K, Kaufman A: It’s time to integrate public health into medical education and clinical care. Journal of Public Health Management & Practice 2013 May-Jun; 19(3): 197-198.
WHO Regional Office for South-East Asia. Teaching of Public Health in Medical Schools Report of the Regional Meeting Bangkok, Thailand, 8-10 December 2009. WHO, New Delhi 2010.
Gebbie K, Rosenstock L, Hernandez LM (eds.): Committee on Educating Public Health Professionals for the 21st Century. Board on Health Promotion and Disease Prevention. Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century. Institute of Medicine of the National Academies. The National Academic Press, Washington D.C. 2003.
Hernandez LM, Munthali AW (eds.): Committee on Training Physicians for Public Health Careers. Board on Population Health and Public Health Practice. Training physicians for public health careers. Institute of Medicine of the National Academies. The National Academic Press. Washington, D.C. 2007.
Fee E: Divorce between theory and practice: the system of public health training in the United States. Ciênc. saúde coletiva [online] 2008; 13(3): 841-851.
Gillam S, Maudsey G: Public health education for medical students. A guide for medical schools. On behalf of Academic Departments of Public Health in the United Kingdom, London 2007.
Faculty of Public Health. Education and Training Department. Undergraduate Public Health Curriculum for UK Medical Schools. Consensus Statement 2014.
Riegelman RK, Albertine S, Wykoff R: A history of undergraduate education for public health: from behind the scenes to center stage. Frontiers in Public Health 2015, published: 27 April 2015.
Koo K, Lapp I: Educating the next generation of physicians in public health: the MPH for medical students. Public Health Reports 2014; 129(5): 460-464.
To MJ, Sharma M: Training tomorrow’s physician-advocates Medical Education 2015 Aug; 49(8): 752-754.
Royal College of Physicians. How doctors can close the gap Tackling the social determinants of health through culture change, advocacy and education. London 2010.
British Medical Association. Social Determinants of Health – What Doctors Can Do. October 2011.
Frenk J, Chen L, Bhutta ZA et al.: Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet 2010; 376(9756): 1923-1958.
Stellman JM, Cohen S, Rosenfield A: Evaluation of a one-year Masters of Public Health program for medical students between their third and fourth years. Academic Medicine 2008; 83(4): 365-370.
Edwards R, White M, Chappel D, Gray J: Teaching public health to medical students in the United Kingdom – are the General Medical Council’s recommendations being implemented? J Public Health Med. 1999 Jun; 21(2): 150-157.
Harris R, Kinsinger LS, Tolleson-Rinehart S et al.: The MD-MPH program at the University of North Carolina at Chapel Hill. Academic Medicine 2008 Apr; 83(4): 371-377.
Navinan MR, Wijayaratne DR, Rajapakse S: Final-year medical students’ perceptions regarding the curriculum in public health. Indian J Community Med 2011 Oct; 36(4): 268-274.
